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The Henry J. Kaiser Family Foundation

An Overview of Medicare

This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with permanent disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries’ out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

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The Henry J. Kaiser Family Foundation

Searching for Savings in Medicare Drug Price Negotiations

In response to higher drug spending growth and heightened attention to drug prices, some policymakers and presidential candidates are proposing to allow Medicare to negotiate the price of prescription drugs. This issue brief provides a short history of this proposal, describes various approaches, and assessments of their potential savings from the Congressional Budget Office (CBO), and considers the prospects for action in the future.

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The Henry J. Kaiser Family Foundation

Allowing Medicare to Negotiate Drug Prices Is A Popular Idea But May Not Produce Substantial Savings

In response to rising drug costs, some policymakers and presidential candidates, including Republican Donald Trump and Democrats Hillary Clinton and Bernie Sanders, have proposed allowing Medicare to negotiate directly with pharmaceutical companies over the price of prescription drugs, in contrast to the current approach under Medicare Part D drug where…

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The Henry J. Kaiser Family Foundation

Although a Small Share of Medicare Part D Enrollees Take Specialty Drugs, A New Analysis Finds Those Who Do Can Face Thousands of Dollars in Out-of-Pocket Drug Costs Despite Plan Limits on Catastrophic Expenses

Some Medicare Part D enrollees can expect to pay thousands of dollars out-of-pocket for a single specialty drug in 2016, even though Part D plans provide substantial protection against catastrophic costs, according to a new analysis from the Kaiser Family Foundation. The findings illustrate how high prescription drug prices, one…

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The Henry J. Kaiser Family Foundation

It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016

This analysis focuses on out-of-pocket drug costs for Medicare Part D enrollees in 2016 for specialty, brand, and generic drugs. Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be substantial. In addition to examining costs for common drugs, we also examine profiles of multiple drugs for several hypothetical Part D enrollees.

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The Henry J. Kaiser Family Foundation

Medicare Drug Plan Enrollees Would Face Average 13 Percent Premium Increase Unless They Switch Plans During Open Enrollment, New Analysis Finds

Second Analysis Finds Modest Shifts in Medicare Advantage Plan Options When Medicare’s 2016 open enrollment begins Oct. 15, current enrollees in stand-alone Medicare Part D plans are projected to face an average 13 percent increase in premiums if they remain in their current plan for 2016, a new analysis finds.…

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The Henry J. Kaiser Family Foundation

The Medicare Part D Prescription Drug Benefit

This fact sheet includes the latest information and data for 2016 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 program spending and financing.

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Figure 1: Average Number of PDPs Offered to Medicare Beneficiaries, 2006-2016

Medicare Part D: A First Look at Plan Offerings in 2016

During the Medicare open enrollment period, beneficiaries have the opportunity to enroll in a plan that provides Part D prescription drug coverage, either a stand-alone prescription drug plan (PDP) to supplement traditional Medicare, or a Medicare Advantage drug plan. This issue brief provides an overview of the 2016 PDP marketplace, focusing on key changes from 2015, based on analysis of data from the Centers for Medicare & Medicaid Services. It presents analysis of PDP availability, premiums, benefit design, and low-income subsidy plans.

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The Henry J. Kaiser Family Foundation

Medicare’s Drug Benefit Is Firmly-Established After Its First Decade, With Flat Premiums in Recent Years but Higher Cost-Sharing Over Time 

With Medicare Part D nearing the end of its tenth year, the program — which now provides drug coverage to 72 percent of all Medicare beneficiaries — has experienced no growth in average premiums in recent years but some notable increases in cost-sharing, according to a new report from the…

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The Henry J. Kaiser Family Foundation

Health Affairs Article: Medicare’s Part D Drug Benefit At 10 Years: Firmly Established But Still Evolving

Despite initial controversy and uncertainties, Medicare Part D now provides drug coverage to thirty-nine million beneficiaries through dozens of private plans in each region. Although firmly established, the program faces challenges, including projected spending growth. Enrollees also face challenges as plans adopt new strategies to control costs.

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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.