Using data from all Medigap policies in 2008, we estimated models to explain variation in Medigap premiums. The key results are:
Medical Loss Ratios (MLRs) are one measure used to gauge the performance of insurance markets. High ratios mean that a large share of premium revenues is paid out for medical care services provided to enrollees. On the other hand, low ratios can mean either very large administrative costs or high profit rates. Under the Affordable Care Act, issuer
In 2010, according to data filed by insurers with the National Association of Insurance Commissioners, 9.6 million Medicare beneficiaries (about 20 percent of all beneficiaries) purchased supplemental coverage through Medigap. 12 As displayed in Figure 2, the percentage of Medicare beneficiaries enrolled in Medigap plans declined over the past de
While Medicare covers many services, it does not cover them in full. Individuals with Medicare coverage are responsible for some out‐of‐pocket expenses such as copayments, coinsurance, and deductibles (see Appendix A for more information). Fee‐for‐service Medicare also does not include a cap on out‐of‐pocket payments. Medigap (also cal
In response to a letter from Senators Reid, Baucus, and Kerry, 1 the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services has prepared this report. The report describes the market in Medigap insurance (also known Medicare Supplemental Health Insurance policies), analyzes trends in Medig
Compared with other Americans, Latinos are less likely to receive preventive care and more likely to have chronic diseases such as diabetes, cancer, and HIV/AIDS. 12,13 The Affordable Care Act helps to make prevention affordable and accessible by requiring most health insurance plans to cover prevention and wellness benefits with no cost-sharin
Estimates from the RAND COMPARE microsimulation model suggest that 5.4 million Latinos who would otherwise be uninsured will gain coverage by 2016 under the Affordable Care Act. 6 The Affordable Care Act expands Medicaid coverage to include Americans with family incomes at or below 133 percent of federal poverty guidelines (currently $30,657 fo
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. Other Key Provisions of the House Republican Plan
The discussion above focuses on the savings that seniors will obtain once the full Medicare drug benefit is available. But the bill would generate other benefits as well and would not make seniors wait until 2005 to begin getting help with their drug costs.
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. Illustrative Beneficiary Scenarios
These savings under the House Republican plan will really add up for seniors who now lack drug coverage, as indicated in the following hypothetical but true-to-life examples:
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. State-by-State Analysis of Help for Lower-Income Seniors and Savings for State Governments
The House Republican plan recognizes that seniors with the lowest incomes have the greatest difficulty affording the drugs they need. That is why it offers substantial premium subsidies and only nominal co-payments to those beneficiaries with incomes below 175% of poverty.
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. Added Help for Lower-Income Seniors
Seniors with incomes below 175% of poverty would see even more dramatic savings under the House Republican bill. They would generally pay only $2-5 for each prescription. And those with incomes below 150% of poverty would pay no monthly premium, while seniors with incomes between 150% and 175% of poverty would pay reduced monthly premiums.
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. Protection Against High Drug Costs with a Secure Entitlement
The House proposal also includes generous catastrophic protection for all seniors who have high out-of-pocket drug expenses – targeting help to those who need it most. It thus would help fulfill President Bush’s call to renew the commitment that President Johnson made when Medicare was enacted – so that illness will no longer crush and dest
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. Effects of Prescription Drug Benefit Proposals for Typical Medicare Beneficiaries
Under the 2002 House Republican bill, CBO’s analysis indicates that seniors now paying full retail prices would on average save 20-25 percent on their prescriptions as plans compete to serve them by offering price discounts and other help to lower their drug costs. Seniors would benefit from the efficiencies of private sector management tools a
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. Background on Current Prescription Drug Coverage and Spending
About 25 percent of Medicare beneficiaries have no drug coverage during the year, and many others have only partial coverage or have a drug plan – such as a Medigap policy – that does not negotiate price discounts on their behalf.
The Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries. Overview
The House Republican plan would provide real relief for seniors and disabled Americans: those who now pay full retail prices would typically see the costs of each prescription cut by 60-85 percent, and their overall out-of-pocket drug costs would fall by as much as 70 percent – in exchange for a stable and affordable premium starting at $34 per
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Methods
This memo was prepared by analysts in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in consultation with the Office of the Actuary (OACT) of the Centers for Medicare & Medicaid Services (CMS).
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Summary
The Affordable Care Act, enacted in 2010, makes many changes to strengthen Medicare and provide better benefits to seniors, while slowing cost growth. As a result, average Medicare beneficiary savings in traditional Medicare will be approximately $5,000 over the 2010 to 2022 period (see Table 1). Beneficiaries who have high prescription drug spend
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act
This report provides estimates of Medicare Parts A, B, and D savings from the Affordable Care Act to seniors and people living with disabilities enrolled in traditional Medicare. The Affordable Care Act will favorably affect beneficiary expenditures in four ways: lowering part B premiums growth, lowering beneficiary copayments and coinsurance grow