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The Henry J. Kaiser Family Foundation

Medicare Prescription Drugs Through Private Drug-Only Plans: A Discussion with Actuaries

Central to the current debate over Medicare prescription drug coverage is the role of private insurance plans in providing drug benefits to Medicare beneficiaries. This report offers views from health actuaries knowledgeable about the Medicare program and the prescription drug debate on key issues that emerge for potential plan sponsors,…

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The Henry J. Kaiser Family Foundation

The Federal Employees Health Benefits Program: Program Design, Recent Performance and Implications for Medicare Reform

This report provides a basic description of the Federal Employees Health Benefits Program's (FEHBP) structure, benefits, financing, and operations. The report also assesses FEHBP's recent performance in a variety of areas, including cost increases, benefit changes, access to providers, and risk selection. It concludes with a brief discussion of the…

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The Henry J. Kaiser Family Foundation

Medicare Cost-Sharing: Implications for Beneficiaries

Tricia Neuman, Vice President and Director of the Medicare Policy Project, testified on behalf of herself and Thomas Rice, Ph.D., of UCLA’s School of Public Health, before the House Ways and Means Subcommittee on Health on cost-sharing requirements under Medicare and supplemental Medigap policies. The statement reviews Medicare beneficiaries’ current…

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The Henry J. Kaiser Family Foundation

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…

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The Henry J. Kaiser Family Foundation

Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues

Regulation of Private Long-Term Care Insurance: Implementation Experience and Key IssuesWhile private long-term care insurance (LTCI) has been available since the mid-1970s, its popularity has grown rapidly in recent years, and Congress is considering proposals that would further encourage LTCI purchase through expanded tax subsidies. Yet there has been little…

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The Henry J. Kaiser Family Foundation

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…

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The Henry J. Kaiser Family Foundation

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…

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The Henry J. Kaiser Family Foundation

A Guide to Developing Assistance Programs for Health Care Consumers

The Health Rights Hotline, based in Sacramento, California, wasestablished in 1997 as a model to demonstrate and assess how anindependent assistance program can help consumers successfully accesscare, navigate the health care system, and improve the system for allhealth care consumers. Based on the experiences of the Health Rights Hotline, this…

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The Henry J. Kaiser Family Foundation

Comparisons of the Liability Provisions of the House and Senate Patients’ Rights Bills

A hotly debated issue in Congress has been the issue of when health maintenance organizations, health insurers, and those who administer health benefit plans should be financially liable to their plan participants for a denial of a claim or for damages for any injuries that result from such denials (known…

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The Henry J. Kaiser Family Foundation

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…

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