Medicare statistics 2026

In this article:

• What is Medicare?
• How many people are covered by Medicare?
• Medicare price trends
• Medicare costs for consumers
• Common conditions among Medicare consumers
• Medicare reform
• Medicare FAQs

In this article

• What is Medicare?
• How many people are covered by Medicare?
• Medicare price trends
• Medicare costs for consumers
• Common conditions among Medicare consumers
• Medicare reform
• Medicare FAQs

Medicare covers more than 69 million Americans and represents one of the largest federal healthcare programs in the U.S. In this article, we share the latest Medicare statistics for 2026, including enrollment numbers, plan costs, prescription drug spending, fraud rates, and key trends shaping the future of Medicare.

What is Medicare?

Established in 1965, Medicare is a federal health insurance program that originally covered individuals 65 years of age and older. It is now also offered to younger people under 65 who have been receiving Social Security Disability Insurance (SSDI) benefits for two years, those with end-stage renal disease, or those with amyotrophic lateral sclerosis (ALS). 

Medicare is divided into several parts: 

• Part A (hospital insurance)
• Part B (medical insurance)
• Part C (Medicare Advantage)
• Part D (prescription drug coverage) 

Medicare Parts A and B (also called Original Medicare) are administered by the United States Centers for Medicare & Medicaid Services (CMS). Some Medicare beneficiaries choose to have their Medicare benefits administered through a private Medicare Advantage plan instead of traditional fee-for-service Medicare. This arrangement is sometimes referred to as “Part C” of Medicare. People with Medicare Advantage usually receive their Medicare drug benefits through their Medicare Advantage plan, rather than a standalone Part D plan, as is the case for people with Original Medicare.

Given the four different parts of Medicare, enrollment can be confusing. In a 2022 Medicare survey by SingleCare, nearly two-thirds (65%) of respondents reported that they would not know which part(s) of Medicare they should enroll in. The following Medicare statistics and data could help clarify the popularity of each part of Medicare and the vast number of people that Medicare helps every year.

RELATED: Can I use SingleCare if I’m on Medicare?

How many people are covered by Medicare?

• As of November 2025, more than 69 million people are enrolled in Medicare. Of these, 34 million are enrolled in Original Medicare (Part A and Part B), and 35 million are enrolled in Medicare Advantage or other health plans. (Centers for Medicare & Medicaid Services (CMS) – Enrollment Dashboard, 2025) 
• Every month, Medicare enrollment grows by about 100,000 people. (CMS – Enrollment Dashboard, 2025)
• By 2036, more than 80.5 million people are projected to receive Medicare benefits. (Congressional Budget Office (CBO), 2026) 
• More than half of Medicare consumers are enrolled in Medicare Advantage plans. (CMS – Enrollment Dashboard, 2025) 
• In 2023, 6.3 million Medicare consumers used their Part A benefits, mostly in an inpatient hospital setting. Meanwhile, 32.9 million Medicare consumers used their Part B benefits, mostly for physician visits and durable medical equipment. (CMS – Fast Facts, 2025) 

Medicare demographics

• About 10% of Medicare beneficiaries qualify due to health conditions, not age. (CMS – Enrollment Dashboard, 2025) 
• In 2025, 49% of Medicare consumers were 65 to 74 years old, 29% were 75 to 84 years old, and 10% were 85 years or older. (CMS – Medicare Beneficiaries, 2025) 
• About 19% of people with Medicare also receive Medicaid benefits. (CMS – Medicare Beneficiaries, 2025) 

Medicare drug coverage statistics

• About 81% of beneficiaries have prescription drug coverage through Medicare Part D or their Medicare Advantage plan.
• Medicare consumers with drug coverage received benefits totaling $145.7 billion in 2024. (CMS – Brief Summaries, 2025) 
• Medicare prescription drug benefits represent about 31% of all prescription drug spending in the U.S. (CMS – National Health Expenditure, 2024) 
• In 2023, 10 drugs accounted for nearly 54% of all Part D spending. Here is a breakdown of the top drugs (CMS, 2023):
  • Eliquis accounted for $18.2 billion of spending.
  • Ozempic accounted for $9.1 billion of spending.
  • Jardiance accounted for $8.8 billion of spending.
  • Trulicity accounted for $7.3 billion of spending.
  • Xarelto accounted for $6.3 billion of spending.
  • Trelegy Ellipta accounted for $4.4 billion of spending.
  • Humira accounted for $4.4 billion of spending.
  • Farxiga accounted for $4.3 billion of spending.
  • Januvia accounted for $4 billion of spending.
  • Revlimid accounted for $3.8 billion of spending.
• In 2024, 30% of the nation’s prescription drug spending was from Medicare consumers. (The IQVIA Institute, 2025)
• In the 2026 enrollment period, there were 360 Part D Drug Plans available, a decline from the 464 plans available in 2025. (Kaiser Family Foundation (KFF) – Medicare Part D, 2025) 

Medicare price trends

• Medicare cost the U.S. $1.1 trillion in 2024. (CMS – National Health Expenditures, 2024) 
• The cost of Medicare is expected to rise to $1.2 trillion in 2026. (CBO, 2026) 
• It is estimated that by 2031, Medicare could cost $7.7 trillion. (CBO, 2026) 

• In 2024, 13.5% of the federal budget was spent on Medicare. (KFF – Medicare 101, 2025) 
• A 2025 Medicare Trustees report projected that the Medicare Part A fund will be depleted by 2033. (CMS Annual Report, 2025) 
• Medicare spending represents about 20% of total health expenditure in the U.S. (CMS National Health Expenditure, 2024)
• In 2025, the Medicare Part D donut hole was eliminated as part of the Inflation Reduction Act.

Medicare fraud statistics

Medicare fraud occurs when someone (a healthcare provider or Medicare beneficiary) knowingly deceives Medicare or a Medicare private plan (Part C or Part D) by receiving payment or benefits when they should not. 

“Examples of fraud range from knowingly submitting false claims to knowingly billing for services at a higher complexity level than the services provided,” says Claire Ernst, director of governmental affairs at the Medical Group Management Association (MGMA). “There are several federal laws that govern Medicare fraud and abuse, such as the False Claims Act and the Physician Self-Referral Law (Stark Law), and the Office of the Inspector General (OIG) is tasked with protecting the integrity of the program.” 

While CMS cannot account for all cases of fraud, it does have figures on improper payments:

• In 2025, the improper payment rate for Medicare Part A and Part B was about 6.55%, which is around $28.83 billion in improper payments. This is a decrease from 2024, when the rate was 7.66%.
• The improper payment rate for Medicare Part C in 2025 was 6.09%, which is about $23.67 billion. This is an increase from 2024, when the rate was 5.61%.
• Medicare Part D had an estimated improper payment rate of 4% in 2025, which is about $4.23 billion. This is an increase from 2024, when the rate was 3.7%.

Common conditions among Medicare consumers

• In 2023, the most recent year with data available, the top 10 chronic conditions among Medicare consumers include the following (CMS – Medicare Beneficiaries, 2025):
  • High blood pressure – 65%
  • High cholesterol – 65%
  • Arthritis – 36%
  • Cataract – 27%
  • Diabetes – 26%
  • Anemia – 22%
  • Ischemic heart disease – 21%
  • Hypothyroidism – 21%
  • Depression – 19%
  • Chronic kidney disease – 19%
• Blood pressure screenings were the most common use of Medicare services in 2023, with 97% of beneficiaries taking advantage of the service. (CMS – Medicare Beneficiaries, 2025)
• In 2023, the prescriptions most commonly prescribed to Medicare beneficiaries included the following (CMS, 2023):
  • Atorvastatin calcium (generic Lipitor), a high cholesterol treatment prescribed to 16.7 million beneficiaries
  • Amlodipine besylate (generic Norvasc), a high blood pressure and coronary artery disease treatment prescribed to 11.5 million beneficiaries
  • Lisinopril (generic Zestril), a high blood pressure treatment prescribed to 8.7 million beneficiaries
  • Levothyroxine sodium (generic Synthroid), a hypothyroidism treatment prescribed to 8.6 million beneficiaries
  • Losartan potassium (generic Cozaar), a high blood pressure treatment prescribed to 8.1 million beneficiaries
  • Gabapentin (generic Neurotonin), a seizure and pain treatment prescribed to 7.5 million beneficiaries
  • Omeprazole, a gastric ulcer and gastroesophageal reflux disease treatment prescribed to 7.2 million beneficiaries
  • Prednisone, an anti-inflammatory treatment prescribed to 7.1 million beneficiaries
  • Metoprolol succinate (generic Toprol), a high blood pressure, chest pain, and heart failure treatment prescribed to 7.1 million beneficiaries
  • Rosuvastatin calcium (generic Crestor), a high cholesterol medication prescribed to 6.9 million beneficiaries

Medicare and COVID-19 statistics

• As of February 2026, approximately 35% of US nursing home residents have received a COVID-19 vaccination. (Centers for Disease Control and Prevention (CDC), 2026)
• Medicare beneficiaries in general have a COVID-19 vaccination rate of about 14% as of November 2025, which is a decline from 25% in November 2024. (CDC – COVID-19, 2026)
• Approximately 251 out of every 100,000 nursing home residents have COVID-19 each week as of February 2026. That’s about 100 more cases than influenza and 200 more cases than respiratory syncytial virus (RSV). (CDC, 2026) 
• Although COVID-19 is more common than the flu in nursing homes, residents are more likely to be hospitalized for the flu. About 15 out of every 100,000 nursing home residents are hospitalized for COVID-19 as of February 2026, compared to 27.5 out of every 100,000 residents hospitalized for influenza. (CDC, 2026) 
• Fifty-two percent of survey respondents, 22% of whom were Medicare-eligible, did not know that Medicare covers COVID tests, vaccines, and monoclonal antibody treatments. (SingleCare, 2022)

Medicare reform

Medicare reform is a topic that comes up often. “The types of reform that people would like to see vary widely,” Ernst says. “Most notably, there has been a push from Democrats in Congress for the inclusion of dental, hearing, and vision benefits, but this has been met with opposition from many across the aisle because of what it could do to the solvency of the program.”

While 92% of Americans support expanding Medicare to include these items, and some in Congress say it is important, these changes are still ongoing. One of the biggest changes for 2025 is that the Medicare ‘donut hole’ has been eliminated. The donut hole refers to a gap in coverage that doesn’t pay for prescription drugs on Medicare Part D after a certain threshold. However, in 2025, the coverage gap was finally eliminated as part of the Inflation Reduction Act. 

Medicare questions and answers

What percentage of people are covered by Medicare?

In 2024, the most recent year with data available, 19.1% of the U.S. population was covered by Medicare. 

What did Medicare cost in 2025? What does it cost in 2026?

Medicare Part A is free for most people receiving Social Security. In 2025, enrollees who paid for Part A of Medicare paid up to $518 every month, which increased to $565 per month in 2026.

Medicare Part B costs $202.90 per month in 2026. In 2025, Part B cost $185 per month. Depending on your income, your Part B premium may be higher.

Medicare Part C premiums vary by plan, but the average premium across all plans was $17 per month in 2025 and is $14 per month in 2026.

Medicare Part D premiums also vary by plan, but the national base premium was $36.78 per month in 2025 and is $38.99 per month in 2026.

This is the cost of the monthly premium and does not include copays, coinsurance, or deductibles.

Some lower-income consumers may qualify for cost subsidies like Extra Help or a Medicare Savings Program, which could significantly lower these costs.

What are the most common health conditions of Medicare consumers?

The top five health conditions among Medicare consumers are high blood pressure, high cholesterol, arthritis, cataracts, and diabetes. (CMS – Medicare Beneficiaries, 2025) 

How much money does Medicare lose every year to fraud?

It is estimated that Medicare gave $56.73 billion in improper payments in 2025. (CMS – Fiscal Year, 2026)

How many people on Medicare have chronic conditions?

In 2017, 67.6% of Medicare consumers, or 33.7 million beneficiaries, were diagnosed with multiple chronic conditions. More recent statistics aren’t available.

This article is updated annually. Some historical data is included for trend analysis.

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