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Medicare Open Enrollment

To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents

Report

To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents This report explores factors that appear to drive relatively high rates of hospitalizations, based on interviews with doctors, nursing home staff and families in four cities. Key factors include liability concerns, limited onsite staff capabilities, difficulty reaching residents' physicians for care instructions on nights and weekends, better and more timely access to diagnostic tests in hospitals, and patient preferences. Physicians with patients…

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.

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

Many PDP Enrollees Will See Modest Premium Increases for 2027, But Others Could Pay Much More If They Don’t Switch Plans

KFF analysis of PDP availability and premiums shows a mixed picture: modest premium increases for many Part D enrollees for their current plan but steeper increases for others, and a reduction in the number of PDP options for the fourth year in a row.

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

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

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

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

NEW AND NOTEWORTHY

Decoding Medicare Advantage Coding Intensity

Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.

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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1,491-1,500 of 1,624 results

  • To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents

    Report

    To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents This report explores factors that appear to drive relatively high rates of hospitalizations, based on interviews with doctors, nursing home staff and families in four cities. Key factors include liability concerns, limited onsite staff capabilities, difficulty reaching residents' physicians for care instructions on nights and weekends, better and more timely access to diagnostic tests in hospitals, and patient preferences. Physicians with patients…

  • Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

    Issue Brief

    This brief summarizes 15 states' preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those…

  • Inside Deficit Reduction: What it Means for Health Care

    Event Date:
    Event

    After much heated debate on the U.S. debt limit, the Budget Control Act of 2011 was passed on August 2, 2011, containing more than $900 billion in federal spending reductions over 10 years. The law also established the 12-person “super committee” charged with finding more than $1 trillion in additional savings. What exactly is called for in the law? What are the implications for health care programs, including Medicare, Medicaid, CHIP and the Patient Protection…

  • Medicare Part D 2011 Data Spotlights

    Report

    The Kaiser Family Foundation has issued a collection of analyses related to the Medicare Part D stand-alone drug plan options available to seniors for calendar year 2011. These spotlights focuses on key aspects of the drug plan choices available and relevant trends since the Medicare drug benefit took effect in 2006. They were prepared by a team of researchers at Georgetown University, NORC and the Kaiser Family Foundation. 2012 Part D Data Spotlights Now Available…

  • Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

    Report

    Several deficit-reduction plans have proposed combining Medicare's separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries. A new Kaiser Family Foundation study examines the potential implications of proposals to revamp Medicare’s cost-sharing requirements as a way of reducing federal spending. The analysis projects what would happen if Medicare's current benefit design were replaced with a unified deductible of $550;…

  • An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

    Issue Brief

    Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs. On January 25, 2012, CMS issued a memorandum providing additional guidance for…

  • Cost and Access Challenges: A Comparison of Experiences Between Uninsured and Privately Insured Adults Aged 55 to 64 with Seniors on Medicare

    Report

    This analysis looks at the difficulties uninsured people ages 55-64 have accessing and affording health care in 2010. Four in 10 of these near-seniors report having unmet health care needs or delaying treatment, while three in 10 uninsured near-seniors lived in families reporting problems paying their medical bills largely due to the cost. Seniors on Medicare report problems accessing care at a significantly lower rate than uninsured near-seniors and at a similar rate to near-seniors…

  • Whom Does the Public Trust More on Health Care and Medicare?

    Poll Finding

    This data note reviews takes a historical look at the public's views of whom they trust more, Democrats or Republicans, when it comes to health care policy and Medicare policy and analyzes these views in the context of the current presidential election, in which both issues are playing a prominent role. Data Note (.pdf)

  • Best Bets for Reducing Medicare Costs for Dual Eligible Beneficiaries: Assessing the Evidence

    Report

    With pressure mounting to slow the growth in federal health care spending, policymakers are exploring ways to reform the way care is delivered to the 9 million low-income Medicare beneficiaries who also receive Medicaid – a group that on average is sicker and frailer than other Medicare beneficiaries, and therefore receive significantly more care at greater cost. Major efforts are underway at the federal and state level to better coordinate care for this population and…

  • Medicare: The Basics, A Public Dialogue on Health Care: The Future of Medicare

    Report

    A public education brochure describing basic facts about the current Medicare program and how it works. This fact sheet is included in a full packet of information as part of a joint public information project between Kaiser Family Foundation and League of Women Voters of public meetings held across the United States in October 1998 (#1427 - available in print). Report Report