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  • 3 Charts: Medicare Drug Price Negotiations

    News Release

    Under the Inflation Reduction Act, the federal government for the first time will negotiate directly with drug companies to determine the prices that Medicare will pay for certain high expenditure drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). Part D covers retail prescription drugs and Part B covers physician-administered medications. This new requirement is the culmination of years of debate among lawmakers in Congress, and the Centers for…

  • I am age 60 and have been receiving Social Security disability insurance (SSDI) payments for two years. My Medicare coverage just started and I would like to get a Medicare supplement insurance policy....

    FAQs

    It depends on the state where you live. Some states require insurance companies to sell Medigap supplement policies to people under age 65, but not all states do. Insurance companies may still voluntarily sell Medigap policies to people under age 65, even in states that do not require insurance companies to sell Medigap policies to people under age 65. However, premiums may be much higher than premiums for people ages 65 and older. If you…

  • Can I change my Medicare coverage outside of the Medicare Open Enrollment period?

    FAQs

    You can, but generally only under special circumstances that qualify you for a Special Enrollment Period (SEP). These circumstances include (but are not limited to) moving to a new location that is outside of your current plan’s service area or where additional plan options are available, moving back into the U.S. after living abroad, moving into or out of a facility, termination of Medicaid eligibility, if Medicare terminates your current Medicare Advantage plan, or if…

  • The Facts About the $35 Insulin Copay Cap in Medicare

    Policy Watch

    This brief describes the facts about actions taken under both the Trump and Biden Administrations related to capping insulin copayments for people with Medicare and explains the differences between their approaches.

  • I have Medicare Part A and Part B. I’ve heard about Part C and Part D, but I don’t know what those are. Do I need to sign up for those during the Medicare Open Enrollment period?

    FAQs

    Medicare Part C plans, also known as Medicare Advantage plans, are private health insurance plans, mainly HMOs and PPOs, for people enrolled in Medicare. If you enroll in a Medicare Advantage plan, you still have Medicare, but you get all of your Medicare-covered benefits through a private plan. Most Medicare Advantage plans also cover prescription drugs and most also cover other services, such as vision, dental, and hearing benefits. If you have Part A and…

  • When Is the Open Enrollment period for Medicare? What changes can I make to my Medicare coverage during this time?

    FAQs

    The Medicare Open Enrollment period runs from October 15 through December 7 each year. During this period, you can make many changes to your Medicare coverage, depending on the coverage you already have. You can change from traditional Medicare to a Medicare Advantage plan (or vice versa). If you prefer Medicare Advantage, you can choose among the Medicare Advantage plans offered in your area during this period. If you are in traditional Medicare, and want…

  • What to Know About Medicare Part D Premiums

    Issue Brief

    Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.

  • Medicaid Enrollment & Spending Growth: FY 2025 & 2026

    Issue Brief

    This brief analyzes Medicaid enrollment and spending trends for FY 2025 and FY 2026, based on data provided by state Medicaid directors as part of the 25th annual survey of Medicaid directors.

  • 5 Key Facts About Medicaid and Veterans

    Issue Brief

    Medicaid helps fill gaps in coverage for veterans who are low-income, have disabilities, or are otherwise ineligible for military health benefits. It supports those with complex health needs and reduces out-of-pocket expenses. This brief presents five key facts about veterans with Medicaid and how policy changes in Congress could affect their coverage and access to care.