Category: Medicare
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UnitedHealthcare members whose plan ends in December fall back to Original Medicare and lose the plan’s drug coverage if they do nothing
UnitedHealthcare is ending some of its 2027 Medicare Advantage plans in parts of the country, and members of those plans who take no action will be moved to Original Medicare on January 1, 2027. If the discontinued plan included prescription drug coverage, that coverage ends with it. The company’s own document says so in plain…
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The subsidy holding standalone Part D premiums down ends in 2027
A federal program that has helped hold down standalone Part D premiums is scheduled to stop after next year’s coverage starts. The Centers for Medicare & Medicaid Services describes the Part D Premium Stabilization Demonstration as voluntary, narrowed for 2026 and slated for discontinuation in 2027. Nothing changes for a member’s coverage today; the rule…
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Standalone Part D premiums are rising less than a dollar on average next year
Premiums for standalone Medicare Part D drug plans are heading up next year, though by less than the cost of a lunch. The Centers for Medicare & Medicaid Services projects the total average monthly premium for stand-alone prescription drug plans to rise by less than $1, from $35.09 in 2026 to $36 in 2027. The…
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Who qualifies for Medicare premium help next year? The income limits are still missing from Medicare’s page
Medicare Savings Programs pay some or all of the Part B premium for people with limited income, and the page that sets out who qualifies has not moved to 2027. As of October 2, medicare.gov’s Medicare Savings Programs page still states monthly income and resource limits for 2026. The year-ahead question, who might qualify when…
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Medicare is scrapping the mid-year notice about unused Advantage benefits
One letter Medicare Advantage members have been entitled to receive partway through the year, the reminder about supplemental benefits they have not used, is being dropped. The Centers for Medicare & Medicaid Services says it is rescinding the requirement for plans to send mid-year notices about unused supplemental benefits, a change that sits in the…
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Orphan drugs, plasma products and gene therapies are excluded from Medicare’s new drug model
Four groups of Part B products fall outside Medicare’s new GLOBE drug payment model: biosimilars and their reference biologicals once a biosimilar is on the U.S. market, orphan-only drugs, plasma-derived products, and certain cell and gene therapies. The Centers for Medicare & Medicaid Services set out the carve-outs when it finalized the model on September…
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Medicare Advantage flex cards will stop working on items the plan does not cover
Debit cards that Medicare Advantage plans load with supplemental-benefit dollars are about to get a gatekeeper at the register. Starting with contract year 2027, the Centers for Medicare & Medicaid Services requires those cards to check each purchase against what the plan actually covers, so a swipe on an item outside the benefit should not…
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Two in ten Medicare Advantage members must re-shop their plan by December 7
Medicare Advantage members heading into this fall’s Open Enrollment have a headline number worth reading carefully. The Centers for Medicare & Medicaid Services says roughly eight in ten Advantage members can stay in their current plan in 2027 at the same or a lower premium. The arithmetic runs the other way for the remainder: about…
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Medicare will randomly assign one in four Original Medicare patients to a new mandatory drug payment model starting January 1
A new mandatory payment model for Part B drugs is scheduled to begin on January 1, 2027, and roughly one in four people in Original Medicare will be placed in it through random selection. The Centers for Medicare & Medicaid Services finalized the program, called the Global Benchmark for Efficient Drug Pricing (GLOBE) Model, on…
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Income above $137,000 doubles a retiree’s Medicare Part B bill because the surcharge matches the premium
One dollar of income decides which row of Social Security’s 2026 Medicare premium table applies, and the third row is where the Part B bill doubles. For a single filer with income above $137,000, or joint filers above $274,000, the surcharge is $202.90 a month, exactly the size of the standard premium. A $37.50 monthly…
