Category: Medicare

Medicare will spend more than $13 billion this year rewarding private insurers for hitting quality targets in their Medicare Advantage plans, with one company alone in line for nearly $4 billion of it — a program that continues to grow even as the number of plans actually earning the money shrinks. The Quality Bonus Program’s…

A major hospital system on Florida’s Gulf Coast is walking away from every contract it has with UnitedHealthcare, a split that will leave its hospitals and physicians out-of-network for tens of thousands of insured patients, including a large share of Medicare Advantage members, starting in the new year. Lee Health’s Break With UnitedHealthcare Becomes Official…

A hospital system in Zanesville, Ohio, has told four of the region’s largest health insurers it plans to walk away from its contracts with them on Jan. 1, 2027, a move that would leave thousands of Medicare Advantage members choosing between a new insurance plan or an out-of-network hospital. The dispute, if it isn’t resolved,…

Buying a Medicare Supplement Insurance policy, commonly called Medigap, is less a matter of shopping around and more a matter of timing. A six-month window opens the first day of the month a person turns 65 and is enrolled in Medicare Part B, and for that stretch only, federal law strips insurance companies of the…

Medicare will pay the full cost of a yearly wellness visit for nearly every enrollee who asks for one: no deductible, no coinsurance, and in most cases no bill at all. Even so, a large share of beneficiaries have historically never booked the appointment, leaving a benefit that costs nothing sitting unused year after year….

Some Medicare Advantage plans quietly return money to a member every month by covering part of the Part B premium, either as a bigger Social Security deposit or a smaller monthly bill. It is not offered by every plan, and simply enrolling in Medicare Advantage does not make it automatic. Whether it applies comes down…

Insurers exit markets or let their Medicare contracts lapse every year, and the members caught in the middle do not have to wait for the fall Open Enrollment Period to find replacement coverage. Medicare grants a special enrollment period built specifically around a plan’s exit, timed to when that exit becomes official rather than to…

Two different Medicare penalties often get lumped together as one, but they are separate charges with separate math and separate triggers. Skipping Part D drug coverage, even for a matter of months, can mean paying its penalty for as long as a person keeps Medicare drug coverage, regardless of what happens with the Part B…

The Annual Enrollment Period every fall gets most of the attention, but a second, narrower window opens every January for people already enrolled in a Medicare Advantage plan. Running January 1 through March 31, the Medicare Advantage Open Enrollment Period gives a current MA member one more chance to fix a plan that isn’t working…

A single income spike in the year before enrolling in Medicare, such as cashing out a pension, selling a business, or collecting a final bonus, can trigger a Medicare premium surcharge that has nothing to do with a retiree’s current income. The surcharge, known as the Income-Related Monthly Adjustment Amount, is normally calculated from a…