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Medicare Restructuring: The FEHBP Model – Report

Report

Medicare Restructuring: The FEHBP Model Executive Summary As policymakers consider measures to assure the long-range solvency of Medicare, one option that has received increasing attention is a "premium support" system. Under such a system beneficiaries would choose between the original Medicare fee-for-service program and a variety of competing health plans. They would receive a fixed government contribution toward the plan of their choice and would pay any remaining costs themselves. Proponents of a premium support…

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 Restructuring: The FEHBP Model – Report

    Report

    Medicare Restructuring: The FEHBP Model Executive Summary As policymakers consider measures to assure the long-range solvency of Medicare, one option that has received increasing attention is a "premium support" system. Under such a system beneficiaries would choose between the original Medicare fee-for-service program and a variety of competing health plans. They would receive a fixed government contribution toward the plan of their choice and would pay any remaining costs themselves. Proponents of a premium support…

  • A Medicare Buy-In for the Near Elderly: Design Issues and Potential Effects on Coverage

    Report

    This report examines a Medicare-based approach to reducing the ranks of the uninsured that would permit early retirees between the ages of 62 and 65 to purchase coverage under Medicare. The paper begins with an overview of the challenges of insuring the near-elderly and explores the potential effects of a Medicare buy-in on coverage of this population. The authors conclude that, unless premiums for such coverage were low or tied to enrollees' income, this approach…

  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison of Selected Proposals

    Report

    Updated, July 31, 2002 This document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of five major federal proposals to provide outpatient prescription drug coverage to Medicare beneficiaries, introduced as of July 31, 2002: H.R. 4954, The Medicare Modernization and Prescription Drug Act of 2002 (passed by the House of Representatives on June 28, 2002); H.R. 5019, The Medicare Rx Drug Benefit and Discount Act of 2002 (Rep. Rangel/House Democratic proposal); S. 2625,…

  • Medicare’s Disabled Beneficiaries: The Forgotten Population in the Debate Over Drug Benefits

    Report

    About 5 million Americans under age 65 qualify for Medicare coverage because they are totally and permanently disabled. They are more likely than the elderly to live in poverty, to be in poor health, and to experience difficulties living independently and performing basic daily tasks. A new study from The Commonwealth Fund and the Henry J. Kaiser Family Foundation, reports that the disabled have few options other than Medicaid for obtaining prescription coverage. In ,…

  • Medicare and Prescription Drug Spending Chartpack

    Report

    This chartpack provides 2003 and 2006 estimates of total and out-of-pocket prescription drug spending by Medicare beneficiaries. The data and analysis for this chartpack, prepared by Actuarial Research Corporation, assume no change in current law. Chart Pack

  • New NPR/Kaiser Family Foundation/Harvard Kennedy School of Government Survey on Health Care

    Poll Finding

    A new survey by NPR, the Kaiser Family Foundation, and Harvard s Kennedy School of Government finds that many Americans have real problems when it comes to accessing and paying for health care, and even if they haven't yet faced a problem, many worry about getting and paying for care in the future. The survey also shows that, while people think helping seniors with the cost of prescription drugs should be a priority, most seniors…

  • Kaiser Health Poll Report – October 2002

    Poll Finding

    A broad and informative bimonthly report, the new Kaiser Health Poll Report provides key tracking information, including historical trends and in-depth analysis of public opinion about hot health care topics. The current Featured Topic contains additional trends in public knowledge and attention to news about seniors and prescription drugs, as well as public opinion about who should be covered by a Medicare prescription drug benefit and what constitutes a good plan. Report Topline & Methodology