Program on Medicare Policy Archives

More Than 4 Million Medicare Beneficiaries Will Have Their Medicare Advantage or Stand-Alone Prescription Drug Plan Terminated at the End of 2026

Oct 27, 2026

Issue Brief

Data from the Centers for Medicare & Medicaid Services (CMS) shows that 4.3 million Medicare beneficiaries, including 3.1 million Medicare Advantage drug plan enrollees and 1.2 million PDP enrollees, will have their plan terminated at the end of 2026. An additional 1.4 million Medicare Advantage enrollees are in a plan that is consolidating with another plan offered by the same insurer.

Nearly Three-Quarters of Medicare Advantage Enrollees Could be Denied a Medigap Policy Due to a Pre-Existing Condition

Oct 13, 2026

Issue Brief

This analysis examines the share of Medicare Advantage enrollees who have a pre-existing condition that could result in a Medigap denial if they seek to switch to traditional Medicare outside their one-time 12-month trial period, including national estimates and estimates by age and by state. KFF finds that nearly three-quarters of Medicare Advantage enrollees (74%) or 20.9 million people in 2023 had a pre-existing medical condition identified from KFF’s review of Medigap applications that could…

Medigap Guaranteed Issue Requirements: An Overview of Federal and State Rules

Oct 13, 2026

Issue Brief

This issue brief analyzes federal and state rules related to guaranteed issue requirements for Medigap policies and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing medical conditions and those under age 65 with long-term disabilities.

Key Facts About Medigap Enrollment and Premiums for Medicare Beneficiaries

Oct 13, 2026

Issue Brief

This brief presents facts about Medigap, including the characteristics of Medicare beneficiaries with a Medigap policy, variation in Medigap enrollment by state, and Medigap premiums.

How Much Do People with Medicare Pay for Coverage?

Oct 9, 2026

Issue Brief

While Medicare covers a wide range of health care services, Medicare beneficiaries generally pay out-of-pocket for their monthly premiums, deductibles, and cost sharing for Medicare covered services. This brief provides an overview of the costs faced by Medicare beneficiaries in traditional Medicare, Medicare Advantage, and Medicare Part D, including premiums, deductibles, copays, and coinsurance, focusing on costs in 2026.

Medicare Advantage Plan Availability Varies Widely by County for 2027

Oct 9, 2026

Issue Brief

The analysis shows that plan level Medicare Advantage prescription drug availability varies widely across the country in 2027, with a modest reduction in the share of enrollees having more than 40 MA-PDs to choose from compared to 2026, and some major insurers exiting a much larger number of counties than they are entering.

Medicare Open Enrollment and Coverage Options: Key Questions and Answers

Oct 9, 2026

Issue Brief

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.

Many Medicare Part D Stand-Alone Drug Plan Enrollees Will See Modest Premium Increases for 2027, But Others Could Pay Much More If They Don’t Switch Plans

Oct 2, 2026

Issue Brief

This brief analyzes the Medicare Part D stand-alone prescription drug plan (PDP) market for 2027. The analysis shows that there will be a modest reduction in the number of PDPs for 2027, along with modest premium increases less than $10 per month for many enrollees, but much larger monthly premium increases of $50 or more for others if they don’t change plans.

The Average Medicare Beneficiary has 28 Medicare Advantage Prescription Drug Plan Options for 2027

Oct 1, 2026

Issue Brief

The average Medicare beneficiary will have 28 Medicare Advantage prescription drug (MA_PD) plans available for general enrollment in 2027. The number of plans varies widely across states.

Prior Authorization Metrics Provide New Insights into Insurer Practices, but Gaps Remain

Aug 13, 2026

Issue Brief

This analysis of available 2025 prior authorization data finds insurers denied at least 1 in 8 standard requests for prior authorization across three insurance markets: Medicare Advantage, Medicaid managed care, and the federally facilitated ACA Marketplaces. Denial rates varied wide segments by insurer. The analysis highlights limitations of the data and challenges for consumers interpreting it.

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