In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.
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Wide Disparities in the Income and Assets of People on Medicare by Race and Ethnicity: Now and in the Future
This report examines the income, savings, and home equity of current and future Medicare beneficiaries, focusing on racial/ethnic disparities. The report finds that these differences in the financial well-being of white, black and Hispanic beneficiaries persist across age, education level, marital status, and other demographic factors.
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.
The Medicare program offers health and financial protection to nearly 50 million seniors and younger people with disabilities, though many beneficiaries still face significant out-of-pocket expenses. This analysis examines how much Medicare households spend on health-related expenses compared to other spending priorities and compared to non-Medicare households, the extent to which Medicare households’ health spending as a share of household budgets varies by age and poverty level, and changes in Medicare households’ health spending over time.
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…
How Much ” Skin in the Game ” is Enough? The Financial Burden of Health Spending for People on Medicare Medicare extends health security and financial protection to seniors and younger people with disabilities. However, premiums, relatively high cost-sharing requirements, and gaps in the benefit package result in some beneficiaries…
Projecting Income and Assets: What Might the Future Hold for the Next Generation of Medicare Beneficiaries?
As national attention turns to the federal deficit, some policymakers have proposed reforms to Medicare, Medicaid and Social Security that could have significant implications for current and future generations of seniors and younger adults with disabilities. This data spotlight, co-authored by researchers at the Kaiser Family Foundation and the Urban…
How Much ‘Skin In The Game’ Do Medicare Beneficiaries Have? The Increasing Financial Burden of Health Care Spending, 1997-2003
This study evaluated the changes in Medicare beneficiaries’ health care spending between 1997 and 2003, and found beneficiaries spent a growing share of their income on health care. The results showed that median out-of-pocket health spending increased from 11.9% of income in 1997 to 15.5% in 2003, and about four…