Home Medicare Topics

Medicare

Prescription Drugs

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

Read More
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

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

1,411 - 1,420 of 1,598 Results

  • How Do Patterns of Prescription Drug Coverage and Use Differ for White, African American, and Latino Medicare Beneficiaries Under 65 and 65+

    Report

    This chartpack provides a snapshot of racial/ethnic differences in Medicare beneficiaries? prescription drug coverage, use, and spending. It examines patterns separately for beneficiaries under age 65 and 65+. The summary discusses the relevance of the key findings to the current policy debates about prescription drug coverage. Chartpack (.pdf)

  • State-level Poverty Data for the Medicare Population

    Report

    Low-income assistance is a key feature of the Medicare prescription drug proposals passed by the House (H.R. 1) and the Senate (S.1). The attached tables present national and state-level data on the number of low-income elderly and disabled Medicare beneficiaries who may be eligible for additional assistance, based on the income eligibility thresholds specified in the House and Senate proposals (135%, 150%, and 160% of poverty). Report

  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison of Selected Proposals

    Report

    This updated document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of the House and Senate Medicare proposals, as passed on June 27, 2003. The side-by-side describes key provisions of H.R. 1, The Medicare Prescription Drug and Modernization Act of 2003, and S. 1, The Prescription Drug and Medicare Improvement Act of 2003. This updated document, which includes CBO's recent estimates of the costs of each bill and additional detail on payments to…

  • The Current Medicare Prescription Drug Debate: Briefing Charts

    Report

    These briefing charts provide background information on prescription drug use and spending among the Medicare population, recent survey data on employers' likely reaction to a Medicare drug benefit, an overview of the proposals for prescription drug coverage passed by the House and Senate at the end of June 2003, and a summary of the key issues to be resolved in the conference. Chart Pack

  • Kaiser Family Foundation/Harvard School of Public Health National Survey of the Public’s Views on Medicare

    Poll Finding

    Kaiser Family Foundation/Harvard School of Public Health National Survey of the Public's Views on Medicare A new national survey by the Kaiser Family Foundation and the Harvard School of Public Health examines the public's attitudes and opinions on issues related to the Medicare reform and prescription drug debate. The survey also takes a separate look at the differing views of younger and older Americans on this topic. Toplines/Survey (.pdf)

  • Medicare and Prescription Drug Spending Chartpack

    Report

    This chartpack provides 2003 and 2006 estimates of total and out-of-pocket prescription drug spending by Medicare beneficiaries. The data and analysis for this chartpack, prepared by Actuarial Research Corporation, assume no change in current law. Chart Pack

  • Medicare Prescription Drugs Through Private Drug-Only Plans: A Discussion with Actuaries

    Report

    Central to the current debate over Medicare prescription drug coverage is the role of private insurance plans in providing drug benefits to Medicare beneficiaries. This report offers views from health actuaries knowledgeable about the Medicare program and the prescription drug debate on key issues that emerge for potential plan sponsors, such as insurers and PBMs, in providing prescription drug benefits to Medicare beneficiaries through private, drug-only plans. The views of the actuaries were obtained through…

  • Kaiser Family Foundation/Harvard School of Public Health National Survey of the Public’s Views on Medicare- Chartpack

    Report

    Kaiser Family Foundation/Harvard School of Public Health National Survey of the Public's Views on Medicare A national survey by the Kaiser Family Foundation and the Harvard School of Public Health examines the public's attitudes and opinions on issues related to the Medicare reform and prescription drug debate. The survey also takes a separate look at the differing views of younger and older Americans on this topic. Chartpack (.pdf)

  • Dual Enrollees: Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    Dual Enrollees: Medicaid's Role for Low-Income Medicare Beneficiaries This fact sheet describes the low-income elderly population that is eligible for both Medicaid and Medicare, why they need Medicaid, what services they receive from Medicaid, and the current policy challenges related to this population. Fact Sheet (.pdf)