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Estimates of Medicare Beneficiaries’ Out-of-Pocket Drug Spending in 2006

This report projects the impact of the new Medicare drug benefit on out-of-pocket spending for people who enroll in 2006. This analysis from November 2004 estimates that 6.9 million beneficiaries are projected to be affected by the coverage gap (the so-called “doughnut hole”) in the standard Part D drug benefit.…

Understanding The Effects of The Medicare Part D Coverage Gap in 2008 and 2009

This Kaiser Family Foundation study examines how the coverage gap in Medicare’s drug benefit known as the “doughnut hole” affects Medicare beneficiaries and their prescribing patterns. Based on actual claims data from 2008 and 2009, before the 2010 health reform law began to close the gap, the study finds that…

Medicare Advantage 2014 Spotlight: Enrollment Market Update

This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2014, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans and describes the changes in limits on out-of-pocket expenses and prescription drug coverage in the Part D “donut hole” provided by the plans in 2014.

How are Seniors Choosing and Changing Health Insurance Plans?

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

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…

Medicare Part D in Its Ninth Year: The 2014 Marketplace and Key Trends, 2006-2014

This report presents findings from an analysis of the Medicare Part D marketplace in 2014 and changes in features of the drug benefit offered by Part D plans since 2006. It examines the latest information and trends related to Part D enrollment and plan availability, premiums, benefit design and cost sharing, pharmacy networks, the Low-Income Subsidy Program, and plan performance ratings.

The Medicare Part D Coverage Gap: Costs and Consequences in 2007

This study quantifies the number of Medicare Part D plan enrollees in 2007 who reached a gap in their prescription drug coverage known as the “doughnut hole,” as well as the changes in beneficiaries’ use of medications and out-of-pocket spending after they reached that gap.

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.