Medicare Advantage
Choosing Medicare Coverage? Look beyond the monthly premium
With about 10,000 people each day turning age 65, most are faced with a very consequential decision about their healthcare coverage. The choices are: to enroll in either “traditional Medicare” (with a supplement plan to cover medical costs Medicare doesn’t);…
Unusually high rates of prior authorization denials
The Department of Health and Human Services’ inspector general’s latest report found three specific Medicare Advantage plans had the highest denial rate for long-term care requests. “The range of denial rates from 8 percent all the way up to 80…
Medicare Advantage Alert: Bill Introduced to Ban Prior Authorization Requirements
In a legislative move to eliminate administrative delays in obtaining medical items and serrvices via Mexicare Advantage plans, two congressional representatives–Ro Khanna (CA-17) and Pramila Jayapal (WA-07)–have introduced the Stop Deadly Denials Act. The bill is co-sponsored so far by…
Is Medicare Advantage the best option for you?
Medicare Advantage plans provide an alternative to Original Medicare. These plans often bundle Part D prescription drug coverage and may include additional benefits not covered by Original Medicare, such as dental, vision, hearing, or wellness programs. But are they the…
Don’t miss this chance to change plans
The Medicare Advantage open enrollment period runs from January 1st through March 31, 2026. If you missed your chance during Medicare open enrollment, you can now switch to another Medicare Advantage Plan (with or without drug coverage). Or, you can…
MA payments are $76 billion above FFS Medicare
Medicare Advantage (MA) plans are funded primarily through fixed monthly payments from Medicare, based on the expected healthcare costs of enrolled beneficiaries. According to a recent report from the Medicare Payment Advisory Commission (MedPAC), in 2026, “Medicare Advantage payments are…
H.R.5454 Medicare Advantage Prompt Pay Act
The Medicare Advantage Prompt Pay Act, H.R.5454, is bipartisan legislation introduced in Congress to address issues related to the reimbursement practices of Medicare Advantage (MA) plans. The act seeks to improve payment timelines for healthcare providers and protect seniors from…
Some potential changes to your new Medicare Advantage plan
Were you one of the over 2.6 million seniors whose Medicare Advantage plan was terminated in 2026? Or are you one of the many seniors -no exact number yet – that switched their Medicare Advantage coverage for other reasons that…
Potential Improvements to Medicare Advantage
Although 2026 has not yet started, the Centers for Medicare & Medicaid Services (CMS) has released the 2027 Medicare Advantage and Part D proposed rule. CMS-4212 P proposes several changes to modernize the Medicare Advantage (MA) program, including significant adjustments…
Unused Medicare Advantage benefits
The Commonwealth Fund reports that three in 10 Medicare Advantage beneficiaries have not used any supplemental benefits in the past year. Although one in four Medicare Advantage enrollees reported choosing their plans because of them. The Centers for Medicare and…