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Medicare Part D 2009 Data Spotlight: Specialty Tiers

Most Medicare Part D prescription drug plans use tiers with different cost-sharing amounts for generic, preferred, and non-preferred drugs, and also include an additional “specialty” tier for very high cost and unique drugs. This 2009 Part D Data Spotlight examines use of the specialty tier, including the numbers and kinds…

The Landscape of Private Firms Offering Medicare Prescription Drug Coverage in 2006

describes key characteristics of the organizations that offer the new Medicare drug benefit and analyzes how companies are positioning themselves to attract Medicare enrollees.• Seven of the 10 organizations that sponsor stand-alone prescription drug plans nationwide are based in commercial insurance firms with substantial Medicare Advantage experience, and three of…

Survey of People with Disabilities

People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing…

Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and…

Medicare Payments and Beneficiary Costs for Prescription Drug Coverage

This March 2007 issue brief, commissioned by the Kaiser Family Foundation, provides a basic introduction to the reimbursement system for private Medicare drug plans. It explains the system of plan bidding and payment, including the special provisions for low-income enrollees, and considers how aspects of the payment system may affect…

Obamacare and You: If You Have Medicare…

This short explainer highlights some of the key information for people with Medicare about how Affordable Care Act, also known as Obamacare, may affect them.

To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans To Save Money?

This analysis finds that relatively few Medicare beneficiaries have switched Part D prescription drug plans voluntarily during the annual open enrollment period — even though those who do switch often lower their out-of-pocket costs as a result of changing plans. The vast majority (87% on average between 2006 and 2010) stayed in the same Part D plan, even though the plans can change premiums, deductibles, cost-sharing amounts, and their list of covered drugs each year. Higher rates of plan switching were observed in PDPs that increased premiums, increased deductibles, or dropped coverage of brand-name drugs in the coverage gap.

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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.