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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.

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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  • Medicare Beneficiaries and HMOs: Highlights of Los Angeles and New York City Medicare HMO Markets

    Fact Sheet

    A growing number of Medicare beneficiaries are enrolling in Medicare HMOs as an alternative to the traditional Medicare program. However, Medicare HMO enrollment has not grown uniformly in market areas across the country. Case studies conducted by researchers at Mathematica Policy Research, Inc. for The Kaiser Family Foundation describe the evolution of Medicare managed care in the two largest markets in the United States: Los Angeles County and New York City. The reports also discuss…

  • Medicare Restructuring: The FEHBP Model

    Other Post

    Executive Summary Part 2 How Well Does FEHBP work? FEHBP has been somewhat more successful than Medicare in controlling costs. However, recent trends indicate that FEHBP's competitive structure alone cannot guarantee cost control over the long term. Until recently, FEHBP experienced slightly lower growth in spending per enrollee than Medicare. Over the period 1987 to 1997, Medicare spending per beneficiary grew at an annual rate of 8.1 percent. FEHBP spending per enrollee grew at 7.1…

  • Medicaid’s Disabled Population and Managed Care

    Other Post

    Medicaid's Disabled Population and Managed Care This fact sheet highlights the key facts about the Medicaid managed care programs that serve persons with disabilities. It describes the Medicaid disabled population and the role managed care plays in serving them. It also provides information on enrollment in managed care, program features, and issues such as quality assurance, rate setting, and benefits. A detailed report is also available (#2114) Medicaid's Disabled Population and Managed Care

  • The New Medicare Drug Benefit:  Potential Effects of Pharmacy Management Tools on Access to Medications

    Issue Brief

    The New Medicare Drug Benefit: Potential Effects of Pharmacy Management Tools on Access to Medications This report describes the pharmacy benefit management tools that will be available to private plans administering the new Medicare drug benefit, including formularies, the definition of categories and classes, and cost sharing requirements. The authors conclude that substantial flexibility given to plans to design management tools could have significant implications for beneficiaries’ access to needed medications and out-of-pocket spending. Issue…

  • Grievance and Appeals Procedures: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Sara Rosenbaum, J.D., Director of the Center for Health Services Research and Policy at George Washington University, examines the procedures for resolving beneficiaries' grievances and appeals under the new Medicare drug benefit. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Navigating Medicare and Medicaid: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005

  • Profile and Analysis of the 26 Medicare Advantage Regions

    Issue Brief

    This issue brief examines the 26 new Medicare Advantage PPO regions and their implications for beneficiaries. The paper describes the characteristics of the new Medicare Advantage regions and the extent to which Medicare Advantage plans are already available in each region. It highlights the substantial gap between the current availability of Medicare Advantage health plans, including Medicare HMOs, PPOs and private fee-for-service plans, throughout the country and that intended for 2006. Issue Brief (.pdf)

  • Premiums and Cost Sharing Features in Medicare’s New Prescription Drug Program, 2006

    Issue Brief

    Premiums and Cost-Sharing Features in Medicare's New Prescription Drug Program, 2006 When Congress created the Medicare drug benefit in 2003, it also sought to generate more private plan options for senior and disabled beneficiaries in Medicare, with increased payments to attract sponsors and to support added benefits attractive to enrollees, especially in rural and other areas that previously had few such plans. The effects of these changes and additional payments are particularly visible this year,…