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The Henry J. Kaiser Family Foundation

A Primer on Medicare: Key Facts About the Medicare Program and the People it Covers

This primer explains key elements of the Medicare program, which now provides health coverage to 55 million people — including 46 million people age 65 and older and another 9 million younger adults with permanent disabilities. It looks at the characteristics of the Medicare population, what benefits are covered, how much people with Medicare pay for their benefits and the program’s overall costs and future financing challenges.

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The Henry J. Kaiser Family Foundation

Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations

This report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.

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The Henry J. Kaiser Family Foundation

Medicare’s Income-Related Premiums: A Data Note

This data note presents new information to help set a context for understanding the implications of recent changes to Medicare’s income-related premiums incorporated in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a new law to repeal and replace Medicare’s Sustainable Growth Rate (SGR) formula for physician payments. It describes current requirements with respect to the income-related premiums under Medicare Part B and Part D, including the number and share of Medicare beneficiaries who are estimated to pay income-related premiums and revenues raised from the income-related premium, based on data from the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT). It also explains the recently enacted changes in MACRA that will affect some higher-income people on Medicare who are already paying income-related premiums, beginning in 2018.

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Medicare 101: What You Need To Know

Hosted by the Kaiser Family Foundation and the Alliance for Health Reform, this briefing reviewed basic questions about the Medicare program, such as: What services does Medicare provide, and how does Medicare pay for these services? How is Medicare financed? What changes did the Affordable Care Act (ACA) make to Medicare? How fast is Medicare spending growing? What are current proposals to strengthen Medicare for the future, and what are prospects for action in the new Congress?

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The Henry J. Kaiser Family Foundation

Income-Related Premiums in Medicare: Who Pays, and How Much Do They Pay?

Since 2007, seniors with incomes greater than $85,000 have had to pay higher premiums for Medicare than their counterparts with lower incomes.  Six percent of Medicare Part B enrollees are expected to pay higher monthly premiums in 2015, ranging from $147 to $336, depending on their income.  Lawmakers on Capitol…

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The Henry J. Kaiser Family Foundation

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.

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The Henry J. Kaiser Family Foundation

Health Reform and Medicare: Overview of Key Provisions Tutorial

This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to…

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The Henry J. Kaiser Family Foundation

Medicare 101 Tutorial

This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to…

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The Henry J. Kaiser Family Foundation

Medicare Advantage: The Role of Private Health Plans in Medicare Tutorial

This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to…

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Retiree Health Benefits At the Crossroads

This issue brief reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare drug benefit and the Affordable Care Act (ACA) on retiree health coverage. The report describes leading strategies employers have been pursuing or considering to limit costs for retiree health benefits. In addition, the report considers the potential implications of proposals aimed at reducing federal spending for retiree health coverage and costs.

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