Medicare News

  • Prior Authorization in Medicare Advantage Plans: How Often Is It Used?

    This year, during the annual Medicare Open Enrollment period, more than 60 million people on Medicare have the opportunity to choose between traditional Medicare and Medicare Advantage plans. In making this decision, they are encouraged to take into account a number of factors, including premiums, cost-sharing, extra benefits, drug coverage, quality of care, and provider networks.
  • Medicare Beneficiaries’ Out-of-Pocket Health Care Spending as a Share of Income Now and Projections for the Future

    Medicare helps pay for the health care needs of 59 million people, including adults ages 65 and over and younger adults with permanent disabilities. Even so, many people on Medicare incur relatively high out-of-pocket costs for their health care, including premiums, deductibles, cost sharing for Medicare-covered services, as well as spending on services not covered by Medicare, such as long-term services and supports and dental care.
  • How Many Seniors Live in Poverty?

    Payments from Social Security and Supplemental Security Income have played a critical role in enhancing economic security and reducing poverty rates among people ages 65 and older. Yet many older adults have limited income and modest savings. In 2016, half of all people on Medicare had income less than $26,200 per person.
  • Medicare Part D: A First Look at Prescription Drug Plans in 2019

    During the Medicare open enrollment period from October 15 to December 7 each year, beneficiaries can enroll in a plan that provides Part D drug coverage, either a stand-alone prescription drug plan (PDP) as a supplement to traditional Medicare, or a Medicare Advantage prescription drug plan (MA-PD), which covers all Medicare benefits, including drugs. This issue brief provides an overview of the 2019 PDP landscape, the largest segment of the Medicare Part D marketplace, with 20.6 million enrollees in 2018.
  • Medicare Advantage 2019 Spotlight: First Look

    More than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This brief provides an overview of the Medicare Advantage plans that will be available in 2019, based on an analysis of data from the Centers for Medicare and Medicaid Services (CMS). Findings include:
  • Sources of Supplemental Coverage Among Medicare Beneficiaries in 2016

    Today, 60 million people, including 51 million older adults and 9 million younger adults with disabilities, rely on Medicare for their health insurance coverage. Medicare beneficiaries can choose to get their Medicare benefits (Part A and Part B) through the traditional Medicare program, or they can enroll in a Medicare Advantage plan, such as a Medicare HMO or PPO. In 2018, two-thirds of Medicare beneficiaries are in traditional Medicare, and one-third are enrolled in Medicare Advantage plans.
  • An Overview of Medicare

    Today, Medicare plays a key role in providing health and financial security to 59 million older people and younger people with disabilities. The program helps to pay for many medical care services, including hospitalizations, physician visits, and prescription drugs, along with post-acute care, skilled nursing facility care, home health care, hospice care, and preventive services.
  • 10 Essential Facts About Medicare’s Financial Outlook

    Medicare, the nation’s federal health insurance program for 57 million people age 65 and over and younger people with disabilities, often plays a major role in federal health policy and budget discussions. This was the case in discussions leading up to enactment of the Affordable Care Act (ACA), which, in addition to expanding health insurance coverage, included changes to Medicare that reduced program spending.