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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KFF Research Shows that Medicare Open Enrollment TV Ads Are Dominated by Medicare Advantage Plans Featuring Celebrities, Active and Fit Seniors, and Promises of Savings and Extra Benefits Without Fundamental Plan Information
News ReleaseThe annual blitz of ads for Medicare Advantage plans has become a rite of fall, as health insurers, brokers and other third parties seek to court enrollees for these private plans, which are offered to the 65 million people with Medicare during the program’s open enrollment season.
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What to Know About the Medicare Open Enrollment Period and Medicare Coverage Options
Issue BriefEach year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.
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A Closer Look at the Growing Role of Special Needs Plans in Medicare Advantage
Issue BriefTo better understand the growing role of Special Needs Plans (SNPs) in Medicare Advantage, this brief examines SNP enrollment trends using recent Medicare Advantage enrollment data published by the Centers for Medicare and Medicaid Services (CMS).
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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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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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Medicare Advantage Quality Bonus Payments Will Total at Least $12.7 Billion in 2025
Issue BriefFederal spending on the Medicare Advantage quality bonus program has more than quadrupled since 2015, rising to at least $12.7 billion in 2025. Most Medicare Advantage enrollees are in a plan that receives a bonus payment in 2025, with employer- and union-sponsored plans receiving the highest bonus payments and special needs plans receiving the lowest bonus payments, on average.
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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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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.