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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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  • The Effect of Formularies and Other Cost Management Tools on Access to Medications: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by John F. Hoadley, Ph.D., of the Health Policy Institute at Georgetown University, examines how formulary designs and other cost-management tools may affect Medicare beneficiaries’ access to medications through their Medicare Part D prescription drug plans. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Grievance and Appeals Procedures: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Sara Rosenbaum, J.D., Director of the Center for Health Services Research and Policy at George Washington University, examines the procedures for resolving beneficiaries' grievances and appeals under the new Medicare drug benefit. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Views of the New Medicare Drug Law – Chartpack By Income Group

    Report

    This comprehensive survey of people on Medicare, conducted in June and July 2004, assesses their attitudes toward the new Medicare drug law. This chartpack, issued in September 2004, presents additional analysis on the survey data, looking at key findings broken down by income group. Chartpack (.pdf)

  • Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations

    Issue Brief

    Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations The Kaiser Family Foundation has commissioned a series of papers to explore key issues that may be of concern for Medicare beneficiaries as the new Medicare drug benefit is implemented. These papers focus on specific areas of potential concern for people with Medicare. In addition, the Foundation also has produced a timeline of upcoming important dates leading up to the implementation of…

  • Issues for Medicare Beneficiaries in Long-Term Care Facilities: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Vicki Gottlich, J.D., of the Center for Medicare Advocacy, looks at issues related to the new Medicare prescription drug benefit for people with Medicare who live in nursing homes or other long-term-care settings. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Health Care and the 2004 Elections: Medicare Coverage and Financing

    Issue Brief

    Medicare Coverage and Financing Download a printable .pdf of Health Care and the 2004 Elections: Medicare Coverage and Financing. IssueBackgroundPolicy Challenges Facing MedicareAssessing Candidate PositionsIssue The Medicare program is a valuable source of health insurance coverage for more than 41 million Americans. Medicare enjoys broad public support, but the program faces a number of challenges in the years ahead, including the implementation of the new Medicare drug benefit beginning in 2006. Another issue pertains to…

  • Health Care and the 2004 Elections

    Other Post

    ** Update: For information on health care and the 2008 election, visit www.health08.org. ** Health care issues continue to be important for many Americans and a vital part of the policy debates in Washington and around the country. During an election season, candidates propose and debate their solutions for the pressing policy issues facing their constituents. The 2004 election season is no different and the Kaiser Family Foundation is issuing informational materials on some of…

  • Views of the New Medicare Drug Law – Toplines

    Poll Finding

    This document includes the toplines from a comprehensive survey of people on Medicare and their attitudes toward the new Medicare drug law. The survey provides detailed insight in their perceptions and opinions about the law, the Medicare-approved drug-discount card program and the new Medicare drug benefit set to begin in January 2006. It also assesses views on the law’s implications for the 2004 elections. Survey Toplines (.pdf)

  • Views of the New Medicare Drug Law: A Survey of People On Medicare

    Poll Finding

    A national Kaiser Family Foundation/Harvard School of Public Health survey of people on Medicare finds nearly twice as many people on Medicare have an unfavorable view of the law as have a favorable view. Conducted from June 16 to July 21, 2004, the survey of 1,223 people on Medicare finds that most don’t think the law will be helpful to them personally. Two out of three people on Medicare say that lawmakers in Washington should…

  • Views of the New Medicare Drug Law – Summary & Chartpack

    Report

    This comprehensive survey of people on Medicare assesses their attitudes toward the new Medicare drug law. The survey provides detailed insight in their perceptions and opinions about the law, the Medicare-approved drug-discount card program and the new Medicare drug benefit set to begin in January 2006. It also assesses views on the law’s implications for the 2004 elections. Summary/Chartpack (.pdf)