Traditional Medicare Enrollment and Coverage

Harriet Komisar, AARP Public Policy Institute

Claire Noel-Miller, AARP Public Policy Institute

Published January 29, 2026

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People enrolled in Medicare, the federal health insurance program for individuals ages 65 and older and some younger people with long-term disabilities, choose to receive benefits either through traditional Medicare (also called original Medicare) or through a private health plan that contracts with Medicare (called Medicare Advantage). The share of Medicare enrollees with traditional Medicare has been declining and, as of 2025, just under half the Medicare population was enrolled in traditional Medicare. In the context of this trend, ensuring a strong traditional Medicare program is important for both people with Medicare and the program as a whole.

Key Takeaways:

Medicare is a foundational component of health and financial security for over 69 million Americans ages 65 and older and younger people with long-term disabilities.
In 2025, 34 million individuals were enrolled in traditional Medicare, representing 49 percent of the Medicare population.
Ensuring a strong traditional Medicare option is vital to people with Medicare, including both people with traditional Medicare and those enrolled in Medicare Advantage.
Traditional Medicare offers, among other features, access to health care providers nationwide and stability of coverage.
For people with Medicare Advantage, traditional Medicare is an important option in case their circumstances, preferences, or health care needs change.
Traditional Medicare is also critical to the entire Medicare program. Key aspects of Medicare rely on traditional Medicare to operate, traditional Medicare is a testing ground for innovative models of health care delivery and payment, and it helps constrain Medicare’s spending growth because it costs less per person than Medicare Advantage.
Implementing policies that address the underlying drivers of declining enrollment in traditional Medicare is essential to ensuring a strong traditional Medicare as part of a Medicare program that meets the needs and preferences of the entire Medicare population.

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Komisar, Harriet, and Claire Noël-Miller. Traditional Medicare: Why It’s Vital to All Medicare Enrollees and Medicare’s Future. Washington, DC: AARP Public Policy Institute, January 29, 2026. https://doi.org/10.26419/ppi.00393.001

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