Main Street Dollars

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A Medicaid enrollee who also carries Medicare, and who then loses Medicaid eligibility, does not have to wait for the next annual enrollment period to fix a drug plan. Federal rules treat that loss as a qualifying event and open a separate window to join, switch or drop Medicare drug coverage outside the usual calendar.…

A veteran with a total disability rating is exempt from Medicaid’s new work rule

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in Government Programs

Medicaid’s community engagement requirement carries a short, specific list of built-in exceptions, and one line on that list settles the question for a defined group of former service members. Someone carrying a total, service-connected disability rating from the Department of Veterans Affairs falls outside the requirement’s work-hour math entirely, not merely into a category that…

Federal watchdogs say the least-screened medical equipment suppliers are the ones billing Medicare Advantage out of network

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Medicare Advantage enrollees who need a wheelchair, a glucose monitor or a hospital bed rarely think about who vetted the company that ships it. A new federal review says that gap in attention carries a real cost: the durable medical equipment suppliers facing the least screening are the same ones billing Medicare Advantage plans from…

NewYork-Presbyterian and UnitedHealthcare have until September 30 to close a Medicare Advantage deal

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A hospital network and an insurer that cover a large share of New York’s Medicare Advantage members are still working out the terms of a new contract, and the clock they set for themselves is running out. Neither side has announced a finished agreement, and neither has announced a breakup. For enrollees who rely on…

Lee Health drops every UnitedHealthcare contract December 31 and tells Medigap holders they are untouched

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A regional hospital system in Southwest Florida is walking away from one of the nation’s largest health insurers, and the fallout lands on patients’ calendars rather than in a courtroom. Lee Health’s hospitals and physicians will stop taking UnitedHealthcare’s employer, individual and Medicare Advantage plans once the year turns over, leaving households across Fort Myers,…

Thirty health systems have lost or ended a Medicare Advantage contract this year, down from 40 last year

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Hospital systems and Medicare Advantage insurers broke off dozens of contracts in 2026, and each break carries the same practical risk for the patients caught in the middle: a plan card that still says one thing while the network behind it says another. When a system exits a network mid-year, enrollees typically keep their coverage…

A Minnesota health system told Medicare Advantage patients to change plans before December 7

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Patients across the Twin Cities and greater Minnesota who carry a UnitedHealthcare Medicare Advantage card are getting a direct instruction from their own hospital system: start looking at other plans now, because this one will not get them into a Fairview clinic much longer. The notice is not a rumor or a leaked memo. It…

A Medicare Advantage benefit card will be limited to its plan year, so leftover dollars do not roll

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A Medicare Advantage debit card meant to cover groceries, dental visits or over-the-counter items has, on some plans, worked like a running account, letting whatever a member did not spend follow the card into the next plan year. That practice ends under a federal rule finalized this spring. Beginning with 2027 coverage, the money loaded…

Medicare Advantage plans no longer have to send the mid-year notice about unused supplemental benefits

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Two Julys in a row, Medicare Advantage insurers combed six months of claims data and sent enrollees a personalized letter listing which dental, vision or over-the-counter benefits sat untouched. That mailing is now optional, starting with the 2027 plan year. The Centers for Medicare & Medicaid Services eliminated the requirement inside a broader deregulatory package…

Medicare prices negotiated for 15 more medicines take effect January 1

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