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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This report presents findings from an analysis of the Medicare Part D marketplace in 2012 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan plan availability, premiums, cost-sharing, the coverage gap and availability for low-income beneficiaries, the coverage gap, benefit design…
Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group…
With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance…
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…
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.
Foundation Senior Vice President Tricia Neuman testified June 26, 2013 before the House Energy and Commerce Committee Subcommittee on Health about Medicare’s benefit design, and the implications of possible changes for beneficiaries, other stakeholders, and program spending.
This brief provides details of the benefit and cost-sharing rules that will govern the coverage available under health reform to these newly eligible adults Medicaid beneficiaries, and it identifies key considerations for state policymakers making Medicaid benefit design choices.
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.
This short explainer outlines key changes for people with employer-based health benefits under the Affordable Care Act (ACA), also known as Obamacare.