"…Medicare has been a boon to the elderly and their children. Surveys show that beneficiaries are overwhelmingly satisfied with their care. Before Medicare, only 56 percent of the elderly had hospital insurance; the program has contributed to an increase in life expectancy and a sharp reduction in poverty among the elderly."
Robert Pear, Walt Bogdanich, Some Successful Models Ignored as Congress Works on Drug Bill, NY Times, p.1 (9/4/2003)
- How many elders and people with disabilities have Medicare as their health insurance?
- When was the last time the Medicare tax rate was increased?
- How do the costs of Medicare compare with private insurance?
- How does enrollment and costs in the traditional program compare with Medicare managed care?For further information, follow one of the links below or scroll down the page.
| Category | Statistics | Source and Notes |
| # of people with Medicare | 52.3 Million (2013) | http://www.ncpssm.org/Medicare/MedicareFastFacts (site visited October 16, 2015) |
| # of elders (65 & older) w/ Medicare | 43.5 Million (2013) | http://www.ncpssm.org/Medicare/MedicareFastFacts (site visited October 16, 2015) |
| # of people w/ Medicare who are younger than 65 & disabled | 8.8 Million (2013) | http://www.ncpssm.org/Medicare/MedicareFastFacts (site visited October 16, 2015) |
| % of people w/ Medicare who are younger than 65 & disabled | 16.8% (2013) | http://www.ncpssm.org/Medicare/MedicareFastFacts (site visited October 16, 2015) |
| # of ESRD Patients on Medicare | 447,990 (2012) | http://kff.org/medicare/state-indicator/enrollees-with-esrd/ (site visited September 11, 2015) |
| % of elders (65 & older) w/ health insurance before Medicare existed | 54% (2009 analysis of a 1965 population) | http://www.cdc.gov/nchs/data/nhsr/nhsr017.pdf (site visited September 2, 2015) |
| % of elders (65 & older) w/ health insurance now | 98.4% (2013) | https://www.census.gov/content/dam/Census/library/ publications/2014/demo/p60-250.pdf (site visited September 2, 2015) |
| Annual Income of Medicare beneficiaries | 25% below $14,000 5% Greater than $93,900 | http://kff.org/report-section/income-and-assets-of-medicare-beneficiaries-2013-2030-issue-brief-income-of-medicare-beneficiaries/ (site visited September 2, 2015) |
| % with Income less than $24,150 | 50% (2014) | http://kff.org/medicare/issue-brief/income-and-assets-of-medicare-beneficiaries-2014-2030/ (site visited November 16, 2015) |
| Income < 400% FPL ($43,320) | 77% (2005) | June 2008 MedPAC data book, page 25. |
| Income > $80,000 | 4% (2002) | Kaiser Medicare Chartbook 2005, page 6. |
| Medicare administrative costs | 1.7% of expenditures (2006) | CMS Data Compendium 2007, "Medicare Administrative Expenses Selected Fiscal Years." |
| Medicare Advantage (private plans) average non-medical costs | 13.1% broken down by: Marketing & sales (2.4%), Adminstration (6.6%), Reinsurance (.1%) and profit (4%) (projected for 2007) | GAO-08-359 February 2008, p. 27. |
| Last time the Medicare tax rate was increased | 1985 (from 1.35% to 1.45%)
Since 1994, no cap on maximum taxable earnings for Medicare | Marilyn Moon, Urban Institute.
CMS Data Compendium 2007, "Medicare Annual Maximum Taxable Earnings, 1966-2007." |
| Spending increase per beneficiary | 5.4% (2002-2006) | June 2008 MedPAC data book, page 9. |
| Private Health Insurance Spending increase per beneficiary | 7.7% (2002-2006) | June 2008 MedPAC data book, page 9. |
Medicare Advantage (Medicare Managed Care: Private Plans)
| Category | Statistics | Source and Notes | ||||||||||||||
| # of Medicare Advantage (MA) contracts | 523 (2008) | Kaiser Family Foundation, Medicare Advantage Contracts: 2008. | ||||||||||||||
| # of beneficiaries in MA plans | 8.9 million (2008)
Increased from 4.6 million in 2003 | March 2008 MedPAC report, p. 244. | ||||||||||||||
| % of people in Medicare who are enrolled in MA plans | 20% (2007)
Increased from 11% in 2004 | March 2008 MedPAC report, p. 237. | ||||||||||||||
| # of enrollees in plans offering Prescription Drugs | 7.63 million (2008) | CMS, Prescription Drug Coverage Enrollment Information, Beneficiaries with Prescription Drug Coverage. | ||||||||||||||
| Access to MA | 100% of beneficiaries have access to MA plans | March 2008 MedPAC report, p. 237. | ||||||||||||||
| Medicare Advantage Plan Enrollment, by Plan Type
CCP = Coordinated Care Plans HMO = Health Maintenance Organization PPO = Preferred Provider Organization PFFS = Private Fee For Service MSA = Medical Savings Account |
| Kaiser Family Foundation, Medicare Advantage Plan Enrollment, by Plan Type. | ||||||||||||||
| Medicare Advantage Plan Penetration, by Plan Type (2007) |
| Kaiser Family Foundation, Medicare Advantage Plan Penetration, by Plan Type. | ||||||||||||||
| Medicare Advantage Contracts, by Plan Type (2008) |
| Kaiser Family Foundation, Medicare Advantage Contracts, by Plan Type. | ||||||||||||||
| Special Needs Plans (SNP) Enrollment, by SNP Type (2007) |
| CMS, Medicare Advantage Part D Enrollment Data, Special Needs Plan Data. | ||||||||||||||
| SNP Contracts by SNP Type (2008) |
| CMS, Medicare Advantage Part D Enrollment Data, Special Needs Plan Data. | ||||||||||||||
| Cost of MA program in 2006 | $59 billion | GAO-08-359 Feb. 2008, page 1. | ||||||||||||||
| Average amount above a plan’s bid that CMS gives to MA plans | $87 per member per month (2007)
$8.3 billion paid out in total (2007) | GAO-08-359 Feb. 2008, pages 6 and 3. | ||||||||||||||
| Average MA payment per beneficiary | $783 per beneficiary per month (projected 2007) | GAO-08-359 Feb. 2008, page 27. | ||||||||||||||
| Average traditional Medicare payment per beneficiary | $699 per beneficiary per month (2007) | Extrapolated from other data. | ||||||||||||||
| MA payment as a percent of traditional Medicare costs | 113% (2008) | March 2008 MedPAC report to the Congress, page 238. | ||||||||||||||
| Program payments that exceed traditional Medicare expenditures, by plan type (2006) |
| March 2008 MedPAC Report to Congress, pg. 247. | ||||||||||||||
| Excess MA payments | $10 billion | March 2008 MedPAC report to the Congress, page 246. | ||||||||||||||
| Excess MA payments over 10 years | Projected excess payments of $149 billion (2009-2017) | CBO, Medicare Advantage: Private Health Plans in Medicare, June 28, 2007. |
| Category | Statistics | Source and Notes |
| # of beneficiaries in Part D Plans | 25.4 million (2008) | CMS, Prescription Drug Coverage Enrollment Information, Beneficiaries with Prescription Drug Coverage. |
| # of beneficiaries in stand-alone Prescription Drug Plans (PDP) | 17.39 million (2008) | CMS, Prescription Drug Coverage Enrollment Information, Beneficiaries with Prescription Drug Coverage. |
| # of beneficiaries in MA-PDs and other Medicare health plans with drug coverage | 8.01 million (2008) | CMS, Prescription Drug Coverage Enrollment Information, Beneficiaries with Prescription Drug Coverage. |
| # of beneficiaries with non-Medicare drug coverage (Government and private retirees) | 14.19 million (2008) | CMS, Prescription Drug Coverage Enrollment Information, Beneficiaries with Prescription Drug Coverage. |
| Average # Part D plans per state (2008) | 54 plans per state
Low: 47 (Alaska) High: 63 (Pennsylvania) | Kaiser Family Foundation, Prescription Drug Plans. |
| Average premium for PDP for 2008 | $39.86 (2008)
$36.66 (2007) | Kaiser Family Foundation, Average Premium for PDPs. |
| % of PDPs with coverage in donut hole | 29% (2008) | Avalere, Beneficiaries and the 2008 Medicare Part D Marketplace, slide 21. |
| # of PDPs with brand name coverage in donut hole | 1 plan (2008) | Avalere, Beneficiaries and the 2008 Medicare Part D Marketplace, slide 21. |
| # of plans that are Low-Income Subsidy eligible | 495 (2008)
483 (2007) 411 (2006) | Kaiser Family Foundation, Prescription Drug Plans that are Low-Income Subsidy Eligible. |
Low-Income Medicare Beneficiaries
| Category | Statistics | Source and Notes |
| # beneficiaries with incomes below 100% of the Federal Poverty Level | 6.9 million (16%) (2005) | June 2008 MedPAC data book, page 25. |
| # beneficiaries with incomes 100%-125% of the Federal Poverty Level | 3.9 million (9%) (2005) | June 2008 MedPAC data book, page 25. |
| # beneficiaries with incomes 125%-200% of the Federal Poverty Level | 8.7 million (20%) (2005) | June 2008 MedPAC data book, page 25. |
| # of beneficiaries estimated eligible for LIS | 12.5 million (2008)
13.2 million (2007) | CMS, Prescription Drug Coverage Enrollment Information, LIS Eligible Beneficiaries. |
| # of beneficiaries enrolled in LIS | 9.4 million (2008) | Kaiser Family Foundation, Low-Income Subsidy Recipients. |
| % of beneficiaries enrolled in LIS who are deemed through another program | 84% (2008) | CMS, Prescription Drug Coverage, 2008 Enrollment Information. |
| % of estimated eligible beneficiaries enrolled in QMB | 33% | CBO, A Detailed Description of CBO's Cost Estimate for the Medicare Prescription Drug Benefit. |
| % of estimated eligible beneficiaries enrolled in SLMB | 13% | CBO, A Detailed Description of CBO's Cost Estimate for the Medicare Prescription Drug Benefit. |
| # of dual eligibles | 7.5 million (2006) | Kaiser Family Foundation, Dual Eligibles: Medicaid's Role for Low-Income Medicare Beneficiaries. |
| # LIS enrollees whose plan lost benchmark status | 2.56 million (2008) | CMS, Limited Income and Resources. |
| # LIS enrollees reassigned to a new plan with the same sponsor | 965,482 (2008) | CMS, Limited Income and Resources, Reassignment Data. |
| # LIS enrollees reassigned to a new plan with a different sponsor | 1.15 million (2008) | CMS, Limited Income and Resources, Reassignment Data. |
| # LIS enrollees who must choose a new plan | 442,719 | CMS, Limited Income and Resources, Chooser Data. |
| Category | Statistics | Source and Notes | |||
| # of overall US populace w/ chronic conditions | 133 million (2005) | Partnership for Solutions, Chronic Conditions: Making the Case for Ongoing Care. | |||
| % of non-institutionalized Medicare beneficiaries with at least one chronic condition | 87% (2002) | Kaiser Medicare Chartbook 2005, page 5. | |||
| % of Medicare spending on people with chronic conditions | 1 CC = 3% 2 CC = 6% 3 CC = 10% 4 CC = 12% 5+ CC = 68 % (2004)
99% of Medicare expenditures are for beneficiaries with 1 or more chronic conditions | Partnership for Solutions, Chronic Conditions: Making the Case for Ongoing Care, page 27. | |||
| Average length of hospital stay for Medicare beneficiaries for short-stay hospitals | 5.6 days (2006)
6.0 days (2000) | CMS Data Compendium, Utilization, "Medicare Short-Stay Hospital Utilization." | |||
| Average length of skilled nursing facility stay for Medicare beneficiaries per discharge | 34 days (2006)
31 days (2000) | CMS Data Compendium, State Data, "Medicare Skilled Nursing Facility Utilization by State." | |||
| Average reimbursement per skilled nursing facility discharge | $10,304 (2006) | CMS Data Compendium 2006, State Data, "Medicare Skilled Nursing Facility Utilization by State." | |||
| Average # of home health visits per episode | 19 (2006) Visits down 57% since 1997 (pre-prospective payment) | June 2008 MedPAC data book, page 131- 132. | |||
| Mean out-of-pocket spending, by income quintile for the elderly population, as a share of income | 1970 | 1987 | 2002 | Glenn Follette and Louise Sheiner, The Federal Reserve Board, "The Sustainability of Health Spending Growth," table 11. | |
| 1 | 10% | 15% | 19% | ||
| 2 | 9% | 12% | 13% | ||
| 3 | 7% | 9% | 7% | ||
| 4 | 5% | 6% | 5% | ||
| 5 | 2% | 3% | 2% | ||