Medicare
VI. Key Issues: Financing and Delivery >> D. Health Insurance Coverage >> Public Health Insurance >> Medicare (last updated 10.8.18)
General Links
- Medicare: A Primer 2010 (Kaiser Family Foundation)
- Medicare Primer (Congressional Research Service, January 31, 2013)
- Chapter 7 – Medicare (Alliance for Health Reform)
- Medicare (Health Affairs topic page)
- Medicare Payment Advisory Commission (MedPAC)
- Congressional Budget Office. Medicare—Baseline Projections (April 2014).
- Medicare Coverage Advisory Committee (MEDCAC). The Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) was established to provide independent guidance and expert advice to CMS on specific clinical topics. The MEDCAC is used to supplement CMS’ internal expertise and to allow an unbiased and current deliberation of “state of the art” technology and science. The MEDCAC reviews and evaluates medical literature, technology assessments, and examines data and information on the effectiveness and appropriateness of medical items and services that are covered under Medicare, or that may be eligible for coverage under Medicare. The MEDCAC judges the strength of the available evidence and makes recommendations to CMS based on that evidence.
- Medicare & Medicaid Web Links (HealthHippo)
- EHealth Medicare. Find Low Cost Medicare Plans By State. Availability and costs of plans may vary from state to state and by private insurance company, so it is recommended that beneficiaries compare options in their area to find the right plan for their needs. To learn more about Medicare plans in a specific state, users can select a link to a state to get information about Medicare insurance companies and products offered there or they can enter a Zip code to obtain a side-by-side comparison of plans.
- Ten Facts You Must Know When Going on Medicare. My Medicare Answer, Bradshaw, Charles. 5.14.16
Medicare Part D Prescription Drug Coverage
The Medicare Prescription Drug Benefit was passed in 2003. The government doesn’t directly negotiate drug prices in Part D of Medicare, nor does it set the cost of the benefit. Instead, health plans and PBMs negotiate prices with drug manufacturers and then compete with one another based on price and quality, for market share.
- Cost Savings. As a result, Part D is the rare federal program that has come in under-budget. According to the Congressional Budget Office, total program costs between 2004-2013 were 45 percent less than original projections.
- Spillover Benefits. Academic studies have associated Part D coverage with decreases in hospital admissions and over $2 billion in savings due to improved drug adherence among patients with congestive heart failure.
News
- Kaiser Health News. Medicare.