Home Medicare Topics

Medicare

Medicare Advantage

Medicare Advantage in 2026: Enrollment Update and Key Trends

More than half (55%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage in 2026, continuing a decades-long shift toward private plans. Special Needs Plans have driven recent growth, with nearly 1 in 4 enrollees now in such plans.
To better understand trends in the growth of the Medicare Advantage program, this brief provides current information about enrollment, including by plan type and firm.

See Also: Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization

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

Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024

Medicare Advantage Out-of-Pocket Limits: Variation & Trends

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

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).

Prescription Drugs

What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge

CMS's temporary program to cover GLP-1 drugs for obesity in Medicare, called the BALANCE model, will not launch as scheduled on January 1, 2027. Instead, CMS is extending the Medicare GLP-1 Bridge, a separate short-term program that was to run from July to December 2026. It will now run through the end of 2027.

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

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

Medicare Part D

Analyzing Changes in Medicare Part D Enrollment for 2026

Analysis of CMS data shows that 56.1 million people have Medicare Part D drug coverage as of Feb. 2026, with 56% of enrollees in Medicare Advantage plans with drug coverage (MA-PDs) and 44% in stand-alone prescription drug plans (PDPs.)PDP enrollment increased, mainly due to the rise in enrollment in group employer/union plans for retirees.

Between 2025 and 2026, enrollment in group Medicare Advantage drug plans dropped for the first time since 2010, while group PDP enrollment rose by the largest amount Since 2013.

Premiums Are Decreasing for Many Stand-Alone Part D Drug Plans in a Number of States in 2026

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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

Read More
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

Latest News

More KFF Health News

Subscribe to KFF Emails

Choose which emails are best for you.
Sign up here

View the Latest: Medicare

Filter

List Grid

81 - 90 of 1,599 Results

  • There are a lot of Medicare Part D plan options in my area. How do I decide which plan is best for me?

    FAQs

    There are two ways you can get drug coverage. If you have traditional Medicare, you can sign up for a stand-alone prescription drug plan. Or you can join a Medicare Advantage plan that covers all your Medicare benefits including the prescription drug benefit. Whichever you choose, your costs and coverage can vary from one plan to another. In picking the drug coverage that best meets your needs, you can compare plan costs for the premium,…

  • Can I be charged a higher premium for Medicare Part D plans if I have a pre-existing condition or if I smoke?

    FAQs

    No. Part D plan premiums are not allowed to vary depending on your age, health status, whether you have pre-existing conditions, or are a smoker. The monthly premium that any given Part D plan charges is the same for any beneficiary who chooses to enroll in that plan. If your income is over a certain level, you may be required to pay a higher premium. If you have a relatively low income and limited assets,…

  • What is Medigap?

    FAQs

    Medicare supplement insurance policies, or Medigap policies, help to pay the copayments, coinsurance, and deductibles for Medicare-covered benefits under traditional Medicare (Part A and Part B services). Some Medigap policies also cover services that traditional Medicare does not cover, such as medical care when you travel outside the country. Medigap policies do not work with Medicare Advantage plans and will not help to cover Medicare Advantage enrollees’ out-of-pocket costs.

  • I have Medigap and I’m finding it difficult to afford. What are my other options for supplemental coverage?

    FAQs

    You may want to find out if you qualify for Medicaid, if your income and assets are low enough. Medicaid helps many low-income people on Medicare with their Medicare premiums and cost-sharing requirements, and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports. To find out if you qualify, you can contact the State Medical Assistance Office or the State Health Insurance Assistance Program…

  • I am 66 years old, work for a large employer, and have health insurance coverage through my job. I am planning to keep working for a few more years and keep the coverage that my employer offers. What ar...

    FAQs

    When you stop working and/or your group health insurance coverage ends, you should enroll in Medicare Part A and Part B. If you’re eligible for premium-free Part A, you can sign up any time after you’re first eligible for Medicare. Your Part A coverage will go back retroactively 6 months from when you sign up (but no earlier than the first month you were eligible). You have an 8-month Special Enrollment Period (SEP) to enroll…

  • If my employer offers retiree health benefits, do I need to sign up for Medicare when I turn 65?

    FAQs

    For most people with retiree health benefits, it makes sense to sign up for Medicare when you are first eligible to do so. Retiree health plans are typically designed to supplement Medicare, and might not pay your medical costs during any period that you were eligible for Medicare but not signed up for it. You should review any information provided by your employer to be sure you understand how your retiree health benefits coordinate with…

  • I am about to turn 65; my spouse is 60 and still working. We are both covered under her employer’s health plan. Do I have to do anything with regard to Medicare this year?

    FAQs

    A person (or a person’s spouse) with group health coverage through a current employer may be able to delay enrolling in Part A and Part B until that coverage ends, and won’t face penalties for enrolling later, but only if the employer has 20 or more employees. If your wife’s employer has at least 20 employees, you may want to enroll in Part A (if you qualify for premium-free Part A) but delay enrollment in…

  • I’m under 65 and have a long-term disability. I am no longer working and receiving Social Security disability benefits. Am I eligible for Medicare?

    FAQs

    It depends on how long you have been receiving Social Security disability insurance (SSDI) payments. You are automatically enrolled in Medicare Part A and Part B after you have been receiving SSDI payments for two years. However, people with disabilities who have Amyotrophic Lateral Sclerosis (ALS) do not have to wait two years and are eligible for Medicare immediately upon collecting SSDI, and people with end-stage renal disease (ESRD) are eligible for Medicare three months…

  • What is a Medicare Accountable Care Organization? Can I enroll in one when I sign up for Medicare or during the Medicare Open Enrollment period?

    FAQs

    Medicare Accountable Care Organization (ACOs) are groups of doctors, hospitals, and other health care providers who voluntarily form partnerships to have collective responsibility for the quality and total cost of care delivered to their patients. ACOs are not health plans and you cannot “enroll” in them. Medicare may assign you to an ACO if your primary care doctor is in one, but you are still free to seek services from any Medicare provider inside or…

  • How can I find out if my doctor accepts Medicare?

    FAQs

    Most doctors in the United States accept Medicare. To find a list of doctors in your area who accept Medicare and agree not to bill you for more than the approved Medicare amount for your visit or procedure, go to Medicare’s Care Compare website , select “Doctors & clinicians” under the Provider Type dropdown menu, and look for providers noted as charging the Medicare-approved amount. If you do not have access to a computer, you…