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If you switch from a Medicare Advantage plan to traditional Medicare and you want drug coverage, you can sign up during the Medicare Open Enrollment period for a stand-alone prescription drug plan in your area. Your new coverage will take effect on January 1.
On July 4, President Trump signed the budget reconciliation bill, previously known as the “One Big Beautiful Bill Act,” into law. This summary provides background, description, budgetary impact and related information on the health care provisions of the law in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).
Ahead of the Trump administration’s planned expansion of Medicare coverage for GLP-1s to treat obesity through temporary models and the availability of Medicare’s negotiated price for certain GLP-1 products beginning in 2027, this analysis examines CMS’s Medicare Part D claims data from 2019 to 2024 to document the increase in the number of beneficiaries being treated with GLP-1 drugs and the growth in Medicare spending and claims for these drugs.
This issue brief explains the rules for private insurance coverage of contraceptives at the federal and state level, the exemptions and accommodations available for certain employers, gaps in coverage for contraceptives obtained outside of the traditional clinical setting, and how changes in the agencies responsible for making contraceptive recommendations may affect coverage for contraceptives.
There is some overlap in the enrollment periods for Medicare and the Marketplaces, but they are not the same. The Medicare Open Enrollment period runs from October 15 through December 7 each year.
This Health Policy 101 chapter provides an overview of the Affordable Care Act (ACA), a major reform of the U.S. health care system aimed at reducing high uninsured rates and alleviating issues like high out-of-pocket costs and coverage exclusions for preexisting conditions. The ACA significantly altered many aspects of the health system and the chapter explores its mechanisms, such as the Health Insurance Marketplaces, and the evolution of the law since its passage in 2010 to the changes in the 2025 budget reconciliation law.
Semaglutide…has been selected for the second round of Medicare drug price negotiation…Many people are familiar with Ozempic and other drugs like it, use of these drugs has expanded rapidly in recent years, and the list price is high. All of that could focus more attention on this year’s drug price negotiation process….
In choosing among the many Medicare Advantage plans, it is useful to think about what’s most important to you in a health plan.
This issue brief provides an overview of the potential impact not extending enhanced ACA premium tax credits could have on people with HIV and the Ryan White HIV/AIDS Program. Enhanced credits have improved insurance coverage affordability for millions of people, including those with HIV. People with HIV may be particularly vulnerable, given that they are more likely to have Marketplace plans and many also rely on the federally-funded Ryan White HIV/AIDS Program to help cover plan costs. Loss of coverage and increased costs could lead to disruptions in care for people with HIV which could have serious implications for individual and public health.
Yes, you are eligible to purchase coverage through the Marketplace, and if your expected income is at least 100% of the federal poverty level in 2026 ($15,650 for an individual) you may qualify for premium tax credits to help make Marketplace coverage more affordable.
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