Category: Medicare
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Medicare’s hospital deductible rose to $1,736, and it applies to each benefit period
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…
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Original Medicare is testing AI prior authorization, and the companies reviewing claims are paid a share of the savings
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,…
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Every NewYork-Presbyterian hospital leaves UnitedHealthcare’s Medicare Advantage network October 1, though patients in treatment keep coverage into December
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…
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Humana is dropping mostly its lowest-rated Medicare Advantage plans, its finance chief says
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…
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Fairview hospitals stop scheduling UnitedHealthcare Medicare Advantage patients on January 1
Fairview Health Services will stop scheduling non-emergency appointments for patients enrolled in UnitedHealthcare Medicare Advantage plans starting January 1, 2027, the Minneapolis-based health system confirms on its own patient-notice page. The change reaches every M Health Fairview hospital and clinic across the Twin Cities metro area, plus Fairview Range in Hibbing and Grand Itasca Clinic…
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Medicare must announce negotiated prices for 15 more drugs by November 30
The Centers for Medicare & Medicaid Services confirmed on March 13, 2026, that the manufacturers of all 15 drugs picked for the next round of Medicare price negotiations had agreed to take part, locking in a process that now has a hard federal deadline. By law, CMS has to publish the negotiated price for each…
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Medicare’s 2027 plan lineup arrives in September, before enrollment opens October 15
Medicare runs on a fixed fall calendar, and the next few months follow it closely. Sometime in September, the Centers for Medicare & Medicaid Services will publish the finalized 2027 Medicare Advantage and Part D plan lineup, along with the final average premiums that replace the preliminary figures insurers have been working from all summer.…
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A cancelled Medicare Advantage plan opens a guaranteed right to buy Medigap
A letter arrives from a Medicare Advantage insurer notifying a household that their plan is leaving Medicare, pulling out of their county, or no longer covering their address. For a retired couple used to a low premium and routine dental coverage, the news reads like a threat: shop for new coverage with a lung condition,…
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Medicare Advantage debit cards must be locked to approved items starting in 2027
Beginning with the 2027 Medicare Advantage plan year, the prepaid debit cards insurers hand out for groceries, over-the-counter items and other supplemental extras will have to check every purchase against an approved list the instant the card is swiped. The Centers for Medicare & Medicaid Services finalized that requirement on April 2, 2026, writing it…
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Medicare set the 2027 base drug premium at $41.33 and dropped the subsidy that softened it
On July 28, 2026, the Centers for Medicare & Medicaid Services set the government’s benchmark for what Part D prescription drug coverage will cost to obtain in 2027, and confirmed that a program which had been softening premium increases since 2025 is going away. The base beneficiary premium for next year will be $41.33, and…
