Medicare is the federal health insurance program for more than 70 million people ages 65 and over and younger adults with long-term 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.

People with Medicare may choose to receive their Medicare benefits through traditional Medicare or through a Medicare Advantage plan, such as a health maintenance organization (HMO) or preferred provider organization (PPO), administered by a private health insurer. People who choose traditional Medicare can sign up for a separate Medicare Part D prescription drug plan for coverage of outpatient prescription drugs and may also consider purchasing a supplemental insurance policy (Medigap) to help with out-of-pockets costs if they do not have additional coverage from a former employer, union, or Medicaid. People who opt for Medicare Advantage can choose from among more than two dozen Medicare Advantage plans on average, which include all services covered under Medicare Parts A and B, and typically include Part D prescription drug coverage as well.

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

1. When is the annual Medicare open enrollment period?

The annual Medicare open enrollment period runs from October 15 to December 7 each year (Figure 1). During this time, people with Medicare can review features of Medicare plans offered in their area and make changes to their Medicare coverage, which go into effect on January 1 of the following year. These changes include switching from traditional Medicare to a Medicare Advantage plan (or vice versa), switching between Medicare Advantage plans, and electing or switching between Medicare Part D prescription drug plans.

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2. What changes can Medicare beneficiaries make during the annual open enrollment period?

People in traditional Medicare can use the Medicare open enrollment period to enroll in a Medicare Part D prescription drug plan or switch between Part D plans. Traditional Medicare beneficiaries who did not sign up for a Part D plan during their initial enrollment period for Medicare can enroll in a Part D plan during the annual open enrollment period, though they may be subject to a late enrollment penalty if they did not have comparable prescription drug coverage from another plan before signing up for Part D. Traditional Medicare beneficiaries with Medicare Parts A and B can also use this time to switch from traditional Medicare into a Medicare Advantage plan, with or without Part D coverage.

People who are enrolled in a Medicare Advantage plan can use the Medicare open enrollment period to choose a different Medicare Advantage plan or switch to traditional Medicare. Medicare Advantage enrollees who switch to traditional Medicare can enroll in a Part D plan if they want outpatient prescription drug coverage, which is not covered under Medicare Parts A and B. (Beneficiaries may be subject to late enrollment penalties if they go without Part D drug coverage and don’t have other creditable coverage.) They may also consider purchasing a Medicare supplemental insurance policy (Medigap) if the option is available to them (see Q4 for details about Medigap and potential limits on enrollment).

Medicare beneficiaries are encouraged to review their current source of Medicare coverage during the annual open enrollment period and compare other options that are available where they live. Because an individual’s medical needs can change over the course of the year, and from one year to the next, this might influence their priorities when choosing how they want to get their Medicare benefits. Medicare Advantage and Medicare prescription drug plans typically change from one year to the next and might vary in many ways that could have implications for a person’s access to providers and costs. Despite this, nearly two-thirds (65%) of Medicare beneficiaries did not compare their Medicare coverage options during a recent open enrollment period. The share of beneficiaries who did not compare coverage options was larger among people in traditional Medicare relative to those enrolled in Medicare Advantage (71% vs. 60%, Figure 2).

3. What other opportunities do Medicare beneficiaries have to make coverage changes outside of the open enrollment period?

Medicare provides several different Special Enrollment Periods (SEPs) where Medicare beneficiaries can make changes to their coverage outside of the annual open enrollment period under certain circumstances. For example, beneficiaries who experience disruptions to existing coverage, such as a cross-county move, losing employer- or union-sponsored coverage, or losing Medicaid eligibility, may qualify for a SEP at any time of year.

As of 2025, people who are enrolled in both Medicare and Medicaid (i.e., dual-eligible individuals) or who qualify for the Medicare Part D Low-Income Subsidy program (also known as “Extra Help”), can make certain changes to their coverage once per month. Beneficiaries in these groups may use this monthly SEP to disenroll from a Medicare Advantage plan into traditional Medicare, enroll in a stand-alone Part D drug plan, or switch between Part D plans. However, they may not use the monthly SEP to newly enroll in Medicare Advantage from traditional Medicare or switch between Medicare Advantage plans, with the exception of individuals with full Medicaid benefits who are switching to a Fully Integrated Dually Eligible Special Needs Plan (FIDE SNP), a Highly Integrated Dually Eligible Special Needs Plan (HIDE SNP), or a coordination-only D-SNP that is an Applicable Integrated Plan (AIP) (meaning it meets certain criteria for integration of Medicare and Medicaid coverage). People living in nursing homes and certain other facilities may also change their Medicare Advantage or Medicare Part D coverage once per month.

Medicare Advantage enrollees who wish to change plans or switch to traditional Medicare may do so between January 1through March 31 each year, during the Medicare Advantage Open Enrollment Period. (This is in addition to the open enrollment period that runs from October 15 to December 7.) Additionally, those who are enrolled in a Medicare Advantage or Medicare Part D plan with less than a 5-star quality rating and who have a plan with a 5-star quality rating available in their area may switch into a 5-star plan between December 8 and November 30 of the following year. Finally, Medicare Advantage enrollees may qualify for an SEP if their plan makes certain changes to its provider network that are deemed “significant,” such as terminating a large number of in-network providers. (See Q6 for more information about Medicare Advantage provider networks.)

The annual open enrollment period and other opportunities to switch coverage are distinct from the initial enrollment period for people who are newly enrolling in Medicare, which begins three months before a person’s 65^th birthday and ends three months after it. For more information on initial enrollment, see KFF’s Medicare Open Enrollment FAQ.

4. How does supplemental coverage, like Medigap and employer-sponsored retiree health benefits, factor into Medicare coverage decisions?

Many Medicare beneficiaries have some form of additional coverage, such as a Medicare Supplement Insurance policy (also known as Medigap) or coverage offered by an employer or a union, that helps with Medicare’s cost-sharing requirements. Enrollment in these plans and programs is not tied to the Medicare open enrollment period, though beneficiaries might wish to take them into account when considering their options for Medicare coverage.

Medigap. People in traditional Medicare with both Part A and Part B can apply for a Medigap policy at any time of the year. Medigap policies are designed to help beneficiaries in traditional Medicare with Medicare’s deductibles and cost-sharing requirements and have standard benefits to allow for apples-to-apples comparisons across insurers. Traditional Medicare beneficiaries with a Medigap plan that covers most deductible and cost-sharing requirements might have lower out-of-pocket spending for Medicare-covered services than people with other coverage, including a Medicare Advantage plan. Medigap policies are designed to wrap around traditional Medicare, and do not work with Medicare Advantage. People enrolled in Medicare Advantage do not need (and can’t buy) a Medigap policy.

While Medigap insurers are required to issue policies to people age 65 or over, without regard to health status or diagnosed medical conditions when they first enroll in Medicare, those with pre-existing conditions may be denied a Medigap policy or face higher premiums in most states if they apply for Medigap coverage after their first six months of enrollment in Part B. People who disenroll from Medicare Advantage within 12 months of first enrolling in Medicare Advantage have a right to purchase a Medigap policy without regard to medical history, but after 12 months, they are not guaranteed Medigap coverage and may be denied a policy due to a pre-existing condition or face higher Medigap premiums if they are offered a policy.

Medigap guaranteed issue rights are different for people under age 65 who qualify for Medicare due to long-term disability. Federal law does not require Medigap insurers to sell a policy to people with Medicare under age 65, although several states do require insurers to offer at least one kind of Medigap policy to people under 65. Premiums for Medigap policies sold to people under age 65 are typically higher than policies sold to those age 65 or older. People under age 65 with disabilities who are already enrolled in Medicare will qualify for the 6-month Medigap open enrollment period when they turn 65 and become age eligible for Medicare. At this point, they can buy any Medigap policy they want without facing higher premiums or denials of coverage based on their existing medical conditions.

Employer-sponsored coverage. While employer-sponsored retiree health benefits are on the decline, more than 14.1 million people with Medicare have retiree health coverage (distinct from people with Medicare Part A only who continue to work and have health insurance through their current employer or a spouse’s current employer). Retiree health benefits may be designed to supplement either traditional Medicare or Medicare Advantage.

If a Medicare beneficiary drops their employer or union-sponsored retiree health benefits for any reason, such as switching from traditional Medicare to Medicare Advantage or vice versa, they might not be able to get them back. For example, some employers that offer health benefits to retirees on Medicare offer these benefits exclusively through a Medicare Advantage plan. Beneficiaries with retiree health coverage offered exclusively through a Medicare Advantage plan might lose these benefits if they choose to switch to traditional Medicare during the annual open enrollment period. Similarly, employers might only offer a retiree health benefit that supplements traditional Medicare. If a person with such coverage switches from traditional Medicare to Medicare Advantage during an open enrollment period, they might lose their retiree health benefits.

5. How does additional support for low-income people factor into Medicare coverage decisions?

Low-income Medicare beneficiaries who meet their states’ Medicaid eligibility criteria qualify for additional coverage of services through Medicaid that are not covered under Medicare, such as long-term services and supports. Additionally, Medicare beneficiaries with low and modest incomes may qualify for assistance with Medicare premiums and out-of-pocket costs from the Medicare Savings Programs (MSP) and Part D Low-Income Subsidy (LIS) if their income and assets are below certain amounts. Medicare beneficiaries who are eligible for Medicaid, MSPs, or LIS, but not yet enrolled in these programs, can enroll at any time of the year. This additional coverage and assistance could factor into how people choose to receive their Medicare benefits. 

Medicaid. For people with Medicare who qualify for full Medicaid benefits, their choice of Medicare coverage can affect how they receive Medicaid benefits and the degree to which those benefits are coordinated with Medicare. In general, Medicaid wraps around Medicare coverage, with Medicare as the primary payer and Medicaid paying for costs and services not covered by Medicare. People who are eligible for both Medicare and Medicaid (dual-eligible individuals) can enroll in a Medicare Advantage plan designed for this population, such as a dual-eligible Special Needs Plan (SNP), and depending on the state and the plan, might experience a higher level of coordination of their benefits. As of 2025, people who qualify for full Medicaid benefits can make certain changes to their Medicare coverage outside of the open enrollment period, up to once per month (see Q3 for further details).

Medicare Savings Programs. Through the Medicare Savings Programs (MSP), state Medicaid programs pay Medicare premiums and, in many cases, cost sharing for Medicare beneficiaries who have income and assets below certain amounts (while the federal government sets minimum income and asset thresholds, some states have opted for higher income and/or asset thresholds). Specifically, states cover the Medicare Part B premium for people who qualify and, in many cases, also provide assistance with Medicare deductibles and other cost-sharing requirements. People who receive MSP assistance and are enrolled in a Medicare Advantage plan might still have cost sharing associated with non-Medicare covered services offered by the plan. People who are enrolled in MSP can also make certain changes to their coverage outside of the open enrollment period, up to once per month. 

Part D Low-Income Subsidy. People who qualify for the Part D Low-Income Subsidy (LIS) receive varying levels of assistance toward their Part D prescription drug coverage premiums and cost sharing, depending on their income and asset levels. People with full-benefit Medicaid coverage, people who receive Part B premium assistance through the Medicare Savings Programs, and people who receive Supplemental Security Income payments from Social Security automatically qualify for LIS benefits, and Medicare automatically enrolls them into a stand-alone Part D drug plan in their area with a premium at or below a certain amount (the Low-Income Subsidy benchmark) if they do not choose a plan on their own. Other beneficiaries are subject to both an income and asset test and need to apply for the LIS through either the Social Security Administration or Medicaid. People who receive LIS assistance can select any Part D plan offered in their area, but if they enroll in a plan that is not a so-called “benchmark plan” (that is, plans available without a premium to enrollees receiving LIS), or their current plan loses benchmark status, they may be required to pay some portion of their plan’s monthly premium. People who receive LIS can also make certain changes to their coverage outside of the open enrollment period, up to once per month.

6. How do the features of traditional Medicare compare to those of Medicare Advantage?

Traditional Medicare and Medicare Advantage both provide coverage of all services included in Medicare Part A and Part B, but certain features, such as cost-sharing requirements, provider networks, and access to extra benefits vary between these two types of Medicare coverage. When deciding between traditional Medicare and Medicare Advantage, Medicare beneficiaries might want to consider a variety of factors, such as their own health and financial circumstances, preferences for how they get their medical care, which providers they see, and their prescription drug needs. These decisions might involve careful consideration of premiums, deductibles, and cost sharing requirements; extra benefits offered by Medicare Advantage plans; how the choice of coverage might affect access to certain physicians, specialists, hospitals and pharmacies; rules related to prior authorization and referral requirements; and variations in coverage and costs for prescription drugs.

People might prefer traditional Medicare if they want the broadest possible access to doctors, hospitals and other health care providers. Traditional Medicare beneficiaries may see any provider that accepts Medicare and, if they are new to the provider, accepts new patients. (Roughly 98% of all non-pediatric physicians participate in the Medicare program.) People with traditional Medicare are not required to obtain a referral for specialists or mental health providers. Additionally, prior authorization is rarely required in traditional Medicare and only applies to a limited set of services. With traditional Medicare, people can choose among stand-alone prescription drug plans offered in their area, which tend to vary widely in terms of which drugs are covered and at what cost. (Beginning in 2026, a pilot initiative known as the Wasteful and Inappropriate Services Reduction (WISeR) model is testing the use of prior authorization in traditional Medicare for a small set of outpatient services in six states. The WISeR model is limited to traditional Medicare, though most Medicare Advantage plans already require prior authorization for some services.)

People might prefer Medicare Advantage if they want extra benefits, such as coverage of some dental and vision services, and reduced cost sharing, which is offered by most plans, often for no additional premium (other than the Part B premium). Additionally, Medicare Advantage plans are required to include a cap on out-of-pocket spending, providing some protection from catastrophic medical expenses. Medicare Advantage plans also offer the benefit of one-stop shopping (i.e., people who enroll have coverage under one plan and do not need to sign up for a separate Part D prescription drug plan or a Medigap policy to supplement traditional Medicare).

7. How do Medicare Advantage plans vary?

The average Medicare beneficiary can choose from 35 Medicare Advantage plans in 2027, including 28 Medicare Advantage plans with Part D coverage, though the average number of plan options varies widely across states (Figure 3). These plans vary across many dimensions, including premiums and cost-sharing requirements, provider networks, extra benefits, prior authorization and referral requirements, and prescription drug coverage. As a result, enrollees face different out-of-pocket costs, access to providers and pharmacies, and coverage of non-Medicare benefits (such as dental, vision and hearing) based on the Medicare Advantage plan they choose.

Premiums and cost-sharing requirements. Medicare Advantage enrollees may be charged a separate monthly premium (in addition to the Part B premium). In 2026, the average enrollment-weighted premium for Medicare Advantage plans was $15 per month, though three quarters (75%) of enrollees were in plans that charged no additional premium (apart from the Part B premium).

Medicare Advantage plans are generally prohibited from charging more than traditional Medicare, but vary in the deductibles, co-pays and co-insurance they require. For example, plans typically charge a daily co-pay for hospital stays, which vary both in the amount and the number of days for which they apply.

Medicare Advantage plans are required to include a cap on out-of-pocket expenses. In 2026, this cap may not exceed $9,250 for in-network services or $13,900 for all covered services. Most plans have an out-of-pocket limit below this cap, averaging $5,421 for in-network services and $9,825 for in-network and out-of-network services combined. Out-of-pocket limits only apply to services covered under Medicare Parts A and B.

Provider networks. Medicare Advantage plans are permitted to limit their provider networks, the size of which can vary considerably for both physicians and hospitals, depending on the plan and the county where it is offered. Medicare Advantage plans that include prescription drug coverage may also establish pharmacy networks or designate preferred pharmacies, where enrollees will have lower out-of-pocket costs. If a Medicare Advantage plan provides coverage of out-of-network providers, it may require higher cost sharing from enrollees for these services. As of 2026, the Medicare Plan Finder tool includes searchable provider directories for Medicare Advantage plans. Insurers must provide plan network information directly to CMS ahead of the open enrollment period each year, as well as notifications within 30 days of any changes to a plan’s network and annual attestations that the listed directories are up to date if no changes have taken place.

Extra benefits. Medicare Advantage plans can offer extra benefits not covered by traditional Medicare, such as some coverage of dental, vision, and hearing services. In 2026, virtually all Medicare Advantage enrollees are in a plan that offers extra benefits, including some coverage of eye exams and/or eyeglasses (more than 99%), dental care (98%), hearing exams and/or aids (95%), and a fitness benefit (91%). Additionally, a majority of Medicare Advantage enrollees are in plans that provide an allowance for over-the-counter items (68%) and meals following a hospital stay (65%). While extra benefits are common, the scope of coverage varies widely from plan to plan. For example, some plans that include a dental benefit may limit coverage to basic preventive services (e.g., dental cleanings) while others may offer coverage of a broader range services (e.g., root canals or dentures).

Special Supplemental Benefits for the Chronically Ill (SSBCI): Since 2020, Medicare Advantage plans have been able to offer a wider range of extra benefits for chronically ill beneficiaries, known as Special Supplemental Benefits for the Chronically Ill (SSBCI). These include benefits that are not primarily health related but support the health and well-being of people living with chronic illness, such as food and produce (often called grocery or healthy food benefits), assistance with housing and utilities, and transportation for non-medical needs, among others. To qualify for these benefits, Medicare Advantage enrollees must have one or more chronic conditions that meet certain criteria related to illness severity and chronic care needs and might also be required to meet additional plan-specific criteria.

Beginning with the 2027 plan year, Medicare Advantage plans must confirm that an enrollee meets these criteria using an objective process such as a health risk assessment or a claims review. Additionally, plans will be required to make the criteria they use to determine eligibility for SSBCI publicly available on their website to ensure that potential enrollees have access to this information when comparing plans.

Prior authorization and referral requirements. Medicare Advantage plans may require enrollees to receive prior authorization before a service will be covered. In 2024, nearly 53 million prior authorization requests were submitted to insurers on behalf of Medicare Advantage enrollees, and in 2026, virtually all Medicare Advantage enrollees are in plans that require prior authorization for some services, such as inpatient hospital stays, diagnostic tests and procedures, or stays in a skilled nursing facility. Prior authorization may also be required for some services included in a plan’s extra benefits, such as hearing and eye exams or comprehensive dental services. In addition, Medicare Advantage plans may require enrollees to obtain a referral from a primary care provider in order to see a specialist or mental health provider.

Medicare Advantage plans are also required to follow additional requirements when making prior authorization decisions. These include issuing decisions within a set timeframe (7 calendar days for standard requests or 72 hours for expedited requests), informing beneficiaries and providers of the specific reason a request is denied, and reporting certain information about their prior authorization processes on their public websites by March 31 each year, such as the share of requests that were approved, denied, or approved after appeal in the prior calendar year.

Prescription drug coverage. Medicare Advantage enrollees who want prescription drug coverage must choose a plan that offers this coverage, as they are not permitted to enroll in a stand-alone prescription drug plan while enrolled in Medicare Advantage. Medicare Advantage plans that include prescription drug coverage typically charge a separate drug deductible. Drug coverage in Medicare Advantage plans varies along the same dimensions as drug coverage in stand-alone Part D plans (described below).

8. How do Part D plans vary?

Medicare beneficiaries have between 8 and 12 stand-alone Part D plans to choose from for 2027 (Figure 4) (in addition to a large number of Medicare Advantage drug plans, if they want to consider Medicare Advantage for all of their Medicare-covered benefits). Both stand-alone Part D plans and Medicare Advantage plans that include prescription drug coverage vary in terms of premiums, deductibles and cost sharing, the drugs that are covered and any utilization management restrictions that apply, and pharmacy networks. These differences can affect enrollees’ access to prescription drugs and out-of-pocket costs.

Premiums. People in traditional Medicare who are enrolled in a separate stand-alone Part D plan generally pay a monthly Part D premium unless they qualify for benefits through the Part D Low-Income Subsidy (LIS) program and are enrolled in a premium-free (benchmark) plan. In 2026, the average enrollment-weighted premium for stand-alone Part D plans was $36 per month. In comparison, most enrollees in Medicare Advantage plans that offer prescription drug coverage do not pay a premium. (Medicare Advantage plans can use rebate dollars from the federal government to reduce premiums for prescription drug coverage, funds that are not available to plan sponsors for PDPs).

Deductibles and cost sharing. Deductibles and cost-sharing requirements for prescription drugs vary across both stand-alone Part D plans and Medicare Advantage prescription drug plans. In 2027, the standard deductible for Part D coverage is $700, but some plans charge a lower or no deductible. Plans generally impose a tier structure to define the cost-sharing amounts charged for different types of drugs. Plans typically charge lower cost-sharing amounts for generic drugs and preferred brands and higher amounts for non-preferred and specialty drugs. Plans also charge a mix of flat dollar copayments and coinsurance (based on a percentage of a drug’s list price) for covered drugs. Separate cost-sharing rules apply to insulin, where copays are capped at $35 per month, and adult vaccines covered under Part D, where no cost sharing can be charged, based on provisions in the Inflation Reduction Act of 2022. Annual out-of-pocket costs for prescription drugs are capped at $2,400 for 2027.

Drugs covered and utilization management restrictions. Part D plans include a list of drugs they cover (also referred to as a plan’s formulary). In addition, plans impose utilization management restrictions on some covered prescription drugs, including prior authorization, quantity limits, and step therapy, which can affect beneficiaries’ access to medications. In 2026, Part D plans applied utilization management requirements to around half of all drugs covered on a plan’s formulary.

Pharmacy networks. Part D plans may establish pharmacy networks or designate preferred pharmacies where enrollees will have lower out-of-pocket costs.

Medicare Prescription Payment Plan. The Medicare Prescription Payment Plan is an opt-in program created by the Inflation Reduction Act and launched in January 2025 that allows Part D enrollees to pay their out-of-pocket drug costs in monthly installments throughout the year rather than paying all at once at the pharmacy. The program does not change the total amount that participants must pay for their covered prescriptions in the course of the year, and total payments are subject to the annual cap on out-of-pocket drug spending for Part D enrollees ($2,400 in 2027). The program is available to all Part D enrollees, whether they get their Part D coverage through Medicare Advantage or through a stand-alone Part D plan, regardless of their level of income. (See Q6 for a discussion of additional cost-sharing support available to low-income beneficiaries.)

Coverage of GLP-1s for obesity. The Medicare GLP-1 Bridge Program is a temporary program launched in July 2026 that offers coverage of GLP-1s for treatment of obesity. Medicare beneficiaries who are enrolled in Part D (either through Medicare Advantage or through a stand-alone Part D plan) and who meet certain clinical criteria related to their body mass index (BMI) and other health risks are eligible for coverage of GLP-1 medications for weight reduction at a copayment of $50 per month. Eligibility for the Medicare GLP-1 Bridge Program is limited to Medicare beneficiaries who have not filled a prescription under their Part D plan for a GLP-1 in 2026, and who do not have a diagnosis with a condition that is a medically accepted indication for a GLP-1 drug, such as type 2 diabetes or obstructive sleep apnea (OSA). While Medicare beneficiaries are required to have some form of Part D coverage to qualify for the GLP-1 Bridge Program, the program operates outside of participants’ Part D plan, and copayments do not count towards plan deductibles or the annual Part D out-of-pocket spending cap.

9. What changes have been made to Medicare eligibility based on immigration status?

Due to changes made in the 2025 reconciliation law, starting in July 2025, Medicare eligibility is limited to U.S. citizens and nationals, permanent residents (i.e., green card holders), Cuban-Haitian entrants, and people residing in the U.S. under the Compacts of Free Association. Lawfully present immigrants who don’t meet these criteria, such as refugees, asylees, and people with Temporary Protected Status, are no longer eligible for Medicare regardless of their age or work history. Individuals with current Medicare coverage who do not fall in any of these categories will have their coverage terminated no later than January 4, 2027. CMS has estimated that roughly 32,000 previously eligible beneficiaries will lose their Medicare coverage beginning in 2027 under these changes.

Lawfully present immigrants who remain eligible for Medicare can qualify on the basis of age, disability, ALS, or end-stage renal disease and must meet all applicable work history and residency requirements. As with U.S. citizens, immigrants with an eligible status who are ages 65 and older generally qualify for premium-free Medicare Part A if they have worked at least 40 quarters (10 years) in jobs where they or their spouse paid Medicare payroll taxes. Those ages 65 and older who do not have this work history may purchase Medicare Part A after residing legally in the U.S. for five continuous years. Immigrants with an eligible status who are under age 65 with long-term disabilities may also qualify for Medicare, provided they meet the same eligibility requirements for Social Security Disability Insurance (SSDI) that apply to U.S. citizens. These requirements are based on work history, payment of Social Security taxes on income, and having enough years of Social Security taxes accumulated to equal between 20 and 40 work credits (5-10 years).

10. What resources are available to assist Medicare beneficiaries in understanding their coverage options?

People with Medicare can learn more about Medicare coverage options and the features of different plan options by reviewing the Medicare & You handbook. In addition, people can review and compare the Medicare options available in their area by using the Medicare Plan Compare website, a searchable tool on the Medicare.gov website, by calling 1-800-MEDICARE (1-800-633-4227), or by contacting their local State Health Insurance Assistance Program (SHIP). SHIPs offer local, personalized counseling and assistance to people with Medicare and their families. Contact information for state SHIPs can be found by calling 877-839-2675 or by checking the listings provided on the Medicare.gov website or the SHIP website.

Additionally, many people use insurance agents and brokers to navigate their coverage options. While independent agents and brokers can be helpful, they are often financially compensated by private insurers for enrolling people in their plans, and may receive higher commissions if people choose a Medicare Advantage plan rather than remaining in traditional Medicare and purchasing a supplemental Medigap policy and stand-alone Part D plan. Commissions may also vary across Medicare Advantage plans, providing an incentive for enrollment in some plans over others.

There has been increased attention on declining fertility rates in the U.S. and globally. Fertility rates have been falling for many years, but they have been in the spotlight of media coverage recently, in part because of the current Administration’s focus on pronatalist policies aimed at encouraging people to have more children. Considerable financial and structural barriers face people who want to start families, including expensive and limited childcare options, inconsistent and limited paid leave and workplace flexibility, low economic mobility, and high cost of living.

The 2026 KFF Women’s Health Survey is a nationally representative survey of 4,688 women and 1,148 men ages 18 to 64, fielded between March 11, 2026 to April 14, 2026. This analysis presents data among women 18 to 49 (n=3,538) and men 18-49 (840), and highlights women’s opinions regarding the possible impact of potential federal actions on their decision to have children in the future as well their experiences with paid parental leave and sick leave in the workplace.

• One in four women ages 18 to 49 say they are considering having children in the next three years. Less than a quarter of reproductive age women (23%) are considering having or adopting a child in the near future, including 24% of those who do not currently have children (under 18 years old). Six in ten women (63%) say they are not planning on having children in the next three years.
• While the majority of reproductive age women say that greater family support policies such as assistance with childcare costs and mandatory paid parental leave would not affect their plans to have children, some say they would be more likely to consider growing their families if these policies were in place. Four in ten women say they are more likely to consider having children if the government assisted with childcare costs (43%) or required employers to offer paid parental leave (43%). This rises to about seven in ten among women who are already considering having a child in the near future. Half of men say these two policies would make them more likely to consider having children.
• Compared to government assistance with childcare costs and mandatory paid parental leave, somewhat fewer women say the expansion of the child tax credit and one-time cash bonuses for a new child in the family would make them more likely to have children in the near future. One-third of reproductive age women say that if the government increased the child tax credit (35%) or provided a one-time cash payment to parents after welcoming a new child (35%), they would be much or somewhat more likely to consider having a child.
• There is wide variation in the types and amount of parental leave women take, including whether they take any at all. Among employed women who had or adopted a child in the past three years, half (52%) took some amount of paid leave. About one-third (35%) took only unpaid leave, while more than one in ten (13%) did not take any leave after the arrival of their child. Among those who took leave, four in ten (37%) took up to two months of time in total, one third (34%) took between 9 to 12 weeks of leave, and 28% took more than 12 weeks off.
• Women are the primary caretakers for children when they are sick at nearly three times the rate of men, and many women lose pay when they take time off. Nearly three times as many working women (58%) than men (20%) say they are the ones who care for their child when they are sick and cannot go to school. Among these women who care for their child either alone or with a partner, half (53%) report losing pay when they miss work.

Family Building

The majority of reproductive age women say they are not planning on having children in the next three years, including those who are already parents of a young child. About one in four women age 18 to 49 (23%) are considering having or adopting a child in the next three years (Figure 1). Larger shares of younger women between the ages of 18 and 25 (22%) and between 26 and 35 (33%) say they are planning on having children compared to women in their later reproductive years (13%). By political affiliation, more Republican women (29%) than Democrats (20%) plan on having children in the next three years. Almost half (45%) of reproductive age women are already parents to a child under 18 years old (data not shown). Half as many parents with older children (14%) than parents of younger children (28%) are planning on having another child in the next three years.

Influence of Potential Family Supports

The costs of having children and raising a family have never been higher. The current administration and other conservative policymakers have been pushing for young Americans to start families and have more children to address concerns about the declining birth rate in the U.S. They have discussed some ideas that they say would help, such as “Trump Savings Accounts,” a “motherhood medal” for women with six or more children, and most recently, using childcare subsidy funds to pay stay-at-home parents. The Administration has also proposed policies aimed at expanding access to fertility care such as in vitro fertilization (IVF), including discounts on medications and clarifying insurance rules for employers that want to offer fertility benefits to their workers.

Many factors come into play when people are thinking about having a child, including cost of living and income, the cost of raising a child, or certainty about having children. Previous KFF research has found that affordable and high-quality childcare is particularly daunting and difficult to find. Some policymakers have been advocating for policies that are intended to support families by offering broader financial assistance.

The survey probed whether people would be more likely to have children if the government did each of the following:

• expanded the child tax credit
• offered a one-time cash bonus for a new child in the family
• provided more financial assistance with childcare costs
• required employers to offer paid parental leave

Overall, less than half of reproductive age women say that enhanced family support policies would make them more likely to consider having a child.

About one-third of reproductive age women say that they would be much more likely or somewhat more likely to consider having a child if the government increased the child tax credit (35%) or provided a one-time cash bonus to parents after welcoming a child (35%). Most women say that these two policies would not have much or any impact on whether they have a child (Figure 2).

The federal child tax credit lowers the amount of taxes that parents/guardians of dependent children under age 18 owe. In 2021, the American Rescue Plan Act (ARPA), a COVID relief law, included a temporary expansion of the child tax credit. Research has found that the policy lowered the rate of child poverty, but that its economic benefits were uneven across different populations.

In the past few years, some states and locales have experimented with different models of cash payments to new parents, and recently, the Trump Administration launched tax-preferred investment accounts available to families with children, with the federal government providing an initial $1,000 deposit for the youngest children.

About four in ten reproductive age women say that if the government provided more financial assistance with childcare costs (43%) or required employers to offer paid parental leave (43%), they would be more likely to consider having a child, but half say that these two policies would have little or no impact. Higher shares of women who are Asian or Hispanic say they would be more likely to consider having a child if these policies were in place (Appendix Tables 3, 4).

Nationally, the average cost of childcare exceeds $13,000 annually, and many parents say that affordable childcare is difficult to obtain. Government assistance with childcare expenses can come in various forms, such as vouchers to help pay costs, public preschools, and tax incentives. Furthermore, the United States is one of the few industrialized nations that does not require employers to provide paid time off for new parents, but some states have enacted paid leave policies that cover a portion of their workers’ salaries.

Consistently, slightly higher shares of men than women say if the government required more family supportive policies that would make them more likely to consider having a child. More than four in ten men ages 18 to 49 say if the government increased the child tax credit (45%) or provided a one-time cash bonus to parents (46%) that they would be much more or somewhat more likely to consider having a child (Figure 2). About an equal share of men, though, say that these policies would not make much difference or any at all. Half of men say they would be more likely if the government provided more assistance with childcare costs or mandated paid parental leave. About four in ten men say these policies would not have much or any impact (Figure 2).

Compared to increased child tax credits and one-time cash incentives, government assistance with childcare expenses and mandatory paid parental leave would make reproductive age women more likely to consider having children, but the rates are highest among those already considering having children. About seven in ten reproductive age women who say they are considering having a child in the next three years also say they would be more likely to consider having a child if the government offered assistance with the costs of childcare (68%) or required paid parental leave (72%) (Figure 3). Notably, more than half of reproductive age women who are unsure about having a child in the next three years also say that support with childcare costs (57%) and paid parental leave (54%) would make them more likely to have children. However, just over one-third (37%) of women who are not considering having a child in the near future say these policies would affect their childbearing plans, but most say they would not make much difference or any at all.

Paid Parental Leave

Among the family support policies the survey asked about, the largest share of women said that paid parental leave would make them more likely to consider having a child. Paid parental leave benefits have been found to be associated with positive health outcomes, including shorter recovery times for women after childbirth, stronger bonding attachments with newborns, and greater access to breastfeeding. Yet, the United States is one of the few industrialized nations that does not have a national paid leave standard for parents caring for a new child or workers that need leave work to care for themselves or family members due to an illness or health condition. The federal Family and Medical Leave Act (FMLA) requires eligible employers to provide certain workers unpaid family leave, but only a minority of workers in the private sector have a paid family leave benefit. This gap has garnered increasing attention among elected officials at the national and local levels, and more than a dozen states now have paid leave policies in place.

More than half of women who had a child in the past three years (57%) were employed at the time, and about half (52%) took some paid time off after the arrival of their child (Figure 4). While most employed women took some time off work after childbirth or adoption, more than one in ten (13%) did not take any time off. Half (52%) took time off and were paid for at least a portion of that time, while 35% took only unpaid time off.

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Among women who took leave after having a child, about four in ten took up to two months or 8 weeks of leave (Figure 5). There is a wide range in the amount of time women take off work after having a child in the U.S. Thirteen percent (13%) of women who had a child in the past three years report taking up to one month of leave, 24% took between five and eight weeks off, a third (34%) took between nine and 12 weeks, while only one in four took more than 12 weeks (28%). Twelve weeks is much shorter than the required maternity leave in most other developed countries, which averages around four months or 17 weeks of paid leave. The amount of parental leave women take in the U.S. is governed by several factors, including whether their employer is required by state law to offer parental and sick leave and the amount of wages they cover. Other factors affecting the amount of leave include their income, childcare availability, and their own or their infant’s health status and needs.

Paid Sick and Medical Leave

Like with parental leave, there is no federal law requiring employers to pay workers when they need time off to care for themselves, children, or other family members who are sick. However, far more employers do provide this benefit than not, and about eight in ten workers have some level of sick leave benefit. For workers with children, paid sick leave can allow them to stay home when their child is sick and cannot attend school without losing pay. Several states as well as cities require employers in their jurisdiction to provide a paid sick leave benefit to their workers.

Among working parents, a higher share of mothers than fathers report they are the ones that care for children when they are too sick to attend school. In addition to taking leave after the arrival of a child, many parents need to take time off when their children are sick and cannot attend school. Among working women, over half (58%) say they are the ones who usually take care of children when they are sick and cannot go to school, nearly three times the share of working fathers (20%) (Figure 6). One fifth (21%) of working mothers and three in ten working fathers (32%) say they share this responsibility equally with a spouse, partner, or co-parent. Only about one in ten (9%) working mothers say their spouse, partner, or co-parent usually takes on this responsibility, whereas this is the most common response among fathers (34%). Just over one in ten mothers (12%) and fathers (14%) say they can call someone else for childcare or their child can stay home alone. These numbers have remained steady over time and are similar to findings in 2022.

About half of working mothers report losing pay when they miss work to care for sick children who can’t go to school. When parents miss work to take care of their sick children, 53% of mothers and 38% of fathers say they are not paid for that time (Figure 7). This has a disproportionate impact on mothers, as they are more likely to care for children when they are sick.

Loss of pay is more common among women who are Black (62%) and Hispanic (65%), compared to those who are White (50%). Approximately three in four (76%) mothers with low incomes report losing pay when they miss work to care for sick children, compared to four in ten of those with higher incomes (41%).

The 2026 KFF Women’s Health Survey was designed and analyzed by women’s health researchers at KFF. The survey was conducted from March 11 – April 14, 2026, online and by telephone among a nationally representative sample of 5,854 adults ages 18 to 64, including 3,538 women ages 18 to 49. Women include anyone who selected woman as their gender. Sampling, data collection, weighting, tabulation, and IRB approval by the University of Southern Maine’s Collaborative Institutional Review Board were managed by SSRS of Glenn Mills, Pennsylvania in collaboration with women’s health researchers at KFF.

Throughout the reports of findings, we refer to “women.” This includes respondents who said their gender is “woman,” and includes those who selected “woman” in addition to another gender, such as “transgender,” or “non-binary,” or another gender. We followed this approach to try to include as many people as possible but recognize that some people who need and seek abortion and other reproductive health care services may not be represented in the findings or identify as women. Some questions about sexual and reproductive health were only asked among those with a specific sex assigned at birth (i.e. male or female).

The national sample was drawn from two nationally representative probability-based panels: the SSRS Opinion Panel and the Ipsos Knowledge-Panel. The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG) through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to five reminder emails. 5,660 panel members completed the survey online and panel members who do not use the internet were reached by phone (n=194). Another 514 respondents were reached online through the Ipsos Knowledge Panel to help reach adequate sample sizes among subgroups of interest, specifically women ages 18 to 49. This panel is recruited using ABS, based on a stratified sample from the CDS. The questionnaire was translated into Spanish, so respondents were able to complete the survey in English or Spanish.  

The national sample was weighted by splitting the sample into three groups: [1] Women 18-49, [2] Women 50-64, and [3] Men 18-64 and each group was separately weighted to match known population parameters (see table below for weighting variables and sources). Weights within the three groups were then trimmed at the 4^th and 96^th percentiles, to ensure that individual respondents do not have too much influence on survey-derived estimates. After the weights were trimmed, the samples were combined, and the weights adjusted, so that the groups were represented in their proper proportions for a final combined, gender by age-adjusted weight.

The margins of sampling error for the national sample of women ages 18 to 64 and reproductive age women ages 18 to 49 are plus or minus 2 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this survey.

General Notes:

• Percentages may not add to 100%, or to subtotals indicated, due to rounding.
• The “No answer” category includes refusals and those who volunteered “don’t know” responses.
• The “Not sure” or “Don’t know” categories are only shown in tables when it was an explicit response option (i.e., shown on web or read via telephone) for survey respondents.
• A category with ‘(VOL.)’ signifies a response option was not shown or read via telephone for survey respondents.
• Insufficient sample size for analysis is denoted with “n/a” (e.g, FER4a). The sample size itself is shown, but the percentages are not.
• Some survey questions were asked of males and females based on sex assigned at birth, which is shown in the base text above each question. However, the topline tables show results based on current gender identity.
• Income is based on 2023 ASPE income levels. Two hundred percent (200%) of the federal poverty level (FPL) in 2023 for an individual was $29,160.
• The sample primarily includes English-speaking Asian adults and, therefore, may not be representative of the overall Asian adult population. Despite this limitation, it is important to report the views of Asian adults on the topics in this study. As always, Asian adults’ responses are incorporated into the general population figures throughout this report.

The high costs of in vitro fertilization (IVF), limited insurance coverage for fertility services, and intersection with state level abortion laws and fetal personhood policies have brought the issue of access to fertility care into the policy spotlight. President Trump has stated that he wants to make fertility care more affordable and said he would institute an insurance coverage mandate as part of his campaign promises.  There is currently no federal requirement for insurance coverage of fertility services, and the Trump administration has not issued a proposal for one.  Recently, the Trump Administration advanced a policy that offers a discount on some IVF medications for people without coverage through the TrumpRx website and clarified regulations about insurance options for employers to encourage them provide fertility benefits to those covered in their employer-sponsored health insurance policies. However, the Administration’s actions to date are likely to provide limited assistance for people seeking IVF services who have gaps in coverage and who are struggling to afford the costs.  While several states have enacted laws requiring some level of fertility coverage in state-regulated plans, these laws have limited reach and only affect a minority of people with private insurance coverage given that most people with employer coverage are in self-insured plans.

To understand the need for and barriers to fertility services, the 2026 KFF Women’s Health Survey included questions on fertility care. The nationally representative survey was conducted from March 11, 2026 to April 14, 2026, online and by telephone. This analysis presents survey findings among women ages 18 to 49 (n=3,538) on their reported need for and use of fertility services.

• Fifteen percent (15%) of reproductive age women say they or their partner have ever needed fertility services to help them become pregnant or prevent a miscarriage. However, not all actually received services. One in ten (11%) women ages 18 to 49 say they or their partner received fertility assistance, but a quarter of these women (3% of all reproductive age women) say they were unable to get the fertility care they needed.
• The fertility services that reproductive age women most commonly use are fertility advice, fertility testing, and medications to improve ovulation. Only a fraction of this population say they have used IVF.  Among women who say they or their partner ever needed fertility care, almost half (46%) say they received advice and 39% say they received testing services. As far as treatments, one-third (34%) say they have received drugs for ovulation. Thirteen percent (13%) of reproductive age women who say they or their partner ever needed fertility care report they received IVF, and 16% report they received artificial insemination (IUI), which translates to 2% of all reproductive age women who report ever receiving either service.
• Cost is a major barrier to the receipt of fertility services for those who need them. Use of all fertility services is more common among women with higher incomes; among women who say they did not receive needed fertility care, the leading reason is cost. For example, among reproductive age women who say they or their partner have needed fertility assistance, 17% with higher incomes say they received IVF compared to just 3% of women with low incomes. Larger shares of women with low incomes report cost as the main barrier compared to those with higher incomes.

Need for Fertility Care and Cost Barriers 

Approximately one in seven women ages 18 to 49 say they or their partner needed fertility assistance services at some point. Nationally, 15% of reproductive age women report needing fertility services to become pregnant or prevent a miscarriage at some time in their lives (Figure 1). The share reporting need increases with age, as fertility declines. Just over one in ten (12%) women ages 18 to 35 say they needed fertility services at some point, compared to 19% of women ages 36 to 49. 

The reported need for fertility care is similar across most other demographic groups, except slightly lower among Black women (11%) compared to their White counterparts (17%). Nationally, 12% of women with lower incomes say they have needed fertility services, compared to 17% of women with higher incomes.  About one in ten women with Medicaid coverage (11%) or who are uninsured (11%) say they have needed fertility services, lower than women with private insurance (17%). While the survey does not find differences across party lines of women reporting needing fertility care at some point, slightly more women who identify as pro-life (17%) say they or their partner has needed fertility services than women who are pro-choice (14%). Higher shares of women who identify as Protestants (16%) or Catholic (16%) report ever needing fertility assistance compared to those who do not follow a particular religion (11%).

Among all reproductive age women, about one in ten (11%) say they or their partner have received fertility services at some point.  Another 3% say they needed services but were not able to obtain them (Figure 2). While a relatively small share of women say they could not obtain fertility services, they may not be able to grow their families as desired because they could not afford the care they needed to get pregnant. Most reproductive age women (85%) say they have never needed fertility services (includes women who have not yet tried to become pregnant as well as women who do not want to have children).

Most women who say they needed fertility services received them, but the leading reason why women say they didn’t get needed fertility services is cost.   Not surprisingly, cost barriers are more common among women with lower incomes.

There are many obstacles to receiving fertility care, including costs, coverage, provider availability, and health status. However, cost is by far the single largest barrier. Among reproductive age women who reported needing fertility services at some point, 25% (3% of all reproductive age women) say they did not receive these services and cost was the primary barrier.

Among the 15% of women who said they ever needed fertility services, one in five (21%) with lower incomes (21%) cite cost as the main reason they could not obtain fertility services, compared to 13% of women with higher incomes (Figure 3). Overall, this represents 3% of all reproductive age women with low incomes and 2% of those with higher incomes who say they did not obtain fertility services because of cost.  

Coverage for fertility services is limited in both private insurance and Medicaid. The 2024 KFF Employer Health Benefits Survey found that about a quarter (27%) of large firms that offer health benefits cover IVF services. Some states require state-regulated private insurers – which do not include self-insured employer plans -- to cover some level of fertility services. Medicaid, the health coverage program for people with lower incomes, rarely covers fertility services. In fact, federal law exempts state Medicaid programs from a requirement to cover fertility medications, which is different from most other outpatient prescription drugs that are typically covered by the program.

Types of Fertility Services

The leading fertility services that women report receiving are advice, testing, and drugs to improve ovulation.

Fertility assistance encompasses a broad array of services, including advice and counseling, medications, surgical procedures, diagnostic tests, imaging studies, cryopreservation, intrauterine insemination (IUI), in-vitro fertilization (IVF), and surrogacy. Depending on individual circumstances, people may use a variety of these services to become pregnant and/or to prevent miscarriages, particularly if they have a history of or are at higher risk for pregnancy loss. The costs of services vary widely, ranging from a few hundred dollars for diagnostic tests and medications to upwards of $25,000 for one cycle of IVF, and some patients may need multiple cycles before they get pregnant.

Among the 15% of reproductive age women who ever needed fertility services, almost half said they received advice (46%). Four in ten said they received testing for themselves or their partner (39%), and about one-third (34%) obtained medications (e.g. clomid, hormones, etc.) to improve ovulation (Figure 4). One in ten (10%) women said they had a corrective surgery or used medications to address an issue that make getting pregnant or carrying a pregnancy difficult such as fibroids or endometriosis.

Among reproductive age women who said they or their partner ever needed fertility services, 13% report they received IVF and 16% report they received artificial insemination, also known as IUI. This translates to 2% of all reproductive age women who report receiving either IVF or IUI.

IVF is a costly medical procedure where eggs are removed from the ovary and are fertilized with sperm in a lab setting to create an embryo, which is then placed in the uterus. Artificial insemination, also known as Intrauterine insemination (IUI) is another fertility procedure that involves injecting sperm into the uterus. It is less invasive and less expensive than IVF and is often selected for those reasons.

While a relatively small share of people ever use IVF or IUI, many seek these services after trying a range of other services to get pregnant, such as medications, acupuncture, and surgeries.

Smaller shares of women with lower incomes report receiving fertility services.

A smaller share of women with low incomes report that they obtained fertility services. This is the case for diagnostic services such as fertility advice and testing as well as treatments, including ovulation drugs. For IVF, the most intensive and expensive service, 17% of women with higher incomes who needed fertility assistance obtained IVF, compared to 3% of women with low incomes (Figure 5).

The 2026 KFF Women’s Health Survey was designed and analyzed by women’s health researchers at KFF. The survey was conducted from March 11 – April 14, 2026, online and by telephone among a nationally representative sample of 5,854 adults ages 18 to 64, including 3,538 women ages 18 to 49. Women include anyone who selected woman as their gender. Sampling, data collection, weighting, tabulation, and IRB approval by the University of Southern Maine’s Collaborative Institutional Review Board were managed by SSRS of Glenn Mills, Pennsylvania in collaboration with women’s health researchers at KFF.

Throughout the reports of findings, we refer to “women.” This includes respondents who said their gender is “woman,” and includes those who selected “woman” in addition to another gender, such as “transgender,” or “non-binary,” or another gender. We followed this approach to try to include as many people as possible but recognize that some people who need and seek abortion and other reproductive health care services may not be represented in the findings or identify as women. Some questions about sexual and reproductive health were only asked among those with a specific sex assigned at birth (i.e. male or female).

The national sample was drawn from two nationally representative probability-based panels: the SSRS Opinion Panel and the Ipsos Knowledge-Panel. The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG) through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to five reminder emails. 5,660 panel members completed the survey online and panel members who do not use the internet were reached by phone (n=194). Another 514 respondents were reached online through the Ipsos Knowledge Panel to help reach adequate sample sizes among subgroups of interest, specifically women ages 18 to 49. This panel is recruited using ABS, based on a stratified sample from the CDS. The questionnaire was translated into Spanish, so respondents were able to complete the survey in English or Spanish.  

The national sample was weighted by splitting the sample into three groups: [1] Women 18-49, [2] Women 50-64, and [3] Men 18-64 and each group was separately weighted to match known population parameters (see table below for weighting variables and sources). Weights within the three groups were then trimmed at the 4^th and 96^th percentiles, to ensure that individual respondents do not have too much influence on survey-derived estimates. After the weights were trimmed, the samples were combined, and the weights adjusted, so that the groups were represented in their proper proportions for a final combined, gender by age-adjusted weight.

The margins of sampling error for the national sample of women ages 18 to 64 and reproductive age women ages 18 to 49 are plus or minus 2 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this survey.

General Notes:

• Percentages may not add to 100%, or to subtotals indicated, due to rounding.
• The “No answer” category includes refusals and those who volunteered “don’t know” responses.
• The “Not sure” or “Don’t know” categories are only shown in tables when it was an explicit response option (i.e., shown on web or read via telephone) for survey respondents.
• A category with ‘(VOL.)’ signifies a response option was not shown or read via telephone for survey respondents.
• Insufficient sample size for analysis is denoted with “n/a” (e.g, FER4a). The sample size itself is shown, but the percentages are not.
• Some survey questions were asked of males and females based on sex assigned at birth, which is shown in the base text above each question. However, the topline tables show results based on current gender identity.
• Income is based on 2023 ASPE income levels. Two hundred percent (200%) of the federal poverty level (FPL) in 2023 for an individual was $29,160.
• The sample primarily includes English-speaking Asian adults and, therefore, may not be representative of the overall Asian adult population. Despite this limitation, it is important to report the views of Asian adults on the topics in this study. As always, Asian adults’ responses are incorporated into the general population figures throughout this report.