On January 1, 2006, the six million Americans who are covered by both Medicare and Medicaid saw a change in how their prescription drugs are covered. The dual eligible population was transitioned from Medicaid into the Medicare prescription drug benefit. As a group, these beneficiaries are poorer and sicker than…
- state & global data
- view as grid
- view as list
Transitions is a video that explores some of the issues and challenges “dual eligibles” may face during the transition from Medicaid drug coverage to Medicare. To download the video, right-click here and select “Save as…”
This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2013, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D “donut hole” provided by the plans in 2013.
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.
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.
The 2014 Part D Data Spotlight analyzes information about the Medicare Part D stand-alone prescription drug plan (PDP) options available to beneficiaries in 2014. The analysis shows that Medicare beneficiaries on average will have a choice of 35 stand-alone prescription drug plans in 2014, and somewhat more “benchmark” plans available to Low-Income Subsidy (LIS) beneficiaries nationwide. The weighted average premium will increase by 5 percent between 2013 and 2014 if enrollees remain in the same plans next year. The analysis also finds more plans are using preferred pharmacy networks and adopting a growing number of cost-sharing formulary tiers for different drugs.
This report summarizes first-hand accounts of seniors’ Medicare private plan decision making strategies, based on focus groups conducted in four cities. Seniors found the initial plan selection process overwhelming due to the volume of information they received and their inability to organize it. Few used the government’s online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, doctor’s offices and pharmacists. After they enroll in a plan, many seniors did not revisit their initial decision or review plan options without the strong provocation of a substantial increase in cost, change in coverage, or shift in personal health care needs. Moreover, they feared that a change in plans may disrupt their care, or lead to an unforeseen increase in out-of-pocket costs, and require them to learn new rules and requirements. They are doubtful they would end up in a plan that is appreciatively different or better for them. Overall, seniors preferred to have numerous choices in plans but would like personalized help and advice from experts to ease the process.
Report & Briefing Examine How Seniors Choose Among Their Medicare Plan Options Seniors appreciate having a wide range of Medicare private plan choices available to them but often feel unqualified to choose among them, a new Kaiser Family Foundation report concludes. Based on discussions with seniors in four cities around…
This blog post discusses Sovaldi (sofosbuvir), an oral drug recently approved by the FDA for the treatment of chronic hepatitis C, and the potential impact of this long-awaited cure on Medicare spending and Part D premiums.