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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 & 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 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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  • Medicare and Women

    Fact Sheet

    As part of The Faces of Medicare, a collection of fact sheets profiling the characteristics and health needs of different groups of Medicare beneficiaries, provides descriptive information about women on Medicare, who constitute nearly seventy percent of Medicare's poor. Fact Sheet

  • The Faces of Medicare

    Fact Sheet

    The Medicare beneficiary population is often described in homogenous terms, yet those covered by the program vary significantly in terms of their health, income, supplemental insurance status, and medical service use. profiles the following six groups within the Medicare population, providing basic information, trends and data: Healthy retirees, who represent less than 10 percent of the total Medicare population, but sometimes are portrayed as typical of all seniors, Under-65 disabled beneficiaries, whose disproportionately high rates…

  • Medicare and Medicaid for the Elderly and Disabled Poor

    Other Post

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries; describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care. Available in PDF format. Return to top Library Index

  • Medicaid Eligibility for the Elderly

    Report

    The purpose of this issue paper is to explain Federal Medicaid eligibility policy for the low-income elderly population and discusses Federal and State policy options to improve coverage. Issue Paper

  • Medicare and Medicaid for the Elderly and Disabled Poor

    Fact Sheet

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries, describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care.This fact sheet is a summary of a longer Background Paper (#2132), which is also available. Fact Sheet

  • Medicare’s Role for Latinos

    Fact Sheet

    Medicare's Role for Latinos Fact Sheet: The Medicare Program: Medicare's Role For Latinos

  • Medicare’s Role for Latinos – (Spanish version)

    Other Post

    Medicare's Role for Latinos - (Spanish version) Note: This publication is no longer in circulation. However, a few copies may still exist in the Foundation's internal library that could be xeroxed. Please email order@kff.org if you would like to pursue this option

  • Medicare Restructuring: The FEHBP Model

    Report

    This report provides a comprehensive description of the Federal Employees Health Benefits Program (FEHBP) and compares the FEHBP and Medicare programs as they are currently structured. It reviews evidence on the performance of FEHBP and examines the implications of restructuring Medicare to conform to a FEHBP-based plan. Overall, the report suggests that FEHBP offers some promise as an approach for reforming Medicare, but important issues would have to be addressed to adapt the model to…

  • Medicare Restructuring: The FEHBP Model

    Other Post

    Executive Summary Part 2 How Well Does FEHBP work? FEHBP has been somewhat more successful than Medicare in controlling costs. However, recent trends indicate that FEHBP's competitive structure alone cannot guarantee cost control over the long term. Until recently, FEHBP experienced slightly lower growth in spending per enrollee than Medicare. Over the period 1987 to 1997, Medicare spending per beneficiary grew at an annual rate of 8.1 percent. FEHBP spending per enrollee grew at 7.1…