Medicare Program Integrity and Efforts to Root Out Improper Payments, Fraud, Waste and Abuse
This brief explains fraud, waste, abuse, and improper payments in Medicare and describes actions to ensure Medicare program integrity.
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Is Medicare’s New Provider Search Tool a Step in the Right Direction?
Quick TakeThe new provider search tool on the Medicare Plan Finder could make it easier for beneficiaries to figure out if their doctors are in a Medicare Advantage plan's network despite some data issues.
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Medicare Part D Premiums Are Decreasing for Many Stand-Alone Drug Plans in a Number of States in 2026
Issue BriefThis brief looks at premium changes for Medicare Part D stand-alone prescription drug plans between 2025 and 2026. For plans that were offered nationwide in 2025 and will continue to be offered in 2026, Part D enrollees in many states will see lower monthly premiums in 2026.
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Medicare Advantage in 2025: Enrollment Update and Key Trends
Issue BriefIn 2025, more than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans. This brief provides current information about Medicare Advantage enrollment, by plan type and firm, and shows how enrollment varies by state and county.
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Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
Issue BriefThis brief provides information about Medicare Advantage plans in 2025, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
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KFF Health Tracking Poll: Public Finds Prior Authorization Process Difficult to Manage
FeatureFollowing a pledge by insurance companies to reduce the burden of prior authorizations, KFF's Health Tracking Poll examines the publics experience with the process. The poll finds that most view insurers' delays and denials as a problem, and few are aware of the newly announced pledge.
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Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2025
Issue BriefThe Medicare Part D program provides an outpatient prescription drug benefit to more than 50 million older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits. This brief analyzes Medicare Part D enrollment and costs in 2025 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS).
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The Uncertain Future of Medicare’s Stand-Alone Prescription Drug Plan Market and Why It Matters
Issue BriefThis brief focuses on the stand-alone Medicare Part D prescription drug plan marketplace and its somewhat uncertain future, in light of recent trends in plan availability and the potential for another year of premium increases in 2026, in part depending on what the Trump administration decides to do with the temporary Part D premium stabilization demonstration. The brief explains why the stability of the PDP market matters, both for people in traditional Medicare who want prescription drug coverage but also for the viability of traditional Medicare as an option vis a vis Medicare Advantage.
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Most Medicare Advantage Markets are Dominated by One or Two Insurers
Issue BriefHigher market concentration in Medicare Advantage insurance markets may lower the incentive for insurers to compete for potential enrollees by making plans more appealing through more comprehensive benefits or lower costs.
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Medigap May Be Elusive for Medicare Beneficiaries with Pre-Existing Conditions
Issue BriefThis issue brief analyzes federal and state guaranteed issue rules and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing conditions and those under age 65 with long-term disabilities. This brief also explores a recently finalized rule: Nondiscrimination in Health Programs and Activities regarding Section 1557 of the Affordable Care Act that may have implications for the Medigap market.