Medicare and Medicaid Policy

Medicare and Medicaid form the backbone of health insurance for millions of Americans—Medicare serves seniors and certain disabled individuals, while Medicaid provides coverage to low-income adults and children. Understanding how these programs work, what they cover, and how policy changes affect beneficiaries is essential to navigating the healthcare system.

Medicare Coverage and Plan Options

Medicare beneficiaries have multiple ways to receive care. Medicare Advantage Plans (Part C) offer an alternative to traditional Medicare, with nearly all beneficiaries having access to at least one plan option in 2026. In 2026, 67% of Medicare Advantage plans with prescription drug coverage charge no additional premium beyond Part B, and 98% of plans offer vision, dental, or hearing benefits. The Medicare Part B premium increases to $202.90 per month in 2026, while Part D deductibles rise to $615.

2026 Changes and Coverage Updates

Medicare is implementing significant updates for 2026. The Part D out-of-pocket cap increases to $2,100, and Medicare now covers GLP-1 weight-loss medications like Ozempic and Mounjaro, with beneficiaries paying a maximum $50 copay. Average Medicare Advantage premiums are decreasing to $14.00 per month in 2026. These adjustments reflect ongoing efforts to modernize the programs and improve beneficiary access to medications and preventive care.