Category: Medicare
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A North Carolina hospital’s UnitedHealthcare extension expires December 31, in the middle of Medicare’s enrollment window
Open enrollment for 2027 Medicare coverage closes December 7. A contract at one Coastal Carolina hospital closes 24 days after that. For Medicare Advantage members near New Bern, North Carolina, that gap between two calendar dates is the whole story: the deadline everyone is told to watch isn’t the one that actually decides whether their…
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UnitedHealthcare drops prior authorization on about 1,700 procedure codes October 1
Millions of UnitedHealthcare members who have waited days for a doctor’s office to get a procedure cleared got a specific answer this week: about 1,700 procedure and diagnostic codes will no longer need that step, starting October 1. The change touches commercial, Medicare Advantage and Affordable Care Act plans alike, and it lands squarely in…
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A Medicare Advantage flex card must now clear at the register and expires with the plan year
Tens of millions of Medicare Advantage enrollees carry a small plastic card loaded with an allowance for groceries, dental work, vision exams, or over-the-counter items. For years, many of those cards behaved like ordinary prepaid debit cards, swiping through checkout with little scrutiny over what actually landed in the cart. Two changes finalized by federal…
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CHI St. Vincent is set to leave every Arkansas Blue Cross network, including Medicare plans, September 1
A contract dispute between one of Arkansas’s largest hospital systems and the state’s dominant health insurer is set to come to a head on September 1, and Medicare Advantage enrollees across central Arkansas are the ones with the most to lose if the two sides don’t reach a deal in time. CHI St. Vincent, part…
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The three biggest Medicare Advantage insurers reversed 36 to 43 percent of the rehab denials people appealed
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…
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A Medicare Advantage plan must give 45 days’ notice before dropping your primary care doctor
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…
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Lee Health is ending its UnitedHealthcare contracts, pushing Fort Myers hospitals out of network for Medicare Advantage on January 1
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…
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Medicare Advantage plans can charge up to $9,850 in network next year, and $14,800 once care goes out of network
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…
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A high income adds up to $91 a month to a Medicare drug plan on top of the premium
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…
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Medicare’s Part B deductible rose $26 to $283 before coverage starts paying
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…
