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This chartpack highlights demographic data about African Americans, Hispanics and whites with Medicare to highlight potential implications for outreach efforts under the new Medicare drug benefit. The information is being used in a series of November 2005 briefings at the start of the first open-enrollment period for the new benefit.…
External Review of Health Plan Decisions: An Overview of Key Program Features in the States and Medicare
In 1978, the state of Michigan established a system to call on independent medical experts to help resolve disputes between health plans and patients about the medical necessity and appropriateness of care. Since then, twelve other states and the Medicare program have established similar kinds of external review programs. In…
This report describes the history of special needs plans, how they fit into the larger Medicare Advantage marketplace, and what information could help assess whether these plans are performing differently from other Medicare Advantage plans. Special needs plans serve individuals such as those who are institutionalized, people covered under both…
Comparing Poverty Rates under the Official Census Poverty Measure and the Supplemental Poverty Measure
This interactive graphic illustrates how poverty rates among seniors in each of the 50 states change under two different Census Bureau measures of poverty: the official poverty measure and an alternative supplemental poverty measure, which takes into account health care and housing costs among other factors.
This short explainer highlights some of the key information for people with Medicare about how Affordable Care Act, also known as Obamacare, may affect them.
Obamacare and You is a series of one-page papers explaining how the Affordable Care Act, also known as “Obamacare,” will affect different groups of people. Click on the links below to learn more: If You Are Uninsured Haga clic para leer en español If You Are Low-Income and May Qualify for…
This analysis finds that relatively few Medicare beneficiaries have switched Part D prescription drug plans voluntarily during the annual open enrollment period — even though those who do switch often lower their out-of-pocket costs as a result of changing plans. The vast majority (87% on average between 2006 and 2010) stayed in the same Part D plan, even though the plans can change premiums, deductibles, cost-sharing amounts, and their list of covered drugs each year. Higher rates of plan switching were observed in PDPs that increased premiums, increased deductibles, or dropped coverage of brand-name drugs in the coverage gap.
The 2014 Part D Data Spotlight analyzes information about the Medicare Part D stand-alone prescription drug plan (PDP) options available to beneficiaries in 2014. The analysis shows that Medicare beneficiaries on average will have a choice of 35 stand-alone prescription drug plans in 2014, and somewhat more “benchmark” plans available to Low-Income Subsidy (LIS) beneficiaries nationwide. The weighted average premium will increase by 5 percent between 2013 and 2014 if enrollees remain in the same plans next year. The analysis also finds more plans are using preferred pharmacy networks and adopting a growing number of cost-sharing formulary tiers for different drugs.