Category: Medicare
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CMS has made a quarter of Original Medicare a mandatory test subject in a new drug pricing model
“Medicare Part B patients and American taxpayers have paid significantly more for prescription medications than people in comparable countries,” said Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, as the agency finalized a new payment model on September 30. The model is mandatory and reaches about 25 percent of beneficiaries…
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NewYork-Presbyterian leaves UnitedHealthcare’s Medicare Advantage network November 1 unless the two sides reach a deal
Seventeen days separate the start of Medicare Open Enrollment on October 15 from November 1, the date NewYork-Presbyterian says all of its hospitals and medical-group practices will be out of network for UnitedHealthcare members if no new contract is signed. The hospital system’s notice, updated September 29, says no deal has been finalized. Members of…
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Medicare’s drug-cost shield weakens in January as the Part D out-of-pocket cap climbs to $2,400
Medicare.gov now lists a 2027 Part D out-of-pocket amount of $2,400, up from the $2,100 the same site gives for 2026. The $300 difference takes effect in January, so anyone on expensive brand-name drugs will cover more of the year’s bills before covered drugs drop to $0. Open Enrollment, which runs October 15 to December…
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Medicare will post 2027 plan star ratings around Oct. 8, before open enrollment
Medicare has put a date on the ratings that many members lean on when picking a Medicare Advantage or Part D plan. The Centers for Medicare & Medicaid Services says 2027 star ratings will be available on Medicare.gov on or around Oct. 8, a week before Open Enrollment starts on Oct. 15. The Oct. 8…
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Wyoming has the priciest Medicare Advantage premiums in the country for 2027, averaging $69.23 a month
Of all the states, Wyoming faces the steepest Medicare Advantage price tag for 2027. The average monthly premium there climbs from $45.91 to $69.23 according to the Centers for Medicare & Medicaid Services, a rise of $23.32, or 51%, on a lineup that shrinks from 14 plans to 8. $45.91 to $69.23: the arithmetic of…
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New York’s cheapest Medicare drug plan will cost $37.30 a month in 2027, versus $5.30 in most states
Shopping for a stand-alone Medicare drug plan for 2027 starts higher in New York than in any other state. The Centers for Medicare & Medicaid Services lists $37.30 a month as the lowest premium among the state’s stand-alone plans, against $5.30 in most states. Two tools for a 2027 drug list: The 2027 Medicare Open…
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Ohio seniors will have 32 fewer Medicare Advantage plans to pick from in 2027, down to 180 from 212
Ohio’s Medicare Advantage market is losing 32 plans between one plan year and the next. The state’s fact sheet from the Centers for Medicare & Medicaid Services lists 180 plans available for 2027, down from 212 in 2026, a cut of about 15% and the second-largest in the country behind Florida. Ohio’s fact sheet: 212…
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Medicare Advantage plan counts drop in 28 states and Washington, D.C., for 2027, as the national total slips to about 5,532
The federal tally of Medicare Advantage plans is thinner for 2027, and the loss is not spread evenly. The Centers for Medicare & Medicaid Services counts about 5,532 plans for next year, compared with 5,553 in 2026, while its state sheets show 28 states and Washington, D.C., losing plans and 21 states adding them. A…
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New Mexico will let Medigap customers switch plans each birthday without health questions starting Jan. 1, as West Virginia did in June
Starting Jan. 1, 2027, New Mexicans who are 65 and older and hold a Medigap policy get a 60-day window every year, opening in the birthday month, to move to another plan without health questions standing in the way. West Virginia’s version took effect on June 11, 2026. New Mexico’s aging department says more than…
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One dollar over $218,000 can cost a married Medicare couple about $2,297 a year in added premiums
A married couple whose joint income lands at $218,001 instead of $218,000 does not pay a little more on that extra dollar. The Social Security Administration’s 2026 tables add $81.20 a month to each spouse’s Part B premium and $14.50 to Part D once joint modified adjusted gross income (MAGI) passes $218,000. For two spouses…
