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Is the Medicare Open Enrollment period the same as the Marketplace Open Enrollment period? Can I buy Medicare and Medigap plans through the Marketplace?

Sep 1, 2025

FAQs

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. For Marketplace coverage in 2026, the open enrollment period will run from November 1, 2025 through January 15, 2026 in states that use the Healthcare.gov website; states that run their own marketplaces may have a longer open enrollment period for 2026. If…

I am 54 and living with a permanent disability, and for the past 12 months I have been receiving Social Security disability insurance (SSDI) payments. But I do not have health insurance. I am required t...

Sep 29, 2025

FAQs

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. If you live in a state that has expanded its Medicaid program to cover adults under age 65 with incomes up to 138% of poverty (about $1,800 per month for an…

There are a lot of Medicare Advantage plan options in my area. How do I decide which plan is best for me?

Sep 1, 2025

FAQs

In choosing among the many Medicare Advantage plans, it is useful to think about what’s most important to you in a health plan. If you feel strongly about getting care from specific doctors and hospitals, it would be a good idea to review the provider directories of each Medicare Advantage plan to be sure the hospitals, doctors, and other health professionals that matter most to you are in the plan network. If you are most…

Medicaid Enrollment & Spending Growth: FY 2024 & 2025

Oct 23, 2024

Issue Brief

This brief analyzes Medicaid enrollment and spending trends for FY 2024 and FY 2025, based on data provided by state Medicaid directors as part of the 24th annual survey of Medicaid directors.

Updated Health Spending Explorer Features the Latest National Data on How Much People Spend and Who Pays the Bills

Dec 15, 2023

News Release

The latest data on U.S. health spending are now available on the Health Spending Explorer, an interactive tool that allows users to explore trends in health spending by federal and local governments, insurers, nursing care, hospital, and other service providers, and consumers. The tool captures just-released 2022 data from the federal government, when national health expenditures totaled nearly $4.5 trillion. Overall spending rose 4.1% in 2022, with almost all categories of health spending experiencing growth.…

Overall Satisfaction with Medicare is High, But Beneficiaries Under Age 65 With Disabilities Experience More Insurance Problems Than Older Beneficiaries

Oct 26, 2023

Issue Brief

This brief analyzes data from the 2023 KFF Survey of Consumer Experiences with Health Insurance to get a current understanding of how Medicare is working for older adults and younger people with disabilities. The analysis shows that people with Medicare who are under 65 with disabilities experience more problems using their Medicare coverage, including access and cost-related problems, than beneficiaries who are 65 and older.

How Recent Manufacturer Savings Programs May Impact Individual Out-of-Pocket Spending on Asthma and COPD Inhalers

Aug 11, 2025

Issue Brief

A new analysis shows that individuals with employer insurance could save 41% on their out-of-pocket spending for asthma and COPD inhalers through manufacturer savings. In response to a U.S. Senate investigation into inhaler costs, 3 drug makers voluntarily capped out-of-pocket costs on their brand-name asthma and COPD inhalers.

People with Medicare Will Face Higher Costs for Some Orphan Drugs Due to Changes in the New Tax and Budget Law

Oct 20, 2025

Issue Brief

This brief analyzes changes in the new tax and budget reconciliation law that modify which drugs will be selected for Medicare drug price negotiation, which will lead to higher Medicare spending and higher costs for beneficiaries who take these medications.

Decoding Medicare Advantage Coding Intensity

Jul 1, 2026

Issue Brief

Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.

Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries

Oct 27, 2025

Issue Brief

Medicare Advantage enrollees were in a plan that included just under half (48%) of all physicians available to traditional Medicare beneficiaries in their area in 2022, on average. The limitations of provider networks illustrate one of the key tradeoffs for beneficiaries in choosing Medicare Advantage for their coverage.

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