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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: Formularies

This Medicare Part D data spotlight examines the formularies (list of covered drugs) of Medicare stand-alone prescription drug plans in 2008, changes since 2006, and differences in how plans cover brand-name and generic drugs. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription…

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The Henry J. Kaiser Family Foundation

Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with…

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The Henry J. Kaiser Family Foundation

Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

Several deficit-reduction plans have proposed combining Medicare’s separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries. A new Kaiser Family Foundation study examines the potential implications of proposals to revamp Medicare’s cost-sharing requirements as…

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The Henry J. Kaiser Family Foundation

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…

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The Henry J. Kaiser Family Foundation

Medicare Part D Prescription Drug Plans: The Marketplace in 2013 and Key Trends, 2006-2013

This report presents findings from an analysis of the Medicare Part D marketplace in 2013 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan availability, enrollment, premiums, low-income subsidies, the coverage gap, benefit design, cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by researchers at Georgetown University, the Kaiser Family Foundation and the National Opinion Research Center at the University of Chicago.

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The Henry J. Kaiser Family Foundation

Obamacare and You: If You Have Medicare…

This short explainer highlights some of the key information for people with Medicare about how Affordable Care Act, also known as Obamacare, may affect them.

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The Henry J. Kaiser Family Foundation

Obamacare and You: If You Have Job-Based Coverage

This short explainer outlines key changes for people with employer-based health benefits under the Affordable Care Act (ACA), also known as Obamacare.

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The Henry J. Kaiser Family Foundation

The Affordable Care Act’s Impact on Medicaid Eligibility, Enrollment, and Benefits for People with Disabilities

Medicaid is an important source of health insurance coverage for people with disabilities. This issue brief explains how Medicaid eligibility and benefits for people with disabilities are affected by the Affordable Care Act (ACA) rules as of 2014. Marketplace rules are discussed to the extent that they relate to Medicaid eligibility determinations for people with disabilities.

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