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Using Medicare Advantage encounter data, this analysis finds that 62% of Medicare Advantage enrollees have at least one chart review record and that diagnoses added from chart reviews increase payments from CMS to insurers for 17% of enrollees. The use of chart reviews varies across the largest Medicare Advantage insurers.
This 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.
To understand the role of Medicare Part D stand-alone prescription drug plans in serving rural Medicare beneficiaries, this data note analyzes 2025 Part D enrollment in PDPs and Medicare Advantage drug plans by geographic area nationally and at the state level.
In a new analysis, KFF finds that 3.6 million people with Medicare could be eligible for coverage of Wegovy (semaglutide) now that the Food and Drug Administration has approved the use of the anti-obesity drug to reduce the risk of heart attacks and stroke in certain patients. This change potentially allows access to Wegovy for just over 1 in 4 of the 13.7 million people on Medicare diagnosed with obesity or overweight, based on data…
Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans, including stand-alone prescription drug plans and Medicare Advantage plans that offer drug coverage. This analysis provides an overview of Medicare Part D plan availability, premiums, and cost sharing in 2025 and key trends over time.
To capture Medicare beneficiaries’ views and experiences in choosing between traditional Medicare and private plans, and among private plans, and the factors that influence these decisions, KFF worked with PerryUndem to conduct focus groups with Medicare beneficiaries in the Fall of 2022, during the annual Medicare open enrollment period. This report summarizes first-hand accounts of participants’ reactions open enrollment advertising and factors that influence their decision-making around Medicare plan choice.
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.
This analysis provides the latest data about Medicare Part D enrollment, premiums, and cost sharing in 2022 and trends over time, including information about stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans.
Medicare Consumer-Directed Health Plan: Medicare MSAs and HSA-like Plans in 2007 This March 2007 issue brief, commissioned by the Kaiser Family Foundation, examines the development of consumer-directed health plans in the Medicare program. Medicare Medical Savings Account plans have high deductibles accompanied by a personal savings account that can be used to pay for medical expenses. The paper examines how such plans operate in Medicare, how they differ from other types of Medicare Advantage plans…
Based on interviews with senior executives at 14 large firms, the issue brief finds that insurers anticipate continuing to offer Medicare Advantage plans in 2012, in part because of a Medicare demonstration project that will award bonus payments to plans based on their quality standards. A companion issue brief examines trends in Medicare Advantage enrollment in 2011. The analysis was conducted by researchers at Mathematica Policy Research, Inc. and the Kaiser Family Foundation. Issue Brief…
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