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Prescription Drugs

The IRA Has Improved Coverage of Drugs Selected for Medicare Price Negotiation

The Inflation Reduction Act, which requires the federal government to negotiate the price of some drugs in Medicare, also requires all Part D plans to cover each of the drugs selected for price negotiation when negotiated prices take effect.

Recent Trends in GLP-1 Use and Spending in Medicare

A Current Snapshot of the Medicare Part D Prescription Drug Benefit

What to Know About Pharmacy Benefit Managers (PBMs) and Federal Efforts at Regulation

President Trump Proposes Codifying MFN Drug Pricing Deals But Key Details Are Missing

New & Noteworthy
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 Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024

Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, up from 49.8 million in 2023. They fully or partially denied 4.1 million, or 7.7%, of the prior authorization requests they received. Just 11.5% of all denials were appealed, but in the vast majority of those cases (80.7%) the initial denial was overturned.

Prior authorization determinations represent requests for approval that providers must submit before providing a service. Lawmakers of both major political parties have pressed insurers on their prior authorization practices, which consumers say unfairly erect barriers to needed care.

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

1 in 6 Medicare Advantage Enrollees Had a Diagnosis Added on a Chart Review That Increased Federal Payments to their Insurer

Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings

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

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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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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  • Medicaid Managed Care for Persons With Disabilities: State Profiles-2114

    Report

    Medicaid Managed Care for Persons With Disabilities: State Profiles This report provides state estimates of the number of Medicaid disabled enrolled in managed care and profiles these programs. It provides detailed comparative state information on enrollment, program features, rate setting, quality issues, and special enrollment features for the disabled in Medicaid managed care.

  • Standard Medicare Drug Benefit, 2006 Chart

    Report

    Standard Medicare Drug Benefit, 2006 Out-of-pocket drug spending for Medicare beneficiaries under the standard Medicare drug benefit described in the Medicare Modernization Act of 2003. Chart (.

  • Medicare Part D 2008 Data Spotlights

    Issue Brief

    To better understand changes in the private plans providing drug coverage to Medicare beneficiaries under the program's Part D benefit, the Kaiser Family Foundation is issuing a series of data spotlights analyzing key elements of Medicare's private drug plans.

  • Medicare Part D 2008 Data Spotlight: Premiums

    Issue Brief

    This Medicare Part D data spotlight analyzes the premiums charged by the 1,824 stand-alone Medicare Part D plans that will be offered in markets across the country in 2008. The analysis finds premiums charged for Part D plans range widely, from $9.80 per month to $107.50 per month.

  • Will the Trump Administration Fast Track the Privatization of Medicare?

    Policy Watch

    The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It's not yet clear whether the administration will promote policies to accelerate the privatization of Medicare or focus more on achieving efficiencies and savings within Medicare Advantage, or pursue policies that aim to achieve both. How this plays out will have implications for beneficiaries, health care providers and insurers, and is worthy of serious debate.

  • The President’s FY 2007 Budget Proposal: Overview and Briefing Charts

    Report

    This chartpack reviews the President’s FY 2007 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by summary information on the overall composition of the Administration’s budget.

  • Political History of Medicare and Prescription Drug Coverage

    Other Post

    A Political History of Medicare and Prescription Drug Coverage Thomas R. Oliver, Philip R. Lee, and Helene L. Lipton This article examines the history of efforts to add prescription drug coverage to the Medicare program. It identifies several important patterns in policymaking over four decades.