A Primer on Medicare: Key Facts About the Medicare Program and the People it Covers
Introduction
Department of Health and Human Services, “Fiscal Year 2016 Budget in Brief: Strengthening Health and Opportunity for All Americans,” 2015. Available at http://www.hhs.gov/budget/fy2016/fy-2016-budget-in-brief.pdf.
What is Medicare?
Congressional Budget Office (CBO), Medicare Baseline, March 2015. Available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/44205-2015-03-Medicare.pdf.
Congressional Budget Office (CBO), Medicare Baseline, March 2015. Available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/44205-2015-03-Medicare.pdf.
Kaiser Family Foundation, Medicare Advantage Fact Sheet, May 2014. Available at: https://www.kff.org/medicare/fact-sheet/medicare-advantage-fact-sheet/.
Congressional Budget Office (CBO), Medicare Baseline, March 2015. Available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/44205-2015-03-Medicare.pdf.
Who is eligible for Medicare?
Department of Health and Human Services, Fiscal Year 2016 Budget in Brief: Strengthening Health and Opportunity for All Americans, 2015. Available at http://www.hhs.gov/budget/fy2016/fy-2016-budget-in-brief.pdf.
Congressional Budget Office (CBO), Medicare Baseline, March 2015. Available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/44205-2015-03-Medicare.pdf.
What are the characteristics of people with Medicare?
Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2010 Cost and Use file.
Jacobson G, Huang J, Neuman T, Smith K, Income and Assets of Medicare Beneficiaries, 2013–2030, Kaiser Family Foundation, January 2014. Available at https://www.kff.org/medicare/issue-brief/income-and-assets-of-medicare-beneficiaries-2013-2030/.
U.S. Census Bureau poverty thresholds for 2013 by size of family and number of children under age 18.
How much do beneficiaries pay for Medicare benefits?
Cubanski J, Swoope C, Damico A, Neuman T, How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook, Kaiser Family Foundation, Kaiser Family Foundation, July 2014. Available at https://www.kff.org/health-costs/report/how-much-is-enough-out-of-pocket-spending-among-medicare-beneficiaries-a-chartbook/.
Cubanski J, Swoope C, Damico A, Neuman T, How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook, Kaiser Family Foundation, Kaiser Family Foundation, July 2014. Available at https://www.kff.org/health-costs/report/how-much-is-enough-out-of-pocket-spending-among-medicare-beneficiaries-a-chartbook/
What is the Medicare Part D prescription drug benefit?
Hoadley J, Cubanski J, Hargrave E, and Summer L, Medicare Part D: A First Look at Part D Plan Offerings in 2015, Kaiser Family Foundation, October 2014. Available at https://www.kff.org/medicare/issue-brief/medicare-part-d-a-first-look-at-plan-offerings-in-2015/.
The ACA eliminated the tax deductibility of the 28 percent federal subsidy payment that employers who accept the retiree drug subsidy (RDS) had been able to claim prior to 2013. RDS claims are also not eligible for the 50 percent brand-name drug discount.
2014 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds.
What is Medicare Advantage?
Jacobson G, Damico A, Neuman T, and Gold M, Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes, Kaiser Family Foundation, December 2014. Available at https://www.kff.org/medicare/issue-brief/medicare-advantage-2015-data-spotlight-overview-of-plan-changes/.
Jacobson G, Damico A, Neuman T, and Gold M, Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes, Kaiser Family Foundation, December 2014. Available at https://www.kff.org/medicare/issue-brief/medicare-advantage-2015-data-spotlight-overview-of-plan-changes/.
Gold M, Jacobson G, Damico A, and Neuman T, Medicare Advantage 2014 Spotlight: Enrollment Market Update, Kaiser Family Foundation, May 2014. Available at https://www.kff.org/medicare/issue-brief/medicare-advantage-2014-spotlight-enrollment-market-update/.
Medicare Payment Advisory Commission, Report to the Congress: Medicare Payment Policy, March 2009.
Gold M and Casillas G. What Do We Know About Access and Quality in Medicare Advantage Versus The Traditional Medicare Program? Kaiser Family Foundation, November 2014. Available at https://www.kff.org/medicare/report/what-do-we-know-about-health-care-access-and-quality-in-medicare-advantage-versus-the-traditional-medicare-program/.
What types of supplemental insurance do beneficiaries have?
Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2010 Cost and Use file.
Jacobson G, Huang J, Neuman T, Medigap Reform: Setting the Context for Understanding Recent Proposals, Kaiser Family Foundation, January 2014. Available at https://www.kff.org/medicare/issue-brief/medigap-reform-setting-the-context/.
Young K, Garfield R, Musumeci M, Clemans-Cope L, and Lawton E, Medicaid’s Role for Dual Eligible Beneficiaries, Kaiser Family Foundation, August 2013. Available at: https://www.kff.org/medicaid/issue-brief/medicaids-role-for-dual-eligible-beneficiaries/.
Centers for Medicare and Medicaid Services, Medicare Savings Program, Available at http://www.medicare.gov/your-medicare-costs/help-paying-costs/medicare-savings-program/medicare-savings-programs.html
What is the role of Medicare for dual-eligible beneficiaries?
Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission, Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid, January 2015. Available at http://www.medpac.gov/documents/data-book/january-2015-medpac-and-macpac-data-book-beneficiaries-dually-eligible-for-medicare-and-medicaid.pdf?sfvrsn=2.
Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2010 Cost and Use file.
Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from the Chronic Conditions Data Warehouse, 2010.
How do Medicare beneficiaries fare with respect to access to care?
Gornick M, et al, Twenty Years of Medicare and Medicaid: Covered Populations, Use of Benefits, and Program Expenditures, Health Care Financing Review, 1985 Annual Supplement.
Kaiser Family Foundation analysis of the Medicare Current Beneficiary Survey 2012 Access to Care file.
Medical Expenditure Panel Survey, 2010. “Usual Source of Health Care and Selected Population Characteristics, United States”; Schiller JS, Lucas JW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey, 2011. National Center for Health Statistics, Vital Health Stat 10, No 256 (December 2012).
Kaiser Family Foundation analysis of 2012 National Ambulatory Medical Care Survey (NAMCS)-National Electronic Health Records Survey.
Medicare Payment Advisory Commission, Report to the Congress: Medicare Payment Policy, March 2014.
How does Medicare pay providers in traditional Medicare?
Centers for Medicare and Medicaid Services, “Fact sheets: Better Care, Smarter Spending, Healthier People: Improving Our Health Care Delivery System,” January 26, 2015. Available at: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26.html.
Congressional Budget Office, Medicare Baseline, March 2015. Available at http://www.cbo.gov/sites/default/files/cbofiles/attachments/44205-2015-03-Medicare.pdf.
How much does Medicare spend, and how does current spending compare to past trends and the future outlook?
Congressional Budget Office, The 2014 Long-Term Budget Outlook, July 2014. Available at http://www.cbo.gov/publication/45471.
How is Medicare financed and what are Medicare's future financing challenges?
2014 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, July 2014.