Category: Medicare

That caller telling seniors they’re owed a “Part D refund” from Medicare’s new $2,100 drug cap is a scam — real Medicare never calls uninvited or collects bank routing numbers The phone rings mid-morning. The caller ID shows an 800 number. A calm, professional voice tells a retired schoolteacher in Florida that Medicare owes her…

When Linda and Jim Kowalski retired in 2022, they figured Medicare would handle the heavy lifting on medical bills. Within two years, Jim needed daily help bathing and dressing after a stroke, and Linda learned that the three crowns her dentist recommended would run more than $4,500 out of pocket. Original Medicare covered neither. Their…

A Medicare patient filling a 30-day supply of Eliquis, the blood thinner prescribed to millions of Americans with atrial fibrillation, used to face a list price north of $500 a month. As of January 1, 2026, the federal government’s negotiated price for that same prescription is $231. That single reduction, applied across the roughly 3.7…

A year ago, the federal government told hospitals they had roughly 11 years before Medicare’s main payment account ran dry. That estimate just shrank to eight. The 2025 Medicare Trustees Report, released this spring, projects that the Hospital Insurance (HI) trust fund will be depleted by 2033, three years sooner than the 2036 date published…

Every month, an unknown number of Medicare beneficiaries pay a surcharge on their Part B premium that will follow them for the rest of their lives. They missed a sign-up deadline, sometimes by just a few months, and the federal government responded with a penalty that never expires: 10 percent of the standard monthly premium…

A 75-year-old who skipped Medicare Part D at 65 and never held other qualifying drug coverage now owes a permanent surcharge of roughly $561 a year on top of whatever their plan already charges. That penalty showed up on their first premium bill and will appear on every bill after it, for life. Someone who…

For 15 straight years, Medicare Advantage grew without interruption. More enrollees signed up, more insurers entered the market, and more plans advertised $0 monthly premiums bundled with dental, vision, and hearing benefits that traditional Medicare does not cover. That unbroken streak is now over. The Centers for Medicare and Medicaid Services announced that the average…

When an orthopedic surgeon in one of six pilot states submits a request to perform knee surgery on a 72-year-old Medicare patient, the claim no longer goes straight to CMS for payment. Instead, it lands with a private technology vendor, which uses algorithms and clinical reviewers to decide whether the procedure should happen at all….

Until recently, a trip to the pharmacy for a shingles vaccine could cost a Medicare enrollee more than a week’s worth of groceries. Shingrix, the two-dose vaccine recommended for adults 50 and older, lists at roughly $200 per shot. Before 2023, most Part D plans required enrollees to cover a copay, coinsurance, or deductible on…

Right now, a Medicare enrollee with heart disease and obesity who fills a monthly prescription for Wegovy pays roughly $1,349 at list price. Zepbound, the other blockbuster GLP-1 drug, lists at about $1,060. For seniors on fixed incomes, those numbers have made clinically proven medications functionally unavailable. That changes on July 1. A new CMS…