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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  • Implications of “Medicare for All” and “Public Plan” Strategies: New Brief and Interactive Tool Summarize Legislative Proposals and Key Issues

    News Release

    The idea of expanding the role of government programs such as Medicare and Medicaid has received renewed attention on Capitol Hill and on the campaign trail this year as policymakers consider ways to expand health insurance coverage and moderate health care costs. Lawmakers have introduced eight such proposals in the current Congress. They range from bills that would create a new, all-encompassing national health insurance program (sometimes called “Medicare-for-All”) to less sweeping measures that would…

  • Examining the Potential Impact of Medicare’s New WISeR Model

    Issue Brief

    On January 1, 2026, the Center for Medicare & Medicaid Innovation (CMMI) launched the Wasteful and Inappropriate Service Reduction (WISeR) Model that establishes new prior authorization requirements in traditional Medicare. This analysis explores the potential impact of the WISeR model by examining recent spending and utilization trends in traditional Medicare for services selected for prior authorization requirements in the six model states (Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington).

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

    Issue Brief

    The Medicare drug price negotiation program could improve coverage of drugs selected for negotiation for Medicare beneficiaries because the law requires all Medicare Part D plans to cover each of the selected drugs, including all dosages and forms, when negotiated prices take effect. This analysis examines 2026 Medicare Part D formulary coverage of drugs selected for negotiation to measure the effect of the IRA's coverage requirement.

  • Analyzing Changes in Medicare Part D Enrollment for 2026

    Issue Brief

    The Medicare Part D prescription drug benefit is provided by private plans, either Medicare Advantage plans that offer drug coverage (MA-PDs) or, for those in traditional Medicare, stand-alone prescription drug plans (PDPs). New data from CMS shows that 56 million people are enrolled in Part D plans as of February 2026, with more in MA-PDs than PDPs, reflecting higher overall enrollment in Medicare Advantage than in traditional Medicare. Enrollment in group MA-PD plans decreased while…

  • While Republicans in Congress have largely opposed the IRA and Medicare drug price negotiation, President Trump appears to be embracing it. With this latest announcement, the Trump administration can take credit for delivering lower drug prices in Medicare, while Democrats can take credit for creating the Medicare drug price negotiation program in the first place.

    Understanding the Trump Administration’s Negotiated Drug Prices for Medicare

    Quick Insights

    While Republicans in Congress have largely opposed the IRA and Medicare drug price negotiation, President Trump appears to be embracing it. With this latest announcement, the Trump administration can take credit for delivering lower drug prices in Medicare, while Democrats can take credit for creating the Medicare drug price negotiation program in the first place.

  • The Role of SHIPs in Helping People with Medicare Navigate Their Coverage

    Issue Brief

    The State Health Insurance Assistance Program (SHIP) offers free counseling to help millions of Medicare beneficiaries make decisions about coverage. However, federal funding has been modest over the last decade, and federal administration of the program appears to be in transition.

  • A promotional image for the the KFF Health Policy 101 Medicare chapter

    Medicare 101

    Feature

    This Health Policy 101 chapter explores Medicare, a federal health insurance program covering more than 68 million people, established in 1965 for people age 65 or older and later expanded to cover people under age 65 with long-term disabilities. In addition to detailing Medicare eligibility, coverage, and spending, the chapter examines the increased role of private plans in providing benefits and the financing challenges posed by increasing health care costs and an aging population.