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Medicare Open Enrollment

Part D Premiums and Cost Sharing in 2027

The average monthly premium for Medicare Part D coverage in stand-alone prescription drug plans (PDPs) will increase to $51 in 2027, up 50% from $34 in 2026, if current enrollees don’t switch into lower-premium plans during the open enrollment period. That is more than five times higher than the drug coverage premium in Medicare Advantage plans that offer Part D coverage, which is projected to average $9 per month in 2027. Most Part D enrollees also will face a deductible of several hundred dollars for drug coverage in 2027.

Also: Many Medicare Part D Stand-Alone Drug Plan Enrollees Will See Modest Premium Increases for 2027

Medicare Open Enrollment and Coverage Options: Key Questions and Answers

Each 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, which runs from October 15 through December 7. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

NEW AND NOTEWORTHY

How Much Do People With Medicare Pay For Coverage?

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.

What’s in a Name? From Today’s Medicare to Medicare for All

KFF’s Larry Levitt explains how proposals to create Medicare-for-All promise more generous benefits than the existing Medicare program, with no premiums or cost-sharing, but could end up looking more like Medicare if it became the subject of a serious national debate about the tradeoffs involved to implement it.

Medigap

Medigap Guaranteed Issue Requirements: An Overview of Federal and State Rules

This issue brief analyzes federal and state rules related to guaranteed issue requirements for Medigap policies and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing medical conditions and those under age 65 with long-term disabilities.

MEDICARE PART D

Medicare Advantage

The Average Beneficiary has 28 Medicare Advantage Prescription Drug Plan Options for 2027

On average, Medicare beneficiaries will have the option of 28 Medicare Advantage prescription drug (MA-PD) plans in 2027, a decline from the 32 options available in 2026 (excluding employer plans and special needs plans not available for general enrollment).
The number varies across states. In 26 states and Puerto Rico, the average beneficiary has at least 20 MA-PD options in 2027, while in nine states and DC, the average beneficiary has fewer than 10 MA-PD options. Open enrollment runs from October 15 through December 7.

Medicare Advantage in 2026: Enrollment Update and Key Trends

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

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

Medicare Will Spend More Than $13 Billion on the Medicare Advantage Quality Bonus Program in 2026

Prescription Drugs

CMS’s Decision to End Temporary Subsidies to Medicare’s Stand-Alone Drug Plans Could Mean Larger Premium Increases for Some Beneficiaries Next Year

The Centers for Medicare & Medicaid Services (CMS) plans to end the temporary Part D Premium Stabilization Demonstration after 2026. The goal of the demonstration, established in 2024, was to stabilize stand-alone prescription drug plan (PDP) premiums and enrollment amid the rollout of changes to the Part D benefit under the Inflation Reduction Act, including a new cap on annual out -of-pocket drug costs.

Key Facts About Medicare Drug Price Negotiation

Recent Trends in GLP-1 Use and Spending in Medicare

What to Know About Pharmacy Benefit Managers (PBMs) and Federal Efforts at Regulation

Nearly Four Million Medicare Beneficiaries Met the Eligibility Criteria in 2023 for the Medicare GLP-1 Bridge

Data Visualization

The Facts About Medicare Spending

This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs. Explore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.

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  • Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

    Issue Brief

    This brief commissioned by the Foundation examines factors that contributed to Medicare's lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program's design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market…

  • Federal Funding Under the Affordable Care Act

    Fact Sheet

    This fact sheet provides highlights from an analysis tracking the flow of federal Affordable Care Act funds to states as reporter in the Department of Health and Human Services grant database as well as periodic reports from HHS and the Internal Revenue Service. The analysis distinguishes between funds awarded to state and local governments (including state and local health departments and school districts) and private entities (including private employers, health centers, universities, and other community-based…

  • The Role of High-Income Seniors in Medicare Reforms: The Public’s Perspective

    Feature

    Medicare remains in the spotlight as policymakers and presidential candidates look for ways to rein in Medicare spending. One facet of the debate has centered on whether seniors with higher incomes should pay more for their coverage under Medicare. Based on data from the February 2012 Health Tracking Poll, this data note examines at what income level the public sees seniors as 'wealthy,' and finds that the answer has a lot to do with how…

  • How Does the Benefit Value of Medicare Compare to the Benefit Value of Typical Large Employer Plans?: A 2012 Update

    Issue Brief

    This study compares the value of Medicare's fee-for-service benefits last year with the value of benefits in two large employer health plans -- a large health plan serving federal employees and a typical large employer Preferred Provider Organization (PPO) plan. For individuals ages 65 and older, the study finds that Medicare remains less generous on average than typical large employer health plans, even after recent improvements in the program's drug coverage. Overall, Medicare would cover…

  • Medicare’s Role for Dual Eligible Beneficiaries

    Issue Brief

    About 9 million low-income seniors and younger people with disabilities in the United States are covered by both Medicare and Medicaid. This brief examines the role of Medicare in providing health coverage for these beneficiaries. Medicare is the primary source of health insurance, while Medicaid provides supplemental coverage, helping with premiums and cost-sharing and paying for services not covered by Medicare. This brief examines overall and per capita Medicare spending for these beneficiaries, including variations…

  • The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare

    Issue Brief

    This issue brief analyzes linked Medicare and Medicaid data to examine dual eligibles' utilization and spending in both programs in 2007. As a group, dual eligibles are costly—with per capita Medicare and Medicaid spending over four times Medicare spending for other beneficiaries. However, a small share of dual eligibles account for most of the group's spending, and dual eligibles who are high cost to the Medicare program are generally not the same individuals who are…

  • Among Dual Eligibles, Identifying The Highest Cost Individuals Could Help In Crafting More Targeted And Effective Responses

    Report

    This Health Affairs article by researchers at the Urban Institute analyzes linked Medicare and Medicaid data to examine dual eligibles' utilization and spending in both programs in 2007. It finds that while the population of people dually eligible for Medicare and Medicaid is indeed costly, it is not monolithic. For instance, although 20 percent of dual eligibles accounted for more than 60 percent of combined Medicaid and Medicare spending, nearly 40 percent of dual eligibles…

  • An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

    Issue Brief

    Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs. On January 25, 2012, CMS issued a memorandum providing additional guidance for…

  • Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors

    Issue Brief

    As part of broad deficit-reduction plans, policymakers are considering reforms to the nation's three major entitlement programs - Medicare, Medicaid and Social Security - that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors' financial security as well as the challenges facing current and future generations when it comes to economic and health security. Drawing from current research and data, the…

  • Kaiser Health Tracking Poll — February 2012

    Feature

    In the midst of continuing debate on the future of the Medicare program, the February Kaiser Family Foundation Tracking Poll finds most Americans and most seniors favor the status quo, though arguments about the program’s solvency have the potential to sway opinion toward new proposals. The survey also gauges public opinion about the ongoing contraceptive coverage debate, views of the Affordable Care Act, and trust in the presidential candidates on health care issues. The February…