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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

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  • Half of Admissions in the Large Group Market Are Paid Above 150% of Medicare Rates, Excluding Maternity Admissions

    Issue Brief

    This analysis looks at in-network payment rates for inpatient hospital stays, other than maternity/newborn admissions, among large employer plans relative to Medicare payment rates. We find that a cap of 150% of Medicare rates would affect 52% of in-network admissions and 36% of in-network spending, while a cap of 300% of Medicare rates would affect 13% of in-network admissions and 13% of in-network spending, with variation across types of admissions.

  • Prices Increased Faster Than Inflation for Half of all Drugs Covered by Medicare in 2020

    Issue Brief

    Recent legislation would require drug companies to pay rebates to the federal government when annual increases in prescription drug prices for Medicare and private insurance exceed the rate of inflation. As context for understanding the possible impact of this proposal, this analysis compares price changes for drugs covered by Medicare Part B (administered by physicians) and Part D (retail prescription drugs) between 2019 and 2020 to the inflation rate over the same period.

  • Marketing Medicare – How Health Insurers and Brokers Use TV Ads to Attract Enrollees

    Event Date:
    Event

    KFF held a web event on September 20, 2023 to discuss Medicare marketing practices in advance of the open enrollment period, which begins Oct. 15. As part of the event, KFF released a new analysis of television ads that aired during last year’s open enrollment season and share insights from focus groups with enrollees about their perceptions of the marketing efforts.

  • Medicare Advantage Enrollment, Plan Availability and Premiums in Rural Areas

    Issue Brief

    Medicare Advantage enrollment is lower, but has grown more rapidly in recent years in rural areas than in metropolitan areas. In 2023, nearly 40% of eligible Medicare beneficiaries in rural areas are in Medicare Advantage. Rural Medicare beneficiaries can choose from 27 Medicare Advantage plans on average and most are enrolled in a plan that charges no additional premium.

  • The 4 Arguments You Will Hear Against Drug Price Negotiation

    Perspective

    As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF's Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.

  • Probing the Legal Arguments in the Drug Industry’s Challenges to Medicare Drug Price Negotiations

    Event Date:
    Event

    With the Biden administration’s announcement of the first 10 drugs to be negotiated for Medicare as part of the Inflation Reduction Act (IRA), an array of legal challenges from the pharmaceutical industry is potentially the biggest obstacle to implementation. On Tuesday, September 12, two legal experts and a health policy expert joined Larry Levitt, executive vice president for health policy at KFF, for a 45-minute discussion about the legal issues underpinning these lawsuits and how they intersect with the policy goals of the legislation.

  • 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 1st, 2022, through December 7th, 2022, the period that includes the Medicare open enrollment period for coverage in 2023.

  • What Do People with Medicare Think About the Role of Marketing, Shopping for Medicare Options, and Their Coverage?

    Report

    To capture Medicare beneficiaries’ views and experiences in choosing between traditional Medicare and private plans, and among private plans, and the factors that influence these decisions, KFF worked with PerryUndem to conduct focus groups with Medicare beneficiaries in the Fall of 2022, during the annual Medicare open enrollment period. This report summarizes first-hand accounts of participants’ reactions open enrollment advertising and factors that influence their decision-making around Medicare plan choice.