This Data Spotlight reviews national and state-level enrollment trends as of March 2016 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.
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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.
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.
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…
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…
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.
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.…
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.
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.
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…