Medicare Roundup: Key Data and Information for Open Enrollment

Also, the latest developments in Medicare policy under the Trump administration. ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏  ͏ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­ ­  

View in browser Medicare The start of Medicare open enrollment on October 15 draws heightened attention to the federal health insurance program for more than 70 million people ages 65 and over and younger adults with long-term disabilities. Several new and updated resources from KFF provide key data and information for beneficiaries and others to consider during open enrollment, which runs through December 7. Other recent analyses unpack the costs, availability and limitations associated with Medigap, the most common form of supplemental coverage for people in traditional Medicare.   Meanwhile, KFF experts have also been keeping tabs on the latest developments in Medicare policy under the Trump administration leading up the midterm elections.   Read the latest from KFF on Medicare policy research and journalism below. Featured Medicare Open Enrollment and Coverage Options: Key Questions and Answers   This explainer tackles such subjects as what changes Medicare beneficiaries can make during open enrollment; how Medigap and other forms of supplemental coverage factor into coverage decisions; how Medicare Advantage plans and Part D stand-alone prescription drug plans vary; and the tradeoffs involved when deciding whether to enroll in traditional Medicare versus Medicare Advantage. Get the details.   Additional analyses explore how the average Medicare beneficiary will have 28 Medicare Advantage prescription drug (MA_PD) plans available for general enrollment in 2027 (the number of plans varies widely across states), and how Medicare Advantage plan availability varies widely by county in 2027.   An analysis of the Part D stand-alone prescription drug plan (PDP) market shows that there will be a modest reduction in the number of PDPs for 2027, along with modest premium increases less than $10 per month for many enrollees -- but much larger monthly premium increases of $50 or more for others if they don’t switch plans.   KFF's searchable database of frequently asked questions about the Medicare open enrollment period has been updated and covers a range of topics related to enrollment, including Medicare Advantage, Part D, Medigap, low-income assistance, and more. Nearly Three-Quarters of Medicare Advantage Enrollees Could Be Denied a Medigap Policy Due to a Pre-Existing Condition   Seventy-four percent of Medicare Advantage enrollees (or 20.9 million people in 2023) had a pre-existing medical condition that could lead private insurers to refuse to sell them a Medigap policy or charge them more if they were to try to purchase one. Such a scenario typically would arise when a beneficiary attempts to buy Medigap coverage as part of a switch from Medicare Advantage to traditional Medicare. Read the analysis.   An updated look at key facts about Medigap finds that while premiums vary by state and by policy type, the average monthly premium among current Medigap policyholders was $244 in 2025 -- or $2,926 for a full year of coverage.   Additionally, we've updated our analysis of federal and state rules related to guaranteed issue requirements for Medigap policies and how they affect beneficiaries’ access to Medigap, including implications for Medicare beneficiaries under age 65 with long-term disabilities. Policy Research The Trump Administration’s $90 Payment to Medicare Beneficiaries, Reminiscent of a Similar Proposal Six Years Ago, May Not Offset Rising Costs Medicare’s standard Part B premium is $2,435 this year and is projected to increase by $79 annually for 2027 – meaning this increase alone would consume most of the Trump administration’s recent $90 payments to millions of Medicare beneficiaries.   How Much Do People with Medicare Pay for Coverage? This analysis provides an overview of the out-of-pocket costs faced by Medicare beneficiaries in traditional Medicare, Medicare Advantage, and Medicare Part D, including premiums, deductibles, copays, and coinsurance.   Nearly Four Million Medicare Beneficiaries Met the Eligibility Criteria in 2023 for the Medicare GLP-1 Bridge 3.8 million Medicare beneficiaries met the criteria to be eligible for the new Medicare GLP-1 Bridge program. The temporary program will provide coverage of three GLP-1 drugs used for weight reduction and weight management to eligible Medicare beneficiaries.   Key Facts About Medicare Spending Trends and Projections from the 2026 Medicare Trustees Report This brief provides an overview of key trends in Medicare spending and spending growth, as well as the impact of these trends on out-of-pocket costs for Medicare beneficiaries and Medicare program solvency, as projected by the Medicare Trustees in the 2026 Trustees Report.   Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. While these decisions are frequently overturned when appealed, this may cause delays for beneficiaries who are particularly vulnerable or have high care needs. Health News The Medicare GLP-1 Discount Has One Big Catch: Some Sick Patients Don’t Qualify Anyone who has a qualifying medical condition that the Food and Drug Administration has approved GLP-1s to treat, such as Type 2 diabetes or moderate to severe obstructive sleep apnea, is instead routed back to their Medicare Part D prescription drug plan. (KFF Health News)    An Arm and a Leg Podcast: Medicare Is More Broken Than We Thought At least 2 million seniors will receive notice this fall that their Medicare Advantage plans will disappear at year’s end, some without a comparable alternative. Here’s a look at this increasingly common problem with Medicare Advantage, and what it says about Medicare as a whole.  (KFF Health News) Did someone forward this to you? Subscribe to KFF emails. 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