Category: Medicare
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Humana ends its Ohio State and James Cancer Center contract on October 1
Medicare’s fall enrollment window and a major hospital network change are about to reach the same central Ohio households at almost the same moment. Humana members who get their care at The Ohio State University Wexner Medical Center or The James Cancer Center will be out of network before that enrollment window even opens. The…
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The subsidy that held Medicare drug-plan premiums down ends after 2026, lifting the 2027 benchmark to $41.33
If you carry a standalone Medicare drug plan, the only question that really matters each fall is whether your premium is about to move and by how much. The answer for 2027 begins with a figure that never appears on a bill: a national benchmark Medicare uses to split the cost of the drug program…
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NewYork-Presbyterian could leave UnitedHealthcare’s Medicare Advantage network on September 1
As of this writing, NewYork-Presbyterian’s hospitals and medical groups are still in-network for UnitedHealthcare Medicare Advantage members — under an extension that expires August 31, 2026. If the two sides do not sign a new contract by then, most of those members would find one of New York’s largest hospital systems out-of-network on September 1.…
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Losing a Medicare Advantage plan opens a Medigap right that expires 63 days later
When a Medicare Advantage plan shuts down or stops serving your area, federal law hands you something valuable with a short fuse: the right to buy a Medigap policy that an insurance company cannot refuse you. The clock on that right runs out 63 days after your old coverage ends. Most people have never heard…
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Eligible Medicare Part D enrollees now pay $50 a month for certain GLP-1 drugs
For eligible people with Medicare drug coverage, a monthly supply of certain GLP-1 weight-loss medications now costs $50 at the pharmacy — a flat, predictable copay for a class of drugs whose price has kept them out of reach for many older Americans. The discount is not a coupon and not a private insurer’s perk.…
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Removing a polyp turns Medicare’s free screening colonoscopy into 15% coinsurance
A preventive colonoscopy can begin with a zero-dollar Medicare cost and end with coinsurance if the doctor removes tissue. Medicare’s current rule says an assigned screening costs nothing, but finding and removing a polyp or other tissue creates 15% coinsurance for the provider’s services and, in an outpatient facility, another 15% facility coinsurance. The Part…
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Could $1,350 monthly income qualify you to have Medicare premiums, deductibles and copays paid?
A monthly income of $1,350 can put a single Medicare beneficiary at the usual 2026 federal limit for the Qualified Medicare Beneficiary program. QMB is unusually valuable because it can cover Part A and Part B premiums and the deductibles, coinsurance and copayments attached to Medicare-covered care. The figure is a reason to apply, not…
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Medicare beneficiaries pay $217 a day for covered skilled nursing care after day 20
A covered skilled-nursing stay can feel free during its first weeks and then produce a $217 daily bill almost overnight. In 2026, Medicare Part A charges no coinsurance for days 1 through 20 of a covered stay in a benefit period. Days 21 through 100 carry the $217 daily amount, making the coverage calendar a…
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Extra Medicare pay for small rural hospitals expires December 31
Under current law, Medicare-Dependent Hospital payments and the temporary low-volume hospital adjustment expire December 31, 2026, unless Congress acts.
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A Medicare rule finalized this week requires all rehab therapy to start within 36 hours
CMS finalized a revision requiring that all — not just some — therapies begin within 36 hours of admission to an inpatient rehabilitation facility.
