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Medicare Open Enrollment

I have Medigap and I’m finding it difficult to afford. What are my other options for supplemental coverage?

FAQs

You may want to find out if you qualify for Medicaid, if your income and assets are low enough. Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements, and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports. To find out if you qualify, you can contact the State Medical Assistance Office or the State Health Insurance Assistance Program…

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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  • I have Medigap and I’m finding it difficult to afford. What are my other options for supplemental coverage?

    FAQs

    You may want to find out if you qualify for Medicaid, if your income and assets are low enough. Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements, and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports. To find out if you qualify, you can contact the State Medical Assistance Office or the State Health Insurance Assistance Program…

  • What is Medigap?

    FAQs

    Medicare supplement insurance policies, or Medigap policies, help to pay the copayments, coinsurance, and deductibles for Medicare-covered benefits under traditional Medicare (Part A and Part B services). Some Medigap policies also cover services that traditional Medicare does not cover, such as medical care when you travel outside the country. Medigap policies do not work with Medicare Advantage plans and will not help to cover Medicare Advantage enrollees’ out-of-pocket costs.

  • There are a lot of Medicare Part D plan options in my area. How do I decide which plan is best for me?

    FAQs

    There are two ways you can get drug coverage. If you have traditional Medicare, you can sign up for a stand-alone prescription drug plan. Or you can join a Medicare Advantage plan that covers all your Medicare benefits including the prescription drug benefit. Whichever you choose, your costs and coverage can vary from one plan to another. In picking the drug coverage that best meets your needs, you can compare plan costs for the premium,…

  • I am enrolled in a Medicare Advantage plan, and I’m happy with my coverage. Do I need to do anything during the Medicare Open Enrollment period?

    FAQs

    No, you do not need to do anything during the Medicare Open Enrollment period if you like your current Medicare Advantage plan, as long as it continues to be offered the following year. However, it is still a good idea to compare your plan options each year, since plans often make changes to their benefits, cost-sharing, premiums, and/or provider networks from year-to-year. By comparing your current plan to others available in your area, you can…

  • Medicare’s Role in Health-Care Payment Reform

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores whether Secretary Burwell's announcement this week about Medicare's payment reform initiative is another sign that the public sector is becoming the engine driving payment and delivery reform.

  • Medicare’s Role in Health-Care Payment Reform

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman explores whether Secretary Burwell's announcement this week about Medicare's payment reform initiative is another sign that the public sector is becoming the engine driving payment and delivery reform. All previous columns by Drew Altman are available online.

  • Summary of Medicare Provisions in the President’s Budget for Fiscal Year 2016

    Issue Brief

    On February 2, 2015, the Office of Management and Budget released President Obama’s budget for fiscal year (FY) 2016, which includes provisions related to federal spending and revenues, including Medicare savings. The President’s FY2016 budget proposal would reduce net Medicare spending by $423 billion between 2016 and 2025, and is estimated to extend the solvency of the Medicare Hospital Insurance Trust Fund by approximately five years. This brief summarizes the Medicare provisions included in the…

  • Medicare Spending Peaks at Age 96  

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of a Kaiser finding: per capita Medicare spending peaks at age 96, and the main reason is not end-of-life care. All previous columns by Drew Altman are available online.

  • How Much (More) Will Seniors Pay for a Doc Fix?

    Perspective

    In this Policy Insight, the Foundation’s Cristina Boccuti and Tricia Neuman examine how Congress’ effort to permanently stave off scheduled cuts in Medicare’s physician payments could affect what Medicare beneficiaries pay for their care -- both in premiums and in other potential changes -- to offset the cost of the Sustainable Growth Rate (SGR) “doc fix.”

  • Medicare Spending Cuts and Hospital Productivity Gains

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman and guest co-author Dana Goldman examine hospital productivity gains, and what they may mean for hospitals’ ability to absorb spending reductions.