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Quick Take: CMS Extends Medicare’s Short-Term Bridge Program for GLP-1 Obesity Drug Coverage

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

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

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.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

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 Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans

Medicare Advantage enrollment rose to 35.1 million people as of Feb. 1, an increase of 1.1 million since February 2025. The 3% uptick belied Medicare Advantage insurers’ projections that overall enrollment would decline compared to 2025. It was the lowest annual percentage increase in two decades.
The latest increase was largely driven by rising enrollment in Medicare Advantage Special Needs Plans (SNPs), which accounted for 83% of enrollment gains in 2026. However, three of the five largest Medicare Advantage insurers, including market leader UnitedHealth Group, Inc., experienced overall Medicare Advantage enrollment declines.

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

Most Medicare Beneficiaries Affected by Plan Terminations in 2025 Have Robust Medicare Advantage Options in 2026

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

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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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  • Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation

    Issue Brief

    Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation This issue brief describes how dual eligibles are treated under the Medicare drug benefit and the issues raised by their transition from Medicaid to Medicare drug coverage. The brief also explores key differences in the Medicare drug benefit compared to Medicaid drug coverage (formularies, copayments, and appeals policies) which could make the shift especially challenging for dual eligibles. Issue Brief (.pdf)

  • The Medicare Drug Benefit: Beneficiary Perspectives Just Before Implementation- Chartpack

    Poll Finding

    This chartpack highlights key results and trends from a comprehensive survey of seniors on their understanding of and views toward the Medicare drug benefit. The survey of 802 seniors was conducted in late October 2005, prior to the start of the benefit's open enrollment period, which runs from Nov. 15, 2005 to May 15, 2006. This survey is part of an ongoing effort to track seniors’ views on the Medicare prescription drug benefit, which has…

  • African Americans and the New Medicare Drug Benefit

    Poll Finding

    In a few short weeks, Medicare will undergo big changes that will have a major impact on nearly 4 million African American seniors and younger people with permanent disabilities who rely on Medicare for their health coverage. More than four in ten African Americans with Medicare lack coverage for their prescription drugs for at least part of the year. Many others will need to make decisions about their existing coverage and the new Medicare benefit.…

  • Tracking Prescription Drug Coverage Under Medicare:  Five Ways to Look at the New Enrollment Numbers

    Issue Brief

    Tracking Prescription Drug Coverage Under Medicare: Five Ways to Look at the New Enrollment Numbers This new analysis, which assesses Medicare drug benefit enrollment statistics released Feb. 22 by the U.S. Department of Health and Human Services, examines five different approaches to understanding the Medicare drug coverage numbers: What share of the total Medicare population has creditable prescription drug coverage? What share of the total Medicare population is enrolled in a Medicare drug plan? How…

  • Retiree Health Benefits Examined: Findings from the Kaiser/Hewitt 2006 Survey on Retiree Health Benefits

    Report

    This includes the full report on the 2006 Kaiser/Hewitt survey of large businesses that provide retiree health benefits to their workers. The Kaiser/Hewitt study, the fifth joint survey since 2002, analyzes responses from a non-probability sample of 302 businesses with 1,000 or more employees that offer retiree health benefits. These large firms collectively provide health benefits for 5.2 million retirees and dependents, including 3.4 million Medicare-eligible retirees. Together they account for more than one quarter…

  • The Basics of Medicare and Medicaid

    Issue Brief

    Together, Medicare and Medicaid provide health coverage to about 90 million Americans. To help explain the two programs, the Kaiser Family Foundation issued a new primer on the Medicare program and an updated version of its primer on the Medicaid program. Prepared by Kaiser staff, the primers provide an overview of the programs, who they serve, how the programs work and how they are financed. Medicare: A Primer Medicaid: A Primer

  • Methodology Appendix to the Medicare Part D 2008 Data Spotlights

    Issue Brief

    The Kaiser Family Foundation has also posted an appendix detailing the methodology used in the Medicare Part D 2008 Data Spotlight series. The series analyzes key aspects of the 2008 Medicare Part D prescription drug plan choices. All of the spotlights in this series were prepared by a team of researchers at Georgetown University, NORC and the Kaiser Family Foundation. Data Spotlight Appendix (.pdf)

  • The Federal Government’s Authority To Regulate Advertising in Medicare

    Issue Brief

    This policy brief, prepared for the Kaiser Family Foundation by Vicky Gottlich at the Center for Medicare Advocacy, explains the Centers for Medicare & Medicaid Services’ legal authority to regulate advertising and other information issued by the private companies that contract with the government to provide Medicare benefits. The brief also suggests additional steps the agency could take to enhance consumer protections with respect to advertising and marketing practices under its current authority. Issue Brief…

  • Retiree Health VEBAs: A New Twist On An Old Paradigm

    Issue Brief

    This issue brief provides an overview of stand-alone Voluntary Employees' Beneficiary Association trusts, through which employers have been able to rid themselves of future obligations to pay retiree health benefits in exchange for making a significant payment to designed to approximate the projected cost of these benefits. The paper include three case studies, including the VEBAs at the Big Three automakers. Issue Brief (.pdf)