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Transparency and Complexity

This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC).  The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies. The SBC…

Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal

This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.

The Future of Medicare Advantage: Are We on the Right Path?

This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act’s reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.

An Analysis of the Share of Medicare Beneficiaries Who Would Benefit from an Annual Out-of-Pocket Maximum under Traditional Medicare Over Multiple Years

This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means’ Subcommittee on Health.

What is a Mini-Med Plan?

One of the early insurance market changes in the Affordable Care Act (ACA) phases out caps that some insurance plans impose on the annual dollar amount of benefits they will cover. Plans issued or renewed after September 23, 2010 cannot have annual limits of less than $750,000, and the threshold…

Medicare Prescription Drug Plans in 2009 and Key Changes Since 2006: Summary of Findings

Since 2006, Medicare beneficiaries have had access to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Today, more than 26 million Medicare beneficiaries are enrolled in Medicare drug plans, including 17.5 million in stand-alone prescription drug plans…

Uniform Coverage Summaries for Consumers

This brief explains the proposed federal rule that requires private health plans to provide a short, easy-to-read uniform summary of benefits and coverage to all health insurance applicants and enrollees. The rule, which implements a provision in the Affordable Care Act (ACA), is intended to make it simpler for consumers…

The Medicare Part D Prescription Drug Benefit

This fact sheet includes the latest information and data for 2017 about the Medicare Part D prescription drug benefit, including current plan information, the standard benefit parameters, low-income assistance, the latest available enrollment data, and Part D program spending and financing.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.