Home Medicare Topics

Medicare

Medicare Advantage

Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries

With Medicare open enrollment underway, this analysis finds Medicare Advantage enrollees, on average, had access to just under half (48%) of the physicians in their area who were available to people enrolled in traditional Medicare. Such plans can be appealing to beneficiaries because they offer extra benefits and cap out-of-pocket costs, but their provider networks also restrict enrollees’ choice of physicians, hospitals, and other providers without paying additional cost.

Medicare Advantage in 2025: Enrollment Update and Key Trends

A Closer Look at the Growing Role of Special Needs Plans in Medicare Advantage

Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization

Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023

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

New & Noteworthy

Health Provisions in the 2025 Federal Budget Reconciliation Law

On July 4, President Trump signed the budget reconciliation bill, previously known as the “One Big Beautiful Bill Act,” into law. This summary provides background, description, budgetary impact and related information on the health care provisions of the law in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).

Medicare Open Enrollment FAQs

This list of Frequently Asked Questions (FAQs) about the Medicare Open Enrollment period covers a range of topics related to enrollment, including Medicare Advantage, Part D, Medigap, and more.

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 Part D

Premiums Are Decreasing for Many Stand-Alone Part D Drug Plans in a Number of States in 2026

This analysis finds that monthly premiums for many Part D stand-alone prescription drug plans (PDPs) in a number of states will be lower in 2026 than they were this year. At the same time, the total number of PDPs, which provide prescription drug coverage to people in traditional Medicare, will fall for the third year in a row, as insurers continue to scale back their offerings and adjust to higher costs under the redesigned Part D benefit, reflecting changes in the Inflation Reduction Act.

The Uncertain Future of Medicare's Stand-Alone PDP Market and Why It Matters

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

Prescription Drugs

People with Medicare Will Face Higher Costs for Some Orphan Drugs Due to Changes in the Tax and Budget Law

A provision in the 2025 tax and budget law that will expand the exclusion of orphan drugs from Medicare’s drug price negotiation program could lead to at least $5 billion in additional Medicare spending over time, as well as higher out-of-pocket costs for beneficiaries who use these medications.

FAQs About the IRA's Medicare Drug Price Negotiation Program

Allowing Medicare to Negotiate Drug Prices Is Broadly Popular

The Facts About the $35 Insulin Copay Cap in Medicare

Enrollees in Most Rural Areas Rely More on Stand-alone Part D Plans

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.

Related: FAQs on Medicare Financing and Trust Fund Solvency

Read More

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

521 - 530 of 1,574 Results

  • Visualizing Health Policy: Medicare’s Role and Future Challenges

    Other

    November 2012 infographic in the Visualizing Health Policy series takes a look at Medicare—who it covers; the services its beneficiaries use; and the balance policymakers must strike between setting fair payments, keeping care affordable, and sustaining the program for future generations.

  • Transitions 2005

    Video

    Transitions is a video that explores some of the issues and challenges “dual eligibles” may face during the transition from Medicaid drug coverage to Medicare.

  • Transitions 2006

    Video

    On January 1, 2006, the six million Americans who are covered by both Medicare and Medicaid saw a change in how their prescription drugs are covered. The dual eligible population was transitioned from Medicaid into the Medicare prescription drug benefit. As a group, these beneficiaries are poorer and sicker than those on Medicare. Consequently, they have more extensive health and prescription drug needs than most Medicare beneficiaries.

  • Nursing Home Reform: Then and Now

    Video

    To mark the 20th anniversary of the passage of landmark federal legislation to improve the quality of nursing home care, the Omnibus Budget Reconciliation Act of 1987 (known as OBRA 87), this video examines the history surrounding the law. The video includes a look at the state of nursing home care before the law, an overview of the legislative process that brought about the law, and recent developments in nursing home quality. The video features historical clips and new interviews of key individuals from government, the nursing home industry, and consumer advocates who were instrumental in the historical developments related to nursing home reform.

  • Snapshots from the Kitchen Table: Family Budgets and Health Care

    Video

    This Kaiser Family Foundation documentary, “Snapshots from the Kitchen Table: Family Budgets and Health Care,” profiles several American families who are struggling to make ends meet. It depicts the narrow financial ledge on which millions of low- and middle- income working households stand even in normal economic times, and illustrates the central role that health care costs and coverage play in a household’s economic stability. Some of the families profiled have health insurance, others do not.

  • Estimates of Medicare Beneficiaries’ Out-of-Pocket Drug Spending in 2006

    Report

    This report projects the impact of the new Medicare drug benefit on out-of-pocket spending for people who enroll in 2006. This analysis from November 2004 estimates that 6.9 million beneficiaries are projected to be affected by the coverage gap (the so-called "doughnut hole") in the standard Part D drug benefit.

  • Medicare Part D in 2016 and Trends over Time

    Report

    This chartpack presents a summary of Part D enrollment, premiums, cost sharing, benefit design and other key trends in 2016 and changes over time. For 2016, the analysis finds that 40% of Part D enrollees are now in Medicare Advantage drug plans, and over half of all enrollees are in plans offered by just three firms. The chartpack also highlights some concerning trends in the Low-Income Subsidy market, with the fewest number of premium-free plans available since Part D started, and 1.5 million LIS enrollees paying premiums for coverage, even though they have premium-free options available.

  • Medicare and Medicaid at 50

    Video

    With Medicare and Medicaid turning 50 this year, this updated video provides a brief history of both programs, including: an examination of the health care, social and political landscape that gave rise to them, the significant ways each program has evolved over five decades, and the important roles they play in the U.S. health care system. The video includes archival footage, as well as commentary and perspective from policymakers, government officials and experts.

  • Income-Related Premiums in Medicare: Who Pays, and How Much Do They Pay?

    News Release

    Since 2007, seniors with incomes greater than $85,000 have had to pay higher premiums for Medicare than their counterparts with lower incomes.  Six percent of Medicare Part B enrollees are expected to pay higher monthly premiums in 2015, ranging from $147 to $336, depending on their income.