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  • Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage

    Issue Brief

    This analysis builds on our prior work – Medicare and Dental Coverage: A Closer Look – by analyzing hearing and vision use, out-of-pocket spending and cost-related barriers to care among Medicare beneficiaries as well as hearing and vision benefits in Medicare Advantage plans. It also incorporates top-level findings from the analysis of dental services to provide a comprehensive profile of dental, hearing, and vision benefits in Medicare.

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

    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.

  • Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024

    Issue Brief

    Nearly 53 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2024, of which 4.1 million (7.7%) were denied. Just 11.5% of denied requests were appealed, though 80.7% of appeals overturned the initial denial in Medicare Advantage. Substantially fewer prior authorization requests were made in traditional Medicare, reflecting the small number of services subject to prior authorization requirements.

  • Analyzing Changes in Medicare Part D Enrollment for 2026

    Issue Brief

    The Medicare Part D prescription drug benefit is provided by private plans, either Medicare Advantage plans that offer drug coverage (MA-PDs) or, for those in traditional Medicare, stand-alone prescription drug plans (PDPs). New data from CMS shows that 56 million people are enrolled in Part D plans as of February 2026, with more in MA-PDs than PDPs, reflecting higher overall enrollment in Medicare Advantage than in traditional Medicare. Enrollment in group MA-PD plans decreased while…

  • Medicare 101

    Feature

    This Health Policy 101 chapter explores Medicare, a federal health insurance program covering more than 68 million people, established in 1965 for people age 65 or older and later expanded to cover people under age 65 with long-term disabilities. In addition to detailing Medicare eligibility, coverage, and spending, the chapter examines the increased role of private plans in providing benefits and the financing challenges posed by increasing health care costs and an aging population.

  • 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

    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.

  • How Much Do People with Medicare Pay for Coverage?

    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

    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.