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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…

Medicare Part D Spotlight: Part D Plan Availability in 2010 and Key Changes Since 2006

This Medicare Part D data spotlight examines the stand-alone Medicare drug plan options that will be available to beneficiaries in 2010, including the number of available plans, premiums for those plans, and benefit designs. About two-thirds of the nearly 27 million Medicare beneficiaries who are enrolled in Part D plans get…

Medicare Part D 2009 Data Spotlight: Premiums

This Medicare Part D data spotlight analyzes the premiums charged by the 1,689 stand-alone Medicare Part D plans that will be offered in markets across the country in 2009. The analysis finds premiums charged for Part D plans range widely, from $10.30 per month to $136.80 per month. If current…

Medicare Part D 2009 Data Spotlight: The Coverage Gap

This Medicare Part D data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2009. While in the gap in coverage, Part D enrollees (other than those receiving low-income subsidies) are required to pay 100 percent of total drug costs until they reach the catastrophic…

An In-Depth Examination of Formularies and Other Features of Medicare Drug Plans

This study of Medicare Part D plans offered in 2006 examines formularies, drug costs and utilization management tools in drug plans offered by 14 national and near-national organizations. Collectively, these organizations account for 1,222 of the 1,429 Part D plans available to Medicare beneficiaries. The analysis finds that Medicare’s new, private,…

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…

One Year into Duals Demo Enrollment: Early Expectations Meet Reality

One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.

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…