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The Effect of Formularies and Other Cost Management Tools on Access to Medications: An Analysis of the MMA and Proposed Regulations

This paper, by John F. Hoadley, Ph.D., of the Health Policy Institute at Georgetown University, examines how formulary designs and other cost-management tools may affect Medicare beneficiaries’ access to medications through their Medicare Part D prescription drug plans. It is one in a series commissioned by the Kaiser Family Foundation…

Summary of the Proposed Rule to Implement the New Medicare Prescription Drug Benefit

In August 2004, the Centers for Medicare and Medicaid Services published a proposed rule to implement the Medicare Prescription Drug Benefit (Title I of the Medicare Modernization Act). Given the high level of interest in the proposed rules for implementing the Medicare drug benefit, the Kaiser Family Foundation commissioned Health…

Medicare+Choice Withdrawals: Understanding Key Factors

To help understand why M+C plans have exited or limited their participation in the M+C program in recent years, this report presents an empirical analysis of the factors associated with plan withdrawals between 1999 and 2001. This analysis explores factors such as M+C payment levels, local market characteristics, and individual…

How States Are Responding to the Challenge of Financing Health Care for Retirees

State governments are an important source of health insurance coverage for retired state employees. Confronted with rising health care costs, budget deficits, and an overall downturn in the economy, this report describes how states are responding to the challenge of financing health care for retirees who tend to be sicker…

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 2008 Benefits Table

2008 Medicare Benefits TableSummary of Traditional Medicare, 2008 PART A Financing: 1.45% for both workers and employers No premiums* Benefits: Inpatient hospital – Days 1-60 – Days 61-90 – Days 91-150 – After 150 days Deductible of $1,024 per benefit period** No coinsurance $256 a day $512 a day No…

Medicare Beneficiaries: A Population At Risk – Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries

Medicare Beneficiaries: A Population At Risk – Findings from the Kaiser/Commonwealth 1997 Survey of Medicare BeneficiariesThis report by the Henry J. Kaiser Family Foundation and the Commonwealth Fund, based on the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries, highlights the challenges facing Medicare beneficiaries and the importance of addressing the needs…

Medicaid and the Elderly – Policy Brief

Medicaid and the ElderlySeptember 1995Medicaid is a crucial health financing program for the elderly population, providing assistance to over 1 in 10 Americans age 65 or older. Nearly four million elderly people receive Medicaid assistance with medical and long-term care expenses. Medicaid's coverage helps low-income elderly people gain access to…

Key Facts: Women and Medicare

Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Today, 22 million women one in five adult women rely on Medicare for basic health insurance protection. In fact, women comprise 57% of the…

Retiree Health VEBAs: A New Twist On An Old Paradigm

This issue brief provides an overview of stand-alone Voluntary Employees’ Beneficiary Association trusts, through which employers have been able to rid themselves of future obligations to pay retiree health benefits in exchange for making a significant payment to designed to approximate the projected cost of these benefits. The paper include…

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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.