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Quick Take: CMS Extends Medicare’s Short-Term Bridge Program for GLP-1 Obesity Drug Coverage

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

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

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.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

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 Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans

Medicare Advantage enrollment rose to 35.1 million people as of Feb. 1, an increase of 1.1 million since February 2025. The 3% uptick belied Medicare Advantage insurers’ projections that overall enrollment would decline compared to 2025. It was the lowest annual percentage increase in two decades.
The latest increase was largely driven by rising enrollment in Medicare Advantage Special Needs Plans (SNPs), which accounted for 83% of enrollment gains in 2026. However, three of the five largest Medicare Advantage insurers, including market leader UnitedHealth Group, Inc., experienced overall Medicare Advantage enrollment declines.

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

Most Medicare Beneficiaries Affected by Plan Terminations in 2025 Have Robust Medicare Advantage Options in 2026

Medicare Part D

Analyzing Changes in Medicare Part D Enrollment for 2026

Analysis of CMS data shows that 56.1 million people have Medicare Part D drug coverage as of Feb. 2026, with 56% of enrollees in Medicare Advantage plans with drug coverage (MA-PDs) and 44% in stand-alone prescription drug plans (PDPs.)PDP enrollment increased, mainly due to the rise in enrollment in group employer/union plans for retirees.

Between 2025 and 2026, enrollment in group Medicare Advantage drug plans dropped for the first time since 2010, while group PDP enrollment rose by the largest amount Since 2013.

Premiums Are Decreasing for Many Stand-Alone Part D Drug Plans in a Number of States in 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

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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Medicare Open Enrollment

Beneficiaries Have 32 Medicare Advantage Prescription Drug Plans Available, on Average, for 2026

The average Medicare beneficiary will be able to choose among 32 Medicare Advantage plans with prescription drug coverage for 2026, two fewer than in 2025. The number of MA-PD options has grown steadily since 2010, peaking in 2024 when the average Medicare beneficiary had 36 options. Open enrollment runs October 15 through December 7.

Also: Medicare Open Enrollment FAQs

Premiums Are Decreasing for Many Stand-Alone Drug Plans in a Number of States in 2026

A Current Snapshot of the Medicare Part D Prescription Drug Benefit

The Role of SHIPs in Helping People with Medicare Navigate Their Coverage

What to Know About the Medicare Open Enrollment Period and Medicare Coverage Options

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  • New Medicare Drug Benefit’s Impact on States and Low-Income Beneficiaries

    Other Post

    New Medicare Drug Benefit's Impact on States and Low-Income Beneficiaries The recently signed Medicare prescription drug bill transfers responsibility for providing prescription drug coverage to dual-eligible beneficiaries from Medicaid to Medicare and creates a new subsidy program for low-income Medicare beneficiaries. These changes will have a major impact on state Medicaid programs both fiscally and administratively and it will also mean major changes for low-income beneficiaries' drug coverage. Presentation: Medicare Prescription Drugs and Low-Income Beneficiaries…

  • “My Name Is…” A Video

    Event Date:
    Event

    People with disabilities were profiled in “My Name Is…” a video produced by Kaiser Family Foundation Senior Visiting Fellow and former ABC News Correspondent, Jackie Judd, and shown at a December 12 briefing to release the findings from a survey of people with permanent mental and/or physical disabilities and their health-care experiences and challenges in accessing and paying for care. Please note: the video is no longer available.  If you have an urgent need for…

  • Implications of the New Medicare Law for Dual Eligibles:  10 Key Questions and Answers

    Issue Brief

    Implications of the New Medicare Law for Dual Eligibles: 10 Key Questions and Answers This publication is designed to provide a more detailed explanation of the change in drug coverage policy for dual eligibles under the new Medicare law, as well as explore its implications for the individuals affected by it. Issue Paper (.pdf)

  • Implications of the New Medicare Prescription Drug Benefit for State Medicaid Budgets

    Issue Brief

    For a number of years, Governors and other state policymakers have maintained that Medicare - rather than state Medicaid programs - should play the key role in providing prescription drug coverage to Medicare beneficiaries, including those who also qualify for Medicaid because they are impoverished and/or have extensive health care needs (i.e, the "dual eligibles"). Although the new Medicare prescription drug benefit law shifts drug coverage for dual eligibles from Medicaid to Medicare, it does…

  • Survey of People with Disabilities

    Poll Finding

    People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care. This chartpack contains the briefing materials from the event held to release the survey. Chart Pack (.pdf)

  • Standard Medicare Drug Benefit, 2006 Chart

    Report

    Standard Medicare Drug Benefit, 2006 Out-of-pocket drug spending for Medicare beneficiaries under the standard Medicare drug benefit described in the Medicare Modernization Act of 2003. Chart (.pdf)