Medicare

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • Consumer Problems with Prior Authorization: Evidence from KFF Survey

    Issue Brief

    This Data Note highlights findings from the KFF Consumer Survey on problems consumers have experienced with prior authorization requirements. Overall, those with Medicaid, those who are higher utilizers of care, and those who seek certain types of care such as care for a mental health condition or diabetes encountered more problems with prior authorization over the past year.

  • Medicare Advantage Glossary

    Feature

    This glossary serves as a guide to the sometimes arcane terms that inhabit the world of Medicare Advantage, the private plan alternative to traditional Medicare.

  • Coverage of Dental Services in Traditional Medicare

    Issue Brief

    In Medicare Physician Fee Schedule Final Rules from recent years, the administration made changes to Medicare payment policies for certain dental services, in addition to other payment and policy changes. The 2023 rule clarified CMS’s interpretation of when medically necessary dental services can be covered and codified certain payment policies, and the 2023, 2024, and 2025 rules define new clinical scenarios for which Medicare payment can be made for dental services. This brief describes current…

  • Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings

    Issue Brief

    This brief provides an overview of the Medicare Advantage plans that are available for 2026 and key trends over time. In 2026, the average Medicare beneficiary has a choice of 32 Medicare Advantage prescription drug (MA-PD) plans, two fewer than the 34 in 2025. Virtually all Medicare Advantage plans for 2026 provide multiple extra benefits like vision, hearing, and dental benefits, similar to last year.

  • Health Provisions in the 2025 Federal Budget Reconciliation Law

    Issue Brief

    On July 4, President Trump signed the budget reconciliation bill, previously known as the “One Big Beautiful Bill Act,” into law. This summary provides background, description, budgetary impact and related information on the health care provisions of the law in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).