Medicare

Medicare Open Enrollment

Medicare Advantage Plan Availability Varies Widely by County for 2027

Medicare Advantage prescription drug plan (MA-PD) availability varies widely by county in 2027, with a modest reduction in the share of enrollees with more than 40 plans to choose from and some major insurers exiting many more counties than they are entering. 1 in 5 Medicare beneficiaries (20%) can choose from among more than 40 MA-PDs for 2027, down from 27% in 2026. 1% of all beneficiaries will have no plan option for 2027.

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.

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.

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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  • The Small Share of Employers Offering Retiree Health Benefits Are Increasingly Turning to Medicare Advantage

    News Release

    Few employers offer retiree health benefits, and those that do increasingly are turning to Medicare Advantage plans to provide that coverage – a shift that has implications both for retirees and for federal spending, finds a new KFF analysis. Among the relatively small share of large firms (200 or more workers) that offer retiree health benefits to Medicare-age retirees, half (50%) provide these benefits through a Medicare Advantage plan in 2022, according to the analysis…

  • Extra Benefits Offered by Medicare Advantage Firms Vary

    Issue Brief

    Nearly all enrollees in Medicare Advantage plans sponsored by the seven largest firms in the market are in a plan that offers some vision, hearing, fitness, and/or dental benefits. Other benefits, including over the counter, remote access technologies, meals, acupuncture and transportation, vary widely across firms, and in-home support services, bathroom safety, Part B rebates, telemonitoring and caregiver support are relatively uncommon

  • Poll: Nearly Half of Adults Would Be Interested in Prescription Weight-Loss Drugs, But Enthusiasm Fades Based on Lack of Coverage and Risk of Regaining Weight 

    News Release

    Nearly half (45%) of the public are at least somewhat interested in taking a prescription weight-loss drug, including many who say they only want to lose a little weight, though many people lose interest when presented with potential financial and medical drawbacks, the latest KFF Health Tracking Poll reveals.The poll gauges the public’s interest in using prescription drugs to lose weight as a relatively new class of drugs, initially approved to treat diabetes, is garnering…

  • How Health Insurers and Brokers Are Marketing Medicare

    Report

    To capture the state of television marketing activities and consider the implications for people with Medicare, KFF analyzed ad data compiled by the Wesleyan Media Project, that were obtained from Vivvix (formerly Kantar) CMAG, a data analytics and consulting firm, and were coded by the Wesleyan Media Project in collaboration with KFF. The data set included all English-language TV ads that aired across national and local markets on broadcast television or national cable, from October…

  • Medicare Advantage 2016 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2016 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.

  • Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes

    Issue Brief

    This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2015. It describes trends in number of Medicare Advantage plans, plan premiums, and plan quality ratings, including changes in prescription drug coverage and limits on out-of-pocket expenses. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

  • New Trump Administration Proposals Would Further Limit Gender Affirming Care for Young People by Restricting Providers and Reducing Coverage

    Issue Brief

    This brief examines two proposed federal rules that would further restrict youth access to gender affirming care. One rule would change the hospital Conditions of Participation (CoPs) which would prohibit most Medicare and Medicaid enrolled hospitals from providing certain types of gender affirming medical care for young people and the other would prohibit federal Medicaid or CHIP funds from covering this care. The rules have a 60-day comment period, do no take immediate effect, and…

  • The Effect of Delaying the Selection of Small Molecule Drugs for Medicare Drug Price Negotiation

    Policy Watch

    In a new Trump administration executive order, the Secretary of HHS is directed to work with Congress to implement a change in law to delay negotiation of so-called “small molecule” drugs under the Inflation Reduction Act's Medicare Drug Price Negotiation Program for an additional 4 years. This brief analyzes how many of the drugs previously selected for negotiation would not have been eligible if this policy had been in place at the time.