Main Street Dollars

Three of the first ten drugs Medicare negotiated prices for will drop out of the program on January 1, 2027, one year after their negotiated prices took effect. The Centers for Medicare & Medicaid Services (CMS) lists Stelara, Entresto and Xarelto as removed from the negotiation program with a removal effective date of January 1,…

Medicare says its monthly drug payment plan does not lower a household’s drug costs, it only spreads the same bill across the months left in the year

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Medicare’s monthly drug payment option swaps one big pharmacy bill for smaller monthly bills from a drug plan, but the agency is explicit that the total does not shrink. On its page for the option, Medicare says it “might help you manage your monthly expenses, but it doesn’t save you money or lower your drug…

A state must reconsider Medicaid for a person dropped over a missing renewal form if the form arrives within 90 days, with no new application

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Medicaid coverage that ends because a renewal form never came back is not necessarily gone for good. Under a federal rule, a state agency has to take a second look at a terminated person’s eligibility if the form arrives within 90 days of the termination date, and it cannot demand a fresh application to do…

Medicare mails a blue reassignment notice in late October or early November to people with Extra Help whose Advantage plan is leaving, and doing nothing moves them to a drug plan

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Medicare plans to mail a blue notice, labeled CMS Product No. 11443, in late October or early November to people who get Extra Help with drug costs and whose Medicare Advantage plan is leaving the program. According to the agency’s page on the notice, a person who does nothing is reassigned to a Medicare drug…

People living outside the United States were left out of Medicare’s October premium rebate, along with Advantage members and anyone owing an income surcharge

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The $90 Medicare Improvement Fund rebate that began reaching bank accounts around October 8 skipped four groups: people who live outside the United States, Medicare Advantage enrollees, people who pay the income-related surcharge on Part B, and people whose premiums Medicaid helps cover. The Centers for Medicare & Medicaid Services spelled out those limits in…

Medicare flagged four Medicare Advantage plans with drug coverage as low-performing in its October 8 ratings

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Medicare put a low-performing icon on four Medicare Advantage plans that include drug coverage when it posted its 2027 Star Ratings on October 8, 2026. The Centers for Medicare & Medicaid Services lists them in its 2027 Star Ratings fact sheet, a week before open enrollment begins on October 15. CMS counts them as contracts,…

Ohio PERS gives Medicare-eligible retirees until December 7 and everyone else until December 15 to set 2027 coverage

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Retirees on the Ohio Public Employees Retirement System health plan have two different deadlines to set their 2027 coverage. OPERS says Medicare-eligible retirees can make changes from October 15 to December 7, 2026, while retirees who are not yet on Medicare have from November 1 to December 15. Anyone who wants to change or cancel…

A Medicare Advantage plan that is not renewed opens a special enrollment period running December 8 through the last day of February

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Medicare says a Medicare Advantage plan, Medicare drug plan or Medicare Cost Plan whose contract is not renewed opens a special enrollment period that runs from December 8 through the last day of February, which is February 28, 2027. The window starts the day after the annual enrollment period closes on December 7, and it…

Trump’s October Medicare rebate left out anyone whose premium Medicaid pays, and anyone who owes an income surcharge

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