A federal watchdog has put a number on something Medicare Advantage enrollees in rehab facilities have long suspected: a meaningful share of the care insurers initially refuse to pay for turns out, on appeal, to have been medically necessary all along. The finding comes from the three largest Medicare Advantage insurers in the country, measured…

Losing access to a trusted doctor without warning is one of the more disorienting things that can happen to a Medicare Advantage enrollee, and federal rules exist specifically to prevent it from happening overnight. When a plan cuts a primary care doctor or behavioral health provider from its network, it cannot simply stop covering visits…

One of Southwest Florida’s largest hospital systems has told the country’s biggest health insurer it is done doing business together, and the fallout lands squarely on Medicare Advantage enrollees around Fort Myers. Lee Health notified UnitedHealthcare on August 26 that it is ending its hospital and physician contracts, a move that will push every Lee…

Medicare has just locked in the dollar ceiling a Medicare Advantage plan is allowed to charge enrollees in 2027, and the number is higher than what plans could charge this year. For anyone who ends up needing extensive hospital or specialist care, the figure that matters most is not the monthly premium. It is the…

Medicare’s prescription drug coverage comes with its own income-based surcharge, separate from the one attached to Part B, and it hits a different group of people for a different amount. For 2026, the top tier of that surcharge climbed to $91 a month, charged on top of whatever premium a person already pays for their…

Most Medicare beneficiaries never see a bill for Part B the way they’d see one from a doctor’s office, because the premium is typically pulled straight out of a Social Security check before it ever hits a bank account. That makes it easy to miss when the underlying numbers actually change from one year to…

Starting January 1, 2026, Medicare’s Part A inpatient hospital deductible climbed to $1,736, up $60 from 2025’s $1,676. It shows up all at once, at the start of a stay, in the form of a deductible that resets every time a new benefit period begins. For 2026, that number moved higher again, and the way…

Original Medicare has always let patients see any provider or supplier who accepts it, with claims paid after the fact under long-published coverage rules. A new model launched this year adds a layer that looks more like commercial insurance: outside companies using artificial intelligence and machine learning to help decide, in advance in some cases,…

New Yorkers covered by a UnitedHealthcare Medicare Advantage plan have spent much of 2026 watching a contract fight between their insurer and one of the region’s largest hospital systems play out one deadline at a time. The latest extension pushes the cutoff to September 30, with a new one taking its place on October 1…

Humana’s chief financial officer told investors on July 29 that most of the health insurer’s 2027 Medicare Advantage plan exits will land on its lowest-scoring coverage, plans already sitting at 3.5 stars or below in the government’s current quality ratings. The company expects the cuts to touch roughly 600,000 members, with about 40 percent likely…