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Medicare Part D 2008 Data Spotlight: Utilization Management

This spotlight examines three common techniques used by stand-alone prescription drug plans to manage enrollees’ use of formulary drugs, such as quantity limits, prior authorization, and step therapy rules. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices. It analyzes…

A Medicare Prescription Drug Benefit: Implications for Medicaid and Low-Income People

The Senate and House of Representatives each approved legislation in June of 2003 that would establish outpatient prescription drug coverage for Medicare beneficiaries as part of Medicare program reform. Among the key differences in the House and Senate bills that still must be addressed are the treatment of Medicaid beneficiaries…

Standard Medicare Drug Benefit, 2006 Chart

Standard Medicare Drug Benefit, 2006Out-of-pocket drug spending for Medicare beneficiaries under the standard Medicare drug benefit described in the Medicare Modernization Act of 2003. Chart (.pdf)

Examining Sources of Supplemental Insurance and Prescription Drug Coverage Among Medicare Beneficiaries: Findings from the Medicare Current Beneficiary Survey, 2007

This updated chartpack presents sources of supplemental and prescription drug coverage among Medicare beneficiaries in 2007, the most recent year for which national data are available. The chartpack looks at variations in supplemental and prescription drug coverage by income, race/ethnicity, age, urban/rural location, and health status. It also examines characteristics…

Primers on Key Health Care Topics and Programs

The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system.Medicaid: A PrimerMedicare: A PrimerThe Uninsured: A PrimerHealth…

Coverage of Top Brand-Name and Specialty Drugs

This Part D Data Spotlight documents the wide variations across the private stand-alone drug plans with respect to coverage of drugs, what enrollees pay for those drugs, and restrictions and limitations placed on their use. These variations have potentially significant implications for beneficiaries’ access to medications and out-of-pocket costs. The…

Medicare Part D 2011: The Coverage Gap

This data spotlight examines the availability of gap coverage in the private Medicare Part D drug plans offered to beneficiaries in 2011, the first year of the phase-out of the gap, as required under the 2010 health reform law. The changes for 2011 include a 50 percent discount on brand-name…

Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

This brief commissioned by the Foundation examines factors that contributed to Medicare’s lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some…