Every Medicare Advantage and Part D plan gets a public quality score each year, from one to five stars, and that score does more than help shoppers compare options. It also decides how much extra federal money a plan collects. Federal regulators had spent several years developing a new piece of that scoring formula meant…

Every fall, headlines announce the average Medicare Advantage or Part D premium for the coming year, usually sometime in September. It’s easy to assume that means you can go online that same week and see exactly what your own 2027 plan options will cost. You can’t. The number that makes headlines in September is a…

Long before any Medicare Advantage member gets a letter about their plan disappearing, the insurer running that plan has already told the federal government its decision. Federal regulation requires a Medicare Advantage organization to notify the Centers for Medicare & Medicaid Services in writing by the first Monday in June if it won’t renew its…

No drug on Medicare’s newly negotiated price list cost the program more in 2024 than the trio of Ozempic, Rybelsus and Wegovy. All three are versions of the same active ingredient, semaglutide, sold by Novo Nordisk under different brand names for different uses. Together they were dispensed to about 2.28 million people with Medicare Part…

Of the 15 drugs Medicare negotiated new prices for in its second round of talks, none got a bigger percentage discount than Janumet. Merck has agreed to sell the diabetes pill to Medicare drug plans for $80 for a 30-day supply starting January 1, 2027, down from a $526 list price in 2024. That’s an…

Linzess is not a specialty cancer drug or a rare-disease treatment. It’s a capsule millions of Americans with chronic constipation or irritable bowel syndrome take every day, and it’s now one of the 15 drugs Medicare has negotiated a lower price for. Starting January 1, 2027, a Medicare drug plan will pay AbbVie $136 for…

Astellas Pharma has agreed to sell Xtandi, one of the most widely used prostate cancer drugs on the market, to Medicare drug plans for $7,004 for a 30-day supply starting in January 2027. That’s down from the $13,480 the same supply cost at list price in 2024, a discount of 48 percent. The new number…

Medicare has finished bargaining over the price of 15 widely used prescription drugs, and the government now has a number to show for it. If the newly agreed-upon prices had applied during 2024, Medicare would have spent an estimated $12 billion less on those drugs, a 44 percent cut in net spending. The prices themselves…

A federal rule most people never hear about until it affects them sets a hard floor on how much warning a Medicare Advantage member gets before their plan disappears. If an insurer decides not to renew its Medicare Advantage contract for the coming year, it cannot simply drop enrollees with a short heads-up. The notice…

Prosecutors say a Pennsylvania medical-equipment company submitted at least $1.3 billion in fraudulent claims to Medicare and other insurers over five months in 2025, but the money that actually left those insurers’ accounts was a fraction of that: about $6.5 million. The gap between the number in the indictment and the number that got paid…