Medicare

Medicare Open Enrollment

Medicare Advantage Plan Availability Varies Widely by County for 2027

Medicare Advantage prescription drug plan (MA-PD) availability varies widely by county in 2027, with a modest reduction in the share of enrollees with more than 40 plans to choose from and some major insurers exiting many more counties than they are entering. 1 in 5 Medicare beneficiaries (20%) can choose from among more than 40 MA-PDs for 2027, down from 27% in 2026. 1% of all beneficiaries will have no plan option 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.

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.

NEW AND NOTEWORTHY

Decoding Medicare Advantage Coding Intensity

Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.

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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  • Can I change my Medicare coverage outside of the Medicare Open Enrollment period?

    FAQs

    You can, but generally only under special circumstances that qualify you for a Special Enrollment Period (SEP). These circumstances include (but are not limited to) moving to a new location that is outside of your current plan’s service area or where additional plan options are available, moving back into the U.S. after living abroad, moving into or out of a facility, termination of Medicaid eligibility, if Medicare terminates your current Medicare Advantage plan, or if…

  • I am covered by Medicare, but I don’t take any medications. Do I need to sign up for a drug plan?

    FAQs

    Even if you aren’t taking any medications right now, it makes sense to enroll in a drug plan so that you have coverage in case your needs change in the future. If you don’t have coverage and the Medicare Open Enrollment period has ended, you won’t be able to sign up for coverage until the next Medicare Open Enrollment period begins, and your coverage wouldn’t take effect until January 1 of the following year. This…

  • I am currently enrolled in a Medicare Advantage plan, but I received a notice that my plan is not being offered next year. What do I need to do?

    FAQs

    If your current Medicare Advantage plan is not being offered next year and you do not choose another plan, you will be enrolled by default in traditional Medicare. In this case, if you do not receive Extra Help with your Part D drug costs, then you will need to select a Part D prescription drug plan (PDP) if you want Medicare drug coverage, unless you have drug coverage from another source of coverage (for example,…

  • Can I get information about Medigap policies on the Medicare coverage comparison website, or use the website to sign up for a Medigap policy?

    FAQs

    You can find some information about Medigap policies on the Medicare coverage comparison website, by going to the link to “Find a Medicare Supplement Insurance (Medigap) policy” under the Health & Drug Plans: Find & Compare menu. This tool produces a list of companies in your area that offer each type of Medigap plan, although you can’t enroll directly in a Medigap policy on this website. You will need to contact the insurance companies directly…

  • How can I find out if my doctor is in a Medicare Advantage plan network?

    FAQs

    There are a few ways to find out if your doctor is in a Medicare Advantage plan network. Medicare recently added searchable provider directories for Medicare Advantage plans on the Medicare.gov website. You can enter the names of up to five providers and see which plans include them in their networks. You can also identify a “must-have” provider to limit the results to plans that list that provider as in network.  Alternatively, you can go…

  • How can I compare my Medicare coverage options?

    FAQs

    You can compare your Medicare coverage options using an online searchable tool on the Medicare.gov website that allows users to compare Medicare coverage options, including Medicare Advantage plans, Medicare Part D plans, and Medigap supplemental policies. You can get information about the coverage, costs, and benefits of different plan options in your area using the Medicare coverage comparison website. You can also enroll in a Medicare Advantage plan or a Medicare Part D plan on…

  • How can I find out if my doctor accepts Medicare?

    FAQs

    Most doctors in the United States accept Medicare. To find a list of doctors in your area who accept Medicare and agree not to bill you for more than the approved Medicare amount for your visit or procedure, go to Medicare’s Care Compare website , select “Find care providers” under the Providers & Services dropdown menu, and look for providers noted as charging the Medicare-approved amount. If you do not have access to a computer,…

  • What is a Medicare Accountable Care Organization? Can I enroll in one when I sign up for Medicare or during the Medicare Open Enrollment period?

    FAQs

    Medicare Accountable Care Organization (ACOs) are groups of doctors, hospitals, and other health care providers who voluntarily form partnerships to have collective responsibility for the quality and total cost of care delivered to their patients. ACOs are not health plans and you cannot “enroll” in them. Medicare may assign you to an ACO if your primary care doctor is in one, but you are still free to seek services from any Medicare provider inside or…