Medicare Advantage
MA members are not satisfied
Medicare Advantage members are experiencing lower satisfaction rates and widespread lack of trust, according to the J.D. Power 2025 U.S. Medicare Advantage Study. Why is the level of dissatisfaction with Medicare Advantage plans? According to Christoper Lis, managing director of…
CMS releases 2026 Medicare Part D Information
The Centers for Medicare & Medicaid Services (CMS) has released preliminary technical Medicare Part D bid information for the 2026 contract year, which will help Part D plans finalize their Part D and Medicare Advantage (MA) offerings for 2026. As…
Prior Authorization Targeted by CMS Medicare
Under the guise of fraud and waste prevention, the Centers for Medicare & Medicaid Service (CMS),along with dozens of large healthcare insurance companies, have revealed forthcoming changes to the “Prior Authorization” process. Prior Authorization is a process used by various…
What Medicare does not cover
A recent survey conducted by The Kaiser Family Foundation found that 23 percent of adults under 65 and 45 percent of those aged 65 and older believed that Medicare would cover the cost of time in a nursing home or…
CMS expanding its efforts to audit MA plans
The Centers for Medicare and Medicaid Services (CMS) announced it is expanding its efforts to audit Medicare Advantage (MA) plans risk adjustment payments through the Risk Adjustment Data Validation (RADV) program. A risk adjustment factor (RAF) is calculated for each…
How do you qualify for a grocery allowance through Medicare Advantage?
We have all seen TV ads or social media posts about seniors qualifying for a grocery allowance, but who qualifies? First, you must be enrolled in original Medicare Parts A and B and choose to enroll in a Medicare Advantage…
The difference in care between Medicare and Medicare Advantage members
With the increasing enrollment by Medicare recipients in Medicare Advantage health plans and the issue of prior authorization requirements and limited provider networks, a team of health policy researchers at Harvard T.H. Chan School of Public Health looked at the…
A costly mistake for many Medicare Advantage enrollees
A recent study by a leading healthcare system found that people on Medicare Advantage plans are not utilizing dental and vision supplemental benefits provided by their health plan. One of the major draws for a Medicare recipient to choose a…
Who is enrolling in Medicare Advantage?
The creation of Medicare Advantage health plans was part of the 1997 Balanced Budget Act. Medicare Advantage grew from almost zero in 1998 to 33.8 million subscribers in 2024, or 55 percent of Medicare recipients. One reason Medicare recipients enroll…
You have to March 31st to change your Medicare Advantage plan
Are you enrolled in a Medicare Advantage plan you’re not sure is right for you? You can make changes to your health and prescription drug coverage during the Medicare Advantage open enrollment period, which started January 1 and runs through…