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Medicare at a Glance

This fact sheet provides a basic overview of the Medicare program, including how it is financed, who is eligible, and what benefits are covered under the program. In addition, it describes supplemental health insurance, out-of-pocket spending by people on Medicare, and data on Medicare expenditures and financing.

Medicare Part D in Its Ninth Year: The 2014 Marketplace and Key Trends, 2006-2014

This report presents findings from an analysis of the Medicare Part D marketplace in 2014 and changes in features of the drug benefit offered by Part D plans since 2006. It examines the latest information and trends related to Part D enrollment and plan availability, premiums, benefit design and cost sharing, pharmacy networks, the Low-Income Subsidy Program, and plan performance ratings.

How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook

This new analysis and chartbook examines out-of-pocket spending among Medicare beneficiaries, including spending on health and long-term care services and insurance premiums, using the most current year of data available from a nationally representative survey of people on Medicare. It explores which types of services account for a relatively large share of out-of-pocket spending, which groups of beneficiaries (including by age, gender, health status, and chronic conditions) are especially hard hit by high out-of-pocket costs, and trends in out-of-pocket spending between 2000 and 2010.

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.

Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.

Health Care on a Budget: The Financial Burden of Health Spending by Medicare Households

The Medicare program offers health and financial protection to nearly 50 million seniors and younger people with disabilities, though many beneficiaries still face significant out-of-pocket expenses. This analysis examines how much Medicare households spend on health-related expenses compared to other spending priorities and compared to non-Medicare households, the extent to which Medicare households’ health spending as a share of household budgets varies by age and poverty level, and changes in Medicare households’ health spending over time.