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The health issues women face over the course of their lives, as well as policies that shape Medicare, Medicaid, and other supplemental coverage can affect retired women's economic well-being. This study uses a nationally representative sample of Medicare beneficiaries aged 65 and older in 2002 to explore gender-based differences in health and long-term care use, spending patterns, and the financial burden of health and long-term care out-of-pocket health expenses. Women's health care expenses were higher than men's; older women paid for a greater share of their total spending out of pocket and they faced a greater financial burden by shouldering these out-of-pocket costs with less income at their disposal. Low-income women, those with Medigap or no supplemental coverage, and white women, who are less likely to qualify for Medicaid which covers long term care, faced the greatest financial burdens associated with health and long-term care costs. The implications of these findings for women in the context of the current health policy landscape are discussed. Controlling health spending and developing options to finance long-term care are key elements of the policy solutions that will need to he developed to preserve and support economic security for millions of retired women in the United States. KEYWORDS women, Medicare, Medicaid, long-term care, financial burden, health care costs, retirement, health expenses, retirement, low-income DOI: 10.1080/15544770902901874

An interview with Joseph Antos, Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute in Washington, D.C., and Thomas Rice, distinguished professor at the University of California, Los Angeles (UCLA) Fielding School of Public Health, is presented. Topics include the major challenges of the Medicare program, premium support system, and opportunities and risks of promoting more competition in Medicare.

Several graphs are presented that show Medicare and end-of-life (EOL) care, including total Medicare beneficiary deaths in 2014, the share of total Medicare spending for people at the EOL from 2000-2014, and Medicare hospice use and spending in 2000 and 2014.

Several graphs are presented with figures on the U.S. Medicare and Medicaid programs including the annual out-of-pocket medical care costs of Medicare recipients by age group, trends in the share of Medicaid recipients enrolled in managed care programs, and per-person Medicaid spending for different categories of recipients.

Medicare is a primary source of health insurance coverage for several million people younger than age sixty-five who have long-term disabilities. This analysis compared measures of access to care, cost concerns, and satisfaction with care for beneficiaries younger than age sixty-five versus those ages sixty-five and older, using the 2019 Medicare Current Beneficiary Survey. We also compared beneficiaries in traditional Medicare with those in Medicare Advantage, given that a growing share of younger beneficiaries with disabilities are enrolled in private plans. We found that Medicare beneficiaries younger than age sixty-five reported worse access to care, more cost concerns, and lower satisfaction with care than beneficiaries ages sixty-five and older, regardless of their type of Medicare coverage. Among beneficiaries younger than age sixty-five in traditional Medicare, the share reporting cost concerns was highest among those without supplemental coverage. All of these differences were statistically significant. Addressing gaps in coverage for people with disabilities could improve experiences for this often-overlooked segment of the Medicare population. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate whether increased placement of generic drugs on higher cost-sharing tiers in Medicare Part D is associated with coverage of multisource brandname drugs, plan type, or product characteristics. STUDY DESIGN: Descriptive study of Medicare Prescription Drug Formulary Files. METHODS: We analyzed plan coverage and tiering of brand-name drugs and matched generics from 2013-2019. We compared tiering changes and estimated out-of-pocket spending by tier for all Part D plans and by plan type (Medicare Advantage prescription drug [MA-PD] vs stand-alone prescription drug plan [PDP]) for covered generic drugs. Finally, we identified the generic products commonly placed on higher tiers in 2019 and categorized them based on clinical characteristics. RESULTS: Across 5,220,488 plan-product combinations in 2019, 76.4% of generic drug observations reflected coverage on Part D plan formularies, compared with only 12.1% of brand-name drugs. Between 2013 and 2019, the share of observations reflecting covered generics on lower tiers decreased from 76.8% to 53.9%, whereas the share on higher tiers increased from 7.5% to 28.0%. MA-PD plans were more likely than PDPs to place generic drugs on lower tiers, even among plan sponsors offering both plan types. Despite these trends, higher tier placement does not appear to be related to more generous coverage of brand-name products. Instead, in 2019, 70% of high-tier generics had multiple formulations, required heightened clinical monitoring, or had head-to-head treatment options available. CONCLUSIONS: Although Part D plans have increasingly placed covered generic drugs on higher formulary tiers over time, this may be partly explained by a drug's clinical profile and availability of substitutes rather than preferred brand-name drug coverage. [ABSTRACT FROM AUTHOR]