Medicare Advantage

This report projects the impact of the new Medicare drug benefit on out-of-pocket spending for people who enroll in 2006. This analysis from November 2004 estimates that 6.9 million beneficiaries are projected to be affected by the coverage gap (the so-called “doughnut hole”) in the standard Part D drug benefit.…

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…

With Medicare’s 2015 open enrollment set to begin Oct. 15, two new analyses from the Kaiser Family Foundation find modest change in the total number of private Medicare Advantage plans available for 2015, and the fewest Part D prescription drug plans nationwide since the start of the drug benefit in 2006. As in previous years, changes in Medicare Advantage and Part D plan availability, premiums, cost-sharing and benefits could require some beneficiaries to find alternative coverage and lead others to pay more if they continue with their existing coverage.

This Data Note examines the availability of plans nationwide and by state in 2015, and changes in plan availability since 2011. It documents the number and share of Medicare Advantage enrollees affected by plan withdrawals each year, the characteristics of plans that will be entering the market and characteristics of those exiting the market in 2015.

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.