Home Medicare Topics

Medicare

Medicare Part D

How Medicare Advantage Rebates Disadvantage Medicare’s Stand-Alone Drug Plan Market

Rebates that reduce Part D premiums for Medicare Advantage plans with drug coverage make it harder for stand-alone prescription drug plans (PDPs) to compete. That may contribute to instability in the PDP market relied on by people in traditional Medicare. The number of Part D stand-alone Rx drug plan options for the avg Medicare beneficiary has fallen by half in recent years, while Medicare Advantage drug plan options have risen.

Also: Medicare Part D Enrollment, Premiums, and Cost Sharing in 2026

Analyzing Changes in Medicare Part D Enrollment for 2026

Stand-Alone Drug Plans Cover a Larger Share of Part D Enrollees Living in the Most Rural Areas Than Medicare Advantage Plans

A Current Snapshot of the Medicare Part D Prescription Drug Benefit

Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act and How Enrollees Will Benefit

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).

Medicare Advantage

Medicare Advantage in 2026: Enrollment Update and Key Trends

More than half (55%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage in 2026, continuing a decades-long shift toward private plans. Special Needs Plans have driven recent growth, with nearly 1 in 4 enrollees now in such plans.
To better understand trends in the growth of the Medicare Advantage program, this brief provides current information about enrollment, including by plan type and firm.

See Also: Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization

How Medicare Pays Medicare Advantage Plans: Issues and Policy Options

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

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

Medicare Advantage Out-of-Pocket Limits: Variation & Trends

Prescription Drugs

What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge

CMS's temporary program to cover GLP-1 drugs for obesity in Medicare, called the BALANCE model, will not launch as scheduled on January 1, 2027. Instead, CMS is extending the Medicare GLP-1 Bridge, a separate short-term program that was to run from July to December 2026. It will now run through the end of 2027.

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

The IRA Has Improved Coverage of Drugs Selected for Medicare Price Negotiation

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

Read More

Latest News

More KFF Health News

Subscribe to KFF Emails

Choose which emails are best for you.
Sign up here

View the Latest: Medicare

Filter

List Grid

1,231 - 1,240 of 1,601 Results

  • Voices of Beneficiaries: Medicare Part D Insights and Observations One Year Later

    Report

    This report describes the views and experiences of 35 Medicare beneficiaries under the new drug benefit in advance of the 2007 open enrollment period. The report finds that drug plan enrollees generally say that they are satisfied with their drug coverage and have not encountered major difficulties using their plan. At the same time, many of them don't fully understand how their plan works even after almost a year of experience with this new benefit.…

  • Chartpack: The Public’s Health Care Agenda

    Poll Finding

    These charts highlight data from The Public’s Health Care Agenda for the New Congress and Presidential Campaign, conducted jointly by the Kaiser Family Foundation and the Harvard School of Public Health between November 9 and 19, 2006. The survey looks at the public’s priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. Chartpack (.pdf)

  • The Public’s Health Care Agenda for the New Congress and Presidential Campaign, December 2006

    Poll Finding

    This Kaiser Family Foundation/Harvard School of Public Health National Survey looks at the public's priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. It focuses, in particular, on differences and similarities among Democrats, Republicans, and those who identify themselves as Independents or something else. The poll, conducted November 9-19, 2006, by the Kaiser Family Foundation and the Harvard…

  • Health Affairs Article Examines Enrollment in Medicare Drug Plans As The Benefit Approaches Its Second Year

    Report

    Health Affairs Article Examines Enrollment in Medicare Drug Plans As The Benefit Approaches Its Second Year An article by Kaiser Family Foundation researchers published as a Health Affairs Web Exclusive provides a comprehensive look at the 2006 private Medicare drug plan enrollment as the enrollment period for 2007 begins. The article examines organization- and plan-level market share, as well as enrollment by type of plan, benefit design, and gap coverage. Health Affairs Web Exclusive (free…

  • Benefit Design and Formularies of Medicare Drug Plans: A Comparison of 2006 and 2007 Offerings

    Report

    This analysis provides a profile of the 2007 Medicare Part D stand-alone drug plans that are being offered to the program’s 43 million beneficiaries for 2007 and highlights some of the changes in plans between 2006 and 2007. It looks at premiums, covered drugs, the amount enrollees pay to fill a prescription, and other key features that would affect out-of-pocket costs and access to drugs for people with Medicare. The report describes the 1,875 stand-alone…

  • National Survey of Pharmacists 2006: Full Topline Results

    Poll Finding

    National Survey of Pharmacists 2006: Full Topline Results These toplines provide additional findings from a 2006 national survey of pharmacists on their views and experiences on a wide range of health care issues. Toplines (.pdf)

  • National Survey of Physicians 2006: Full Topline Results

    Poll Finding

    National Survey of Physicians 2006: Full Topline Results These toplines provide additional findings from a 2006 national survey of physicians on their views and experiences on a wide range of health care issues. Toplines (.pdf)

  • Additional Findings from the National Surveys of Doctors and Pharmacists

    Poll Finding

    Two Kaiser Family Foundation national surveys of doctors and pharmacists examine additional findings on their views and experiences on a wide range of health care issues. The topics covered in the surveys include views and experiences with medical errors and quality issues, use of health care information technology, prescription drug advertisements, views on Medicaid provisions, doctors' willingness to see Medicaid and Medicare patients, and physicians' views of conscience-clause provisions. The Kaiser Family Foundation National Survey…