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The Henry J. Kaiser Family Foundation

Medicaid: A Primer – Key Information on the Nation’s Health Coverage Program for Low-Income People

This primer provides an overview of Medicaid, the nation’s largest health coverage program, which covers more than 62 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare. Medicaid also is the dominant source of the country’s long-term care financing. The program will expand significantly under the Affordable Care Act in 2014.

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The Henry J. Kaiser Family Foundation

Medicare Part D 2008 Data Spotlight: Benefit Design

This Medicare Part D data spotlight examines the benefit design of Medicare Part D Prescription Drug Plans (PDP) in 2008, focusing on national plans. It shows that in 2008, as in previous years, only about 10 percent of national prescription drug plans offered the defined standard benefit. The spotlight also…

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The Henry J. Kaiser Family Foundation

Preventing Chronic Disease: The New Public Health

There is a groundswell of activity in local communities to support healthier lifestyles and help people make long-lasting and sustainable changes that can reduce their risk for chronic diseases. A number of provisions in the health reform law are aimed directly at improving population health by addressing conditions where Americans…

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The Henry J. Kaiser Family Foundation

Medicaid Payment for Outpatient Prescription Drugs

This fact sheet summarizes Medicaid’s role as the major source of outpatient pharmacy services for low-income Americans. Medicaid spent $25.4 billion on prescription drugs in fiscal year 2009, and outpatient prescription drug coverage is an optional benefit that all state Medicaid programs currently provide. Fact Sheet (.pdf)

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The Henry J. Kaiser Family Foundation

Medicaid Enrollment and Expenditures by Federal Core Requirements and State Options

To receive federal Medicaid matching funds, states that participate in Medicaid must meet federal requirements, which include covering specified “federal core” enrollee groups and mandatory health benefits. States also may choose to cover additional “state expansion” enrollees and optional benefits with federal Medicaid matching funds. The federal core eligibility standards…

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The Henry J. Kaiser Family Foundation

Briefing – Medicare: A Primer

This briefing provided an overview of the Medicare program and its role in the health care system. Panelists discussed who is eligible for Medicare, what benefits are covered and how the program is administered. Medicare financing and the program’s role in health reform was also explained. More information on Medicare…

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The Henry J. Kaiser Family Foundation

Essential Health Benefits: Balancing Affordability and Adequacy

Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets – will be required to cover a set of health benefits and services called the “essential health benefits” package. Guidance issued…

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The Henry J. Kaiser Family Foundation

Medicare Part D 2010 Data Spotlight: Benefit Design and Cost Sharing

The Medicare Modernization Act established a defined standard drug benefit for Part D stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug (MA-PD) plans, while giving plans flexibility to offer alternative benefit designs. Only about one in 10 PDPs offer the standard benefit in 2010. Plan sponsors can offer…

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The Henry J. Kaiser Family Foundation

The Role of Clinical and Cost Information in Medicaid Pharmacy Benefit Decisions: Experience in Seven States

This policy brief provides perspective on the potential for using comparative effectiveness research in Medicaid pharmacy programs by looking at seven states to determine how they currently evaluate relative clinical and cost information about prescription drugs when making coverage decisions for their Medicaid pharmacy benefits. The brief was prepared by…

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The Henry J. Kaiser Family Foundation

Medicare Part D 2008 Data Spotlight: The Coverage Gap

This Medicare Part D data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2008. Part D enrollees (other than those receiving low-income subsidies) will reach the coverage gap after they incur $2,510 in total drug costs in 2008. At that point, enrollees are required…

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