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How Do M+C Plans Manage Pharmacy Benefits? Implications for Medicare Reform

Understanding how Medicare+Choice (M+C) plans manage their drug benefits may generate important lessons for Medicare. This report, based on interviews with both national and regional managed care firms, provides an in-depth look at how plans have managed their M+C outpatient pharmacy benefits in recent years. Findings show that plans rely…

Private Long-Term Care Insurance:  Who Should Buy It and What Should They Buy?

Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy?Despite the growing interest in private long-term care insurance (LTCI), there has been little independent examination of how much protection LTCI policies provide consumers or whether LTCI policies are a worthwhile purchase for people of average means. This…

Paying for Choice: The Cost Implications of Health Plan Options For People on Medicare

This report illustrates the financial stakes for Medicare beneficiaries when making choices about supplemental insurance coverage, by examining how much people on Medicare could spend out-of-pocket including premiums and other cost-sharing requirements under different supplemental insurance options. To assess the cost implications of choosing between different Medigap and Medicare+Choice insurance…

Medicare+Choice in California: Lessons and Insights

Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the…

Seniors and Prescription Drugs: An 8-State Survey

A new study conducted by researchers at Tufts-New England Medical Center, the Henry J. Kaiser Family Foundation, and the Commonwealth Fund, reports results from a 2001 survey of 10,927 noninstitutionalized seniors in eight geographically diverse states: California, Colorado, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas. State-level data on drug…

The Wide Circle of Caregiving

The Kaiser Family Foundation helped conduct a national survey of over 1,000 informal caregivers in 1998 to assess the policy issues involved with this new, growing role for many family members and friends. Nearly one of every four adults (23 percent) is an informal caregiver, and, as the American population…

The Role of National Firms in Medicare+Choice

This report addresses national managed care firms participation in M+C and the factors influencing their decision processes about M+C products. Based on interviews with executives and senior staff of national managed care firms, this report examines how eight national firms strategically position their M+C product, including the process that firms…