Medicare Statistics in US 2026 | Enrollment, Premiums, Benefits, Spending & Key Facts

Medicare covered 69.7 million Americans and spent $1.21 trillion in 2025, and the program’s Hospital Insurance trust fund is now projected to become insolvent in the second quarter of 2033. That insolvency date moved one quarter earlier than last year’s projection, triggering an automatic 11% cut to hospital payments if Congress does not act first.

Medicare in America 2026

Medicare enters 2026 as the second-largest federal spending program in the country, trailing only Social Security, and its finances have grown measurably more strained over the past year. The program’s Trustees released their 2026 annual report on June 9, 2026, confirming that total Medicare expenditures reached $1.21 trillion in 2025 while warning that the Hospital Insurance (Part A) trust fund will run out of reserves by 2033, a date that has moved earlier, not later, compared to last year’s forecast.

This report pulls together the verified numbers behind Medicare in 2026: how many Americans are enrolled across each part of the program, how much the system spends and where that money comes from, the health of the trust funds that keep it running, and how enrollment is projected to grow as the Baby Boom generation continues aging into eligibility. Every figure below comes from the Medicare Trustees’ own annual report, CMS enrollment data, or the Congressional Budget Office, not from independent estimates.

Medicare’s 2026 outlook sits at an unusual intersection of good news and bad news depending on which part of the program you’re looking at. Current-year cash flow remains positive, the HI trust fund actually ran a surplus in 2025, while the longer-run trajectory has worsened measurably. Readers looking for a single verdict on “is Medicare in trouble” won’t find one simple answer here, because the honest picture genuinely differs depending on the time horizon and the specific part of the program being examined.

Interesting Facts About Medicare in the US 2026

MEDICARE TOTAL EXPENDITURES, 2025 ($ billions)
Part A (Hospital Insurance)    ██████████████████ $444.2B
Part B (Medical Insurance)     ████████████████████████ $584.3B
Part D (Prescription Drugs)    ████████  $181.5B

Source: 2026 Medicare Trustees Report, CMS, June 9, 2026; Committee for a Responsible Federal Budget analysis.

Medicare’s $1.21 trillion in 2025 spending, confirmed in the Trustees’ June 2026 report, makes it one of the largest single line items in the entire federal budget, and that total is still growing faster than the economy underlying it. The Hospital Insurance trust fund, which pays for Part A inpatient hospital, skilled nursing, and hospice care, took in $462.4 billion in 2025 and still ran a $18.2 billion surplus for the year, but the fund’s long-run trajectory points toward depletion within less than a decade.

That Q2 2033 insolvency date moved one quarter earlier than the Trustees projected just a year before, and the 75-year shortfall widened by 33% year over year, a deterioration the Committee for a Responsible Federal Budget described as a genuine worsening of Medicare’s fiscal outlook rather than a rounding change. If Congress takes no action before 2033, the law requires an automatic 11% cut to Part A payments, a reduction that would grow to 16% by 2040 absent further legislative intervention.

Total Medicare costs, across all parts combined and excluding offsetting premium income, are projected to grow by up to 13% in the Trustees’ long-range 2099 estimate compared to last year’s projection, equivalent to roughly 0.8% of GDP. That long-horizon figure matters less for near-term planning than the 2033 insolvency date itself, but it signals that the pressures driving this year’s worse numbers, an aging population combined with healthcare costs that keep outpacing general inflation, aren’t expected to ease on their own without policy changes.

Medicare Enrollment Statistics by Coverage Type 2026

MEDICARE ENROLLMENT SPLIT, 2025-2026 (millions)
Original Medicare (Parts A & B)     ██████████████████████████████████ 34M
Medicare Advantage (Part C)         ███████████████████████████████████ 35M+

Source: CMS Medicare Enrollment Dashboard; Social Insurance Programs compiled data, 2025-2026.

Medicare Advantage has become the dominant way Americans receive their Medicare benefits, now covering 56% of all beneficiaries, a majority share that didn’t exist a decade ago when private plan enrollment sat closer to 30%. That shift reflects more than a decade of steady growth: Medicare Advantage enrollment climbed from roughly 26 million in 2020 to 35.1 million by 2025, a gain of nearly 10 million enrollees in just five years, even as Original Medicare enrollment held roughly flat or declined slightly over the same period.

The underlying enrollment base keeps expanding regardless of which coverage path beneficiaries choose: Medicare adds roughly 100,000 new beneficiaries every month as the Baby Boom generation continues reaching age 65, a wave that began in 2011 and won’t fully subside until the late 2020s. The overwhelming majority, 89.9%, qualify through age alone, while the remaining 9.1% qualify through disability regardless of age, a ratio that has stayed remarkably stable even as total enrollment has grown by millions.

Medicare Spending by Part: A, B, C, and D in 2026

2025 MEDICARE EXPENDITURES BY PART ($ billions, Trustees Report)
Part A   ██████████████████ $444.2B
Part B   ████████████████████████ $584.3B
Part D   ████████  $181.5B

Source: 2026 Medicare Trustees Report, Table II.B1, CMS.

Part B, which covers outpatient medical care rather than hospital stays, has grown into the single largest line item in Medicare’s budget at $584.3 billion in 2025, now exceeding Part A hospital spending by more than $140 billion a year. That gap reflects a longer-term shift in how Americans use the healthcare system, with more care delivered in outpatient settings, physician offices, and ambulatory surgical centers rather than through traditional inpatient hospital stays, a trend Medicare’s spending mix has tracked closely over the past two decades.

Part D, prescription drug coverage, remains the smallest of the three major spending categories at $181.5 billion, but it has also been reshaped significantly by the Inflation Reduction Act’s $2,000 (now $2,100 for 2026) annual out-of-pocket cap on drug costs, a structural change that shifted more catastrophic-coverage cost onto the federal government and insurers rather than onto beneficiaries themselves. Medicare Advantage plans, which bundle Part A, B, and typically D benefits into a single private-plan product, don’t appear as a separate line in this breakdown since their costs flow through the Part A and B trust funds depending on the service provided. For the fuller federal budget context behind these numbers, the entitlement programs report breaks down how Medicare spending compares with Social Security and Medicaid as a share of total federal outlays.

Medicare Trust Fund Solvency Statistics in 2026

HI TRUST FUND INSOLVENCY PROJECTIONS, SELECTED YEARS
2026 Trustees Report     ███████ 2033 (Q2)
2025 Trustees Report     ███████ 2033 (later in year)

Source: 2026 Medicare Trustees Report; National Committee to Preserve Social Security and Medicare analysis.

Unlike Part A, which relies on a dedicated trust fund that can technically run dry, Parts B and D are funded primarily through general federal revenue and beneficiary premiums on an as-needed basis, which means they cannot become “insolvent” in the same legal sense, though their growing cost still places mounting pressure on the broader federal budget. The Trustees describe this distinction carefully in their annual report specifically because public discussion of “Medicare going bankrupt” often conflates the HI trust fund’s real insolvency risk with Parts B and D’s fundamentally different, open-ended financing structure.

Restoring HI trust fund solvency under the Trustees’ central assumptions would require either raising the Medicare payroll tax rate from 2.90% to 3.46%, a 19% increase, or cutting hospital-related spending by roughly 12%, with the Chief Actuary’s more pessimistic alternative scenario pushing those figures considerably higher, a payroll tax increase of 50% or spending cuts approaching 25%. To date, Congress has never allowed the HI trust fund to actually become depleted, resolving each projected shortfall before it arrived, though the recurring nature of these warnings, dating back to the fund’s first insolvency projection in 1970, underscores how persistent the program’s underlying financing challenge has remained across more than five decades.

Medicare Part D and Prescription Drug Coverage Statistics 2026

PART D ENROLLMENT GROWTH (millions)
2024   ███████████████████████████ 54.4M
2026   ████████████████████████████ 56.3M

Source: 2026 Medicare Trustees Report; KFF Medicare Part D analysis, 2026.

Prescription drug coverage has expanded steadily, growing from 54.4 million enrollees in 2024 to 56.3 million in 2026, even as the program’s cost structure has shifted substantially under the Inflation Reduction Act’s reforms. The $2,100 annual out-of-pocket catastrophic cap, a provision that simply didn’t exist before 2024, has fundamentally changed the financial exposure facing Medicare’s highest-drug-cost beneficiaries, shifting more of that risk onto the federal government and participating insurers rather than onto patients themselves.

The Low-Income Subsidy program, which helps the lowest-income beneficiaries afford both premiums and cost-sharing, now covers 13.6 million people, a population whose Part D costs are effectively absorbed by the broader program rather than paid out of pocket. Because Part D operates on the same general-revenue-and-premium funding model as Part B rather than a depletable trust fund, its continued enrollment and cost growth adds pressure to the federal budget overall without triggering the kind of hard insolvency deadline facing the HI trust fund specifically.

Medicare Spending Compared to Overall US Healthcare Costs 2026

MEDICARE'S SHARE OF US NATIONAL HEALTH EXPENDITURES
Medicare (2024)           █████████████████████ 21% ($1.118 trillion)
Rest of US healthcare     ████████████████████████████ 79%

Source: CMS National Health Expenditure Accounts, 2024; American Action Forum analysis, 2026.

Medicare accounts for roughly 21% of all US healthcare spending, a share that has held relatively stable even as total national health expenditures climbed to $5.3 trillion in 2024, a figure that itself grew 7.2% year over year and now represents 18.0% of US GDP, the highest healthcare-spending share of any country in the world. Medicare’s own spending growth, 7.8% in 2024, slightly outpaced that already-elevated national healthcare growth rate, reinforcing the Trustees’ warning that Medicare costs continue rising faster than the broader economy that funds them.

Combined with Medicaid, the two major public health insurance programs are projected to cost $2.1 trillion in 2026 alone, a figure that illustrates just how central Medicare has become not only to the federal budget but to the entire US healthcare financing system. For a more detailed look at how these national spending trends translate into costs at the individual hospital-bill level, the average hospital bill statistics report breaks down what Medicare actually pays per dollar of hospital cost compared to private insurance and out-of-pocket patients.

Medicare Demographics and Beneficiary Growth Projections 2026

PROJECTED MEDICARE ENROLLMENT GROWTH (millions)
2025   ██████████████ 69.7M
2036   ████████████████ 80.5M

Source: Congressional Budget Office 2026 projections; Social Security Administration.

The Congressional Budget Office projects Medicare enrollment will grow from today’s 69.7 million to 80.5 million by 2036, an increase of nearly 11 million beneficiaries over just eleven years, driven almost entirely by the final wave of Baby Boomers reaching eligibility age combined with increasing life expectancy among those already enrolled. That growth trajectory is the single largest structural driver behind the Trustees’ warnings about long-term program costs, since a larger beneficiary pool mechanically increases total spending even if per-person healthcare costs grew at a perfectly stable rate, which they have not.

Roughly 19% of Medicare beneficiaries are also enrolled in Medicaid, a dual-eligible population that generally includes some of the program’s lowest-income and highest-need enrollees, who typically receive additional cost-sharing protection unavailable to Medicare-only beneficiaries. For the fuller picture of how Medicare fits alongside Social Security and other federal entitlement programs serving this growing beneficiary population, the social insurance programs report tracks enrollment and spending trends across the full range of US social insurance benefits.

Medicare Statistics FAQs

How many people are enrolled in Medicare in 2026?

69.7 million, as of the most recent CMS enrollment data from November 2025.

How much does Medicare spend each year?

$1.21 trillion in total expenditures for 2025, according to the Medicare Trustees’ 2026 report.

Is Medicare running out of money?

The Hospital Insurance (Part A) trust fund is projected to become insolvent in the second quarter of 2033, triggering an automatic 11% cut to hospital payments unless Congress acts. Parts B and D cannot become insolvent in the same way since they draw on general federal revenue.

What percentage of Medicare beneficiaries choose Medicare Advantage?

56%, based on the most recent full-year data, up from about 42% in 2020.

How much does Medicare Part A spend each year?

$444.2 billion in 2025, covering inpatient hospital, skilled nursing, and hospice care.

How much does Medicare Part B spend each year?

$584.3 billion in 2025, the single largest spending category in the Medicare program.

How many people are enrolled in Medicare Part D?

56.3 million in 2026, up from 54.4 million in 2024.

What share of US healthcare spending does Medicare represent?

About 21% of the $5.3 trillion the US spent on healthcare in 2024.

How many new people join Medicare each month?

Roughly 100,000 new beneficiaries, driven by the ongoing wave of Baby Boomers reaching age 65.

How many Medicare beneficiaries are projected by 2036?

80.5 million, according to Congressional Budget Office projections.

What would fix Medicare’s Hospital Insurance trust fund shortfall?

Raising the HI payroll tax from 2.90% to 3.46%, a 19% increase, or cutting hospital spending by roughly 12%, under the Trustees’ central assumptions.

Has the Medicare Hospital Insurance trust fund ever actually run out of money?

No. Despite projected insolvency dates being published since 1970, Congress has always acted before the HI trust fund was depleted.

Disclaimer: This research report is compiled from publicly available sources. While reasonable efforts have been made to ensure accuracy, no representation or warranty, express or implied, is given as to the completeness or reliability of the information. We accept no liability for any errors, omissions, losses, or damages of any kind arising from the use of this report.

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