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What Medicare Advantage Plans Taught Us in 2026

Wed, 21 Oct 2026 06:00:23 GMT

What to Watch for in 2027 Based on Two Years of Changes

For nearly two decades, Medicare Advantage plans grew steadily, becoming the choice for more than half of all Medicare beneficiaries. But starting in 2025, that season of growth reached its apex. The past two years have brought significant changes. Some plans have cut benefits like dental, vision, and hearing coverage. Some insurers have pulled out of entire counties. As a result, millions of beneficiaries have had to shop for new coverage.

If you're on a Medicare Advantage plan, these last two years reveal an important pattern, and it's helpful to understand this as you prepare to look at 2027 plans this month. Read below to learn more about what's been happening and why, plus what to watch for as enrollment season kicks off.

Two Years of Significant Shifts in Plans

The total number of Medicare Advantage plans available nationally declined 10 percent last year, dropping from over 3,700 in 2025 to under 3,400 plans in 2026. Nearly 3 million people with Medicare Advantage plans (about 10 percent of all enrollees) had to find alternative coverage as some health insurers exited markets and scaled back plan options.

The largest insurers led the pullbacks. UnitedHealthcare reduced its coverage in 109 counties, while Humana decreased presence in 194 counties. In some regions, the disruption was more severe. In 122 counties across 13 states, approximately 391,000 beneficiaries lost access to any Medicare Advantage plan at all. Vermont experienced the most dramatic shift: 92.2 percent of Medicare Advantage enrollees in the state had to find alternative coverage. Other rural states were hit hard too: Wyoming now has just three Medicare Advantage-Prescription Drug plans available, South Dakota has four, and Minnesota also saw dramatic reductions.

The changes described here were the second year of a broader trend. So what are the underlying drivers of these changes and what should you do about it?

Why This Is Happening

The root cause centers around profitability. Federal policy changes that aimed to reduce overpayments resulted in lower reimbursement rates from the government to insurers. Meanwhile, following the pandemic, beneficiaries began seeking healthcare they postponed, which drove up medical costs faster than insurers had projected. The combination squeezed profit margins across the industry.

In response, the industry shifted rapidly from prioritizing enrollment growth to prioritizing profitability. The financial pressure remains to this day. CMS projects a 2.48 percent average rate increase for 2027—higher than initially proposed, but still lower than what many insurers need to sustain robust benefit packages. That's why the pattern we've seen these last two years is likely to continue.

What We've Seen Plans Do

Over the past two years, beneficiaries have experienced several types of changes:

Benefit reductions. For example, Aetna, Elevance, and UnitedHealthcare have cut allowances for over-the-counter health and wellness items. UnitedHealthcare and Humana cut OTC benefits for special needs plans. Some deductibles have risen on prescription drugs and medical services.

Network changes. Plans are shifting away from Preferred Provider Organization (PPO) plans, which offer more provider choice. They're prioritizing HMO designs (health maintenance organizations), which have more limited networks.

Geographic targeting. While some carriers expand into select markets, they simultaneously exit others, choosing to focus on areas where they can maintain better margins. Some insurers have pulled out of certain counties or even entire states. This is especially common in rural areas, where profitability is harder to achieve.

Who Should Be Paying Closest Attention

Seniors living in rural areas should pay particular attention. Over the past two years, rural beneficiaries have been disproportionately affected by plan terminations. While rural residents comprise only 14 percent of typical Medicare Advantage enrollees, they represented nearly 23 percent of those whose plans were terminated in 2025.

Certain states have seen more disruption than others. Vermont, Idaho, Wyoming, North Dakota, South Dakota, Maryland, and New Hampshire all saw more than 40 percent of their Medicare Advantage enrollees forced to switch plans between 2025 and 2026.

If you live in a rural area or a state that's seen significant plan activity, pay close attention to 2027 announcements to see if plans have changed in your region, and reach out to us for help.

What to Watch for this Month

Even before CMS releases 2027 plan details in mid-October, there are some important things you can do to prepare:

Review your Annual Notice of Change (ANOC) statement. You should have received this in September. Don't just glance at the plan name and assume everything is the same.

Look for benefit changes. Check whether dental, vision, or hearing benefits have changed. Are OTC allowances being reduced? Has your prescription drug deductible increased? Are out-of-pocket maximums higher?
Examine network changes. Did your plan shift from a PPO to an HMO? Are the doctors and hospitals you use still in-network? This is a critical detail that's easy to miss.

Keep your eyes out for a termination notice. Humana, UnitedHealthcare, Aetna, and other carriers signaled they may make additional plan exits this year. When a plan exits a county, the carrier is required to send impacted members a notice at least 60 days prior. So be sure to open all mail from your current plan, especially if you live in a rural area, in case you receive a notice of plan termination.

Talk to us soon! Don't wait until the last minute. If you receive a termination notice, or you see any changes in your ANOC that concern you, reach out to us for guidance. We can help you interpret the details as you check for changes to your current plan. As soon as plans are released, we can help you select a new plan if needed.

Know Your Options

If your plan does change or exit your area, remember this: you have guaranteed rights. If a Medicare Advantage plan terminates, you can enroll in any Medigap (Medicare Supplement) plan without being denied coverage based on pre-existing conditions, usually for up to 63 days after your coverage ends.

It's also helpful to keep in mind that the changes don't impact everyone. The majority of Medicare beneficiaries still have the same access to multiple Medicare Advantage plans with a range of benefits.

Moving Forward

The Medicare Advantage market has shifted. The days of predictable plans with expanding benefits may be behind us. But understanding the patterns of change and watching for communications puts you in control of your plan.

As 2027 plans are released this month, get in touch with us and we'll have a real conversation about what's changing and what's best for your healthcare needs. We're here to empower you to make informed decisions and stay ahead of change.

Medicare Caddy, LLC Pioneers a New Approach to Medicare Guidance with 12-Month Concierge Services

Fri, 16 Oct 2026 19:44:26 GMT

Press Release: ATLANTA, September 28, 2026

Medicare Caddy, LLC today announced an expanded approach to Medicare guidance built around an increasingly important idea: choosing Medicare coverage should not be treated as a once-a-year transaction.

Through its 12-month Medicare Concierge Services , Medicare Caddy provides individuals and couples with personalized guidance before, during and after their enrollment—helping them understand Medicare options, evaluate coverage and costs, complete enrollment, and respond as healthcare needs and coverage options change.

The model also creates a new opportunity for financial advisors and wealth management professionals to extend their client service into an area that can significantly affect retirement planning: healthcare coverage.

“Financial advisors spend years helping their clients prepare financially for retirement, but when Medicare enters the picture, clients are often left to navigate an entirely different and complicated system on their own,” said Greg O’Brien, Founder, Medicare Caddy, LLC. “We believe there is a better way. Medicare Caddy gives advisors a trusted Medicare resource they can place alongside their clients for an entire year.”

From Medicare Enrollment to Medicare Guidance

The introduction of Medicare Caddy’s Concierge Services comes as the broader health insurance industry is recognizing increased consumer demand for ongoing advisory relationships.

A 2026 eHealth survey of more than 1,500 Americans found that 87% of respondents believe it is important to have an insurance advisor who can help them understand coverage options year-round—not simply during enrollment periods.

Medicare Caddy’s approach is designed around that same fundamental need for continuing guidance while focusing specifically on the Medicare decisions facing individuals approaching or living in retirement.

The company’s concierge process helps clients:

· Understand Medicare eligibility, timelines and coverage options in plain language;

· Evaluate insurance plans, companies, networks, prescription coverage and potential costs;

· Complete electronic enrollments correctly and on time;

· Access Medicare guidance and answers throughout the 12-month concierge period;

· Monitor insurance plan changes, particularly prescription drug coverage; and

· Conduct an annual review to determine whether existing coverage continues to meet the needs.

Each client receives a Medicare Caddy Scorecard—summarizing key benefits, coverage details and insurance plan information to provide peace-of-mind.

A New Client-Service Tool for Financial Advisors

Medicare decisions do not exist in isolation from financial planning. Premiums, deductibles, prescription costs, provider networks, and potential out-of-pocket expenses can all affect a retiree’s financial well-being.

Medicare Caddy Concierge Services are designed to actively complement the important role of the financial advisor.

Financial advisors, wealth managers and other professionals serving individuals approaching retirement can provide the 12-month service to clients, giving them direct access to Medicare expertise while allowing the advisor to remain focused on the broader financial relationship.

“An advisor does not need to become a Medicare expert,” said O’Brien. “The advisor needs a Medicare expert they trust enough to introduce to a valued client. We want Medicare Caddy to be that resource.”

Simple, Transparent Pricing

Medicare Caddy’s 12-month Concierge Services are offered at $300 per individual or $500 per couple . The service can be purchased directly or provided by a financial advisor as a client benefit.

“Our goal is not simply to help someone select an insurance plan,” said Jordan Wood, Senior Operations Manager. “Our goal is to give people clarity and confidence throughout the Medicare decision-making process—and to be available when the next question arises.”

About Medicare Caddy, LLC

Medicare Caddy, LLC is a Georgia-based Medicare advisory firm helping individuals and couples navigate Medicare with expert guidance, clear direction, and confidence for the course ahead. Its 12-month Medicare Concierge Service provides personalized support from Medicare education and insurance plan evaluation through enrollment and ongoing annual guidance.

Medicare Caddy is an independent insurance agency and advisory service and is not connected with or endorsed by the U.S. government or the federal Medicare program. For additional information about Medicare Caddy Concierge Services, visit https://www.MedicareCaddy.com.

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MEDIA CONTACT

Jordan Wood

Medicare Caddy, LLC

770-668-5040

Jordan.Wood@MedicareCaddy.com

A Medicare Drug Plan Program Is Ending. Could Your Premium Change?

Wed, 14 Oct 2026 06:00:01 GMT

A Temporary Federal Program That Helped Limit Premium Increases for Some Medicare Part D Plans Will End After 2026.

If you have a standalone Medicare Part D prescription drug plan, you'll want to pay close attention to the information your plan sent you this fall.

The Centers for Medicare & Medicaid Services (CMS) recently announced that it is ending a temporary program that helped keep premiums more stable for participating Part D drug plans. The program was called the Medicare Part D Premium Stabilization Demonstration, and it will end after 2026.

What Is Changing?

Medicare made major changes to the Part D prescription drug benefit beginning in 2025. During that transition, CMS created a temporary program to help participating standalone Part D plans manage some of the financial impact and limit large year-to-year premium increases.

For 2026, the program provided participating plans with additional financial assistance and limited how much their total Part D premiums could increase from the previous year.

CMS has now decided that this temporary assistance is no longer needed, so the program will end after 2026, rather than running through 2027 as was originally anticipated. That means Part D plans will set their 2027 premiums without the additional help provided by this temporary program.

Does This Mean My Part D Premium Will Go Up?

Not necessarily.

Ending the program does not mean everyone's Part D premium will increase. The impact will vary from one plan to another.

To find out whether this change affects you, and by how much, it's important to look at the Part D plans available for 2027 and compare them with your 2026 coverage. Start with the monthly premium, but don't stop there. Changes in deductibles, prescription costs, covered medications and pharmacy networks can all affect what you ultimately pay.

In other words, a higher premium doesn't necessarily mean a plan will cost you more overall, and a lower premium doesn't necessarily mean it will be the least expensive choice for you. What matters is how the plan covers the medications you take and the pharmacies you use.

Although this temporary program is ending, it doesn't mean all federal measures intended to help control Part D premium increases are going away. Other protections remain in place that limit how quickly certain costs used to calculate Part D premiums can rise from year to year.

However, those protections don't put a cap on how much your individual plan's premium can change. That's why it's still important to focus on the details of the plans available to you and compare your 2027 costs and coverage with what you had in 2026.

What Should I Do?

By now, you should have received an Annual Notice of Change (ANOC) from your current plan, explaining what's changing next year. Review it carefully to see whether your premium, prescription drug coverage, out-of-pocket costs, pharmacy network or other plan features are changing.

As you review it, don't look at the premium alone. A plan with a lower monthly premium could end up costing you more if the medications you take are more expensive under that plan or if the deductible has increased. Likewise, changes to a plan's formulary, deductible or pharmacy network could have a significant impact on your overall costs.

As you review your coverage, consider:

Are all the prescriptions I take still covered?
Have my costs (copayments and coinsurance) for those medications changed?
Is my usual pharmacy still in the plan's network, and is it still considered a preferred pharmacy?
Has the deductible or monthly premium changed?
Are there new coverage requirements or restrictions for any of my medications?
How does my current plan compare with the other Part D options available for 2027?

Medicare Open Enrollment runs from October 15 through December 7 . That's your opportunity to compare your current coverage with other available options for 2027 and make a change if another plan better fits your needs.

You don't have to wait until October 15 to start getting organized, though. When your 2027 plan information arrives, make a list of your current prescriptions, dosages and preferred pharmacies. Having that information ready can make comparing your options much easier.

Conclusion

The end of this temporary Medicare program is good to know about, but there's no reason to assume your prescription drug costs are automatically going to soar. The most important thing you can do is review your coverage rather than automatically renewing it without looking at the changes.

We are here to help you assess your options and prioritize your needs. Working with a licensed Medicare professional from our team means you don’t have to figure this all out on your own.

Medicare for Snowbirds: How to Stay Covered in Two States

Wed, 07 Oct 2026 06:00:16 GMT

Learn How Your Medicare Coverage Moves with You

If you're someone who heads south for the winter or splits your time between two homes in different states, you're what the world often calls a "snowbird." And while your dual-state lifestyle might offer the best of both worlds, it can add some complexity to your Medicare coverage.

That’s why a little extra planning may be needed to make sure your Medicare benefits travel with you. Here's what multi-state dwellers need to know to stay covered, avoid surprises, and make the most of their benefits, from Toledo to Tampa.

The Basics: What Medicare Covers Anywhere in the U.S.

If you have Original Medicare (Parts A and B), you're off to a good start. You can see any doctor or use any hospital that accepts Medicare in the United States with no referral required and no network restrictions. Coverage is consistent across all 50 states and U.S. territories.

It gets trickier if you have other types of Medicare coverage, like a Medicare Advantage plan, a Part D drug plan, or Medicare Supplement Insurance (Medigap).

Medicare Advantage Plans: Check the Network

Medicare Advantage (Part C) plans are offered by private insurers, and most operate within a specific geographic service area. These plans often require you to use doctors and hospitals within their local network for routine care, and some require referrals for specialists. It is important to note that Medicare Advantage plans must cover emergency and urgently needed care while you are outside the plan’s geographic service area.

If you live in one state half the year and another the other half, a plan that works in Florida may not cover your routine care in Michigan, or it may cover it at a much higher out-of-network rate.

Questions to ask:

Is your Medicare Advantage plan a PPO (which may offer some out-of-network coverage) or an HMO (which usually doesn't)?
Do both of your locations fall within the plan's service area?
What happens if you need routine care while living in your second home?

Prescription Drug Plans (Part D): Location Matters

Part D drug plans also have networks, specifically, pharmacy networks. A plan based in New York might not include your favorite neighborhood pharmacy in Arizona.

To avoid disruption in your prescriptions:

Choose a plan with nationwide pharmacy access, like a major chain or mail-order pharmacy.
Double-check that your medications are still covered no matter where in the U.S. you are (most drug plans don't cover drugs received outside the U.S. and its territories).
Review your plan's formulary (drug list) and participating pharmacies yearly during the Medicare Annual Enrollment Period (Oct. 15–Dec. 7) to determine if there is a Part D drug plan better suited to your needs and your dual-state situation.

Medigap Plans: More Flexibility for Travelers

If you've chosen Original Medicare and added a Medicare Supplement Insurance (Medigap) policy, you're in luck. Most Medigap plans allow you to see any Medicare-participating provider in the country, making them an excellent choice for snowbirds.

Just remember:

Medigap policies are standardized, but sold by private insurers, and prices may vary by state.
If you make a permanent move to a new state, you may have a guaranteed-issue right to switch to a new Medigap policy without medical underwriting, but this depends on your state and situation. It's worth checking with a licensed agent before you assume you're covered.

Your Primary Residence and Medicare

Even if you live in two states, Medicare requires you to designate a primary residence, typically the address used for taxes, driver's license, and voter registration. This determines your plan eligibility and service area for Medicare Advantage or Part D plans.

If you make a permanent move (not just a seasonal stay), you'll qualify for a Special Enrollment Period to switch plans that better fit your new location.

Staying Connected to Your Care Team: Telehealth

One thing that's made life easier for snowbirds in recent years is the wider availability of telehealth. Many Medicare Advantage plans and providers now offer virtual visits, which means you may be able to check in with your regular doctor even while you're away from home.

Telehealth isn't a substitute for local, in-person care in an emergency, but it can be a helpful bridge for routine checks, follow-ups, medication management, or specialist check-ins while you're at your second home.

Coverage in Emergencies

Medicare will always cover emergency or urgent care in the U.S., regardless of where you are. So if you're visiting your second home and something unexpected happens, you won't be left without coverage.

For Medicare Advantage members, be sure to check your Evidence of Coverage, which describes how Medicare defines emergencies and urgently needed services and how those services must be covered by Medicare Advantage plans.

Quick Tips for Medicare Snowbirds

Here's a quick checklist to help you make the most of Medicare while living in two states:

Work with a Medicare agent. We can help you compare plans in both states and find the right match.
Choose flexible coverage. Original Medicare + Medigap offers the most freedom. If you use Medicare Advantage, consider a PPO plan with a wider service area.
Confirm your drug plan's pharmacy network. Make sure it works in both locations. Before traveling, request extra refills or a vacation supply of your medications, if your plan allows it.
Keep your legal address up to date. Medicare uses your home address to determine eligibility for plans.
Explore remote care. Ask your primary doctor if they offer telehealth visits while you're away.
Understand emergency and urgent care coverage. Know what's covered and what isn't, especially with Medicare Advantage. Save the contact info for urgent care centers near your homes.
Review plan notices every fall. Networks and costs can change each year. Don't assume this year’s plan will still fit your lifestyle next year.

What Medicare Really Covers for GLP-1 Drugs in 2026

Wed, 23 Sep 2026 16:00:10 GMT

A Plain-English Guide to the New $50 Copay Program and How to Get Started

For years, Medicare generally has not covered medications when they are prescribed solely for weight loss. Federal law currently excludes drugs used for weight loss from the standard Part D benefit. However, a new, limited exception to the rule became available on July 1, 2026.

Through a temporary program called the Medicare GLP-1 Bridge program, certain people with Medicare drug coverage may now be able to get select GLP-1 medications intended for weight management for a $50 copay per one-month supply. The Bridge program does not eliminate the underlying Part D exclusion for weight-loss drugs. Instead, it provides a separate, temporary pathway for eligible Medicare beneficiaries.

Read on to learn what the program covers, who could qualify, and how the process works.

Medicare Part D’s Existing GLP-1 Coverage

Before looking at the new Bridge program, it helps to understand GLP-1 coverage up to this point.

Medicare Part D can cover certain GLP-1 medications when they are prescribed for a medically accepted condition other than weight loss. Depending on the particular drug, those conditions may include:

Type 2 diabetes
Certain cardiovascular risks
Moderate-to-severe obstructive sleep apnea
Certain cases of metabolic dysfunction-associated steatohepatitis (MASH), a serious form of fatty liver disease

If your doctor prescribes a GLP-1 for one of these approved conditions, or something other than weight loss, your Medicare Part D plan may cover it. Which specific drugs are covered and what requirements apply depend on your particular plan.

The New Medicare GLP-1 Bridge Program

The Medicare GLP-1 Bridge program is a temporary program scheduled to run from July 1, 2026, through December 31, 2027. It gives eligible people with Medicare drug coverage access to certain GLP-1 medications for the purpose of weight management for a flat $50 copay per one-month supply. The program is available nationwide, including in U.S. territories.

One important note is that the Bridge program operates outside the regular Part D benefit. Medicare pays participating pharmacies through a central processor rather than having your Part D plan pay for the medication. This means your Part D plan does not have to opt into the Bridge program for you to participate.

Which Drugs Are Covered as of August 2026?

As of August 2026, the Medicare GLP-1 Bridge includes these medications when prescribed to reduce excess body weight and maintain weight reduction:

Foundayo — tablet
Wegovy — injection or tablet
Zepbound — KwikPen only (not single-dose vials or pens)

Because the Bridge program is evolving, Medicare may update covered products over the duration of the program.

What About Ozempic and Mounjaro?

The names of these medications are familiar to many people, so you may wonder if they're covered. The answer is no: Ozempic and Mounjaro are not covered through the Medicare GLP-1 Bridge program. Instead, they remain subject to regular Medicare Part D coverage rules and are most often prescribed to treat type 2 diabetes. Wegovy and Zepbound, on the other hand, are versions approved specifically for chronic weight management.

So, if you take a GLP-1 medication for a condition that can be covered under Part D, continue working with your health care provider and Medicare drug plan or Medicare Advantage plan regarding coverage. If, however, you are seeking a pathway to weight management, then the Bridge program may be worth pursuing. The first step is to find out if you're eligible.

Who Qualifies for the GLP-1 Bridge?

To participate, you must be 18 or older, have Medicare drug coverage, and meet one of Medicare's clinical eligibility standards when starting treatment.

You may qualify if you have:

A body mass index (BMI) of 35 or higher
A BMI of 30 or higher plus heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher
A BMI of 27 or higher plus prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease

You may also qualify for coverage of a GLP-1 drug if you started taking a GLP-1 drug prior to the start of the Bridge program and you met the eligibility conditions when you started taking the drug, even though you may not qualify now. For example, if you started taking a GLP-1 drug in January 2025 and at that time your BMI was 35, you may qualify for the Bridge program even if your current BMI is 25.

Medicare has additional clinical definitions and requirements for these conditions. Your health care provider will determine whether you meet the program's criteria.

You generally aren't eligible for the Bridge program if you already get GLP-1 drugs through your Part D coverage or if you have certain conditions for which GLP-1 treatment may be covered through regular Part D rules, including:

Type 2 diabetes
Moderate-to-severe obstructive sleep apnea
Certain fatty liver disease

Having one of these conditions may make you ineligible for the Bridge program even if your particular Medicare drug plan doesn't currently cover the medication. In that situation, regular Part D coverage and exception rules may apply.

You must also have qualifying Medicare drug coverage. That can include:

A standalone Medicare Part D plan
A Medicare Advantage plan with drug coverage
A Special Needs Plan with drug coverage
Certain employer or union Medicare drug plans
The LI NET program

How Do You Get Started?

The process starts with your health care provider rather than your Medicare drug plan.

Talk with your health care provider. Ask whether one of the covered medications is medically appropriate for you and whether you meet Medicare's BMI and health-condition requirements.
If they agree, your provider will send a prescription to your pharmacy. The medication must be prescribed as part of a treatment plan that includes diet and physical activity.
The first fill may take extra time. The pharmacy's initial claim may trigger a prior-authorization request to your provider. Once the required prior authorization is submitted, CMS says an approval or denial will generally be communicated within 72 hours.
Watch for a letter from Medicare. If your prior authorization is approved, Medicare will send you a letter confirming coverage through the Bridge program.
Be prepared to provide your Medicare information at the pharmacy. Your pharmacy may need your Medicare Number or, in some circumstances, the last four digits of your Social Security Number to process the claim.

Once approved, the prior authorization generally remains valid through December 31, 2027, including for refills and dose changes. A new authorization may be required if you change to a different GLP-1 medication covered by the Bridge.

How Does the $50 Copay Work?

The $50 copay works differently from what you normally pay for medications covered by your Part D plan because Bridge program medications are paid for outside your regular Part D benefit.

For medications you receive through the Bridge program:

You pay a flat $50 copay for a one-month supply
The $50 does not count toward your Part D deductible or annual out-of-pocket limit
It will not appear on your Part D Explanation of Benefits or your Medicare Summary Notice
Extra Help does not reduce the $50 copay
The Medicare Prescription Payment Plan cannot be used to spread the $50 cost across monthly payments

Those differences are especially important to understand if you receive Extra Help or are tracking your prescription drug spending toward your Part D out-of-pocket limit.

Your Next Step

If you think you might qualify for the Medicare GLP-1 Bridge, start by talking with your health care provider. Your provider can help determine whether one of the covered medications is appropriate for you and whether you meet Medicare's eligibility requirements.

The GLP-1 Bridge is currently scheduled to end December 31, 2027, so it's also worth discussing how your treatment and coverage options could change after the program period ends.

If you have questions about your current Medicare drug coverage, we're happy to help you understand how your plan works and where the GLP-1 Bridge program may fit in.

This article is accurate as of August 2026. The GLP-1 Bridge program keeps evolving, so it is good to keep an eye out for ongoing updates.

Medicare Scam Calls and Fake Agents Are Getting Harder to Spot

Wed, 16 Sep 2026 16:00:10 GMT

Who's Really on the Other End of That Medicare Call?

The phone rings. The voice on the other end says your name, your age, and your address. It sounds official. It may even sound friendly. And within a minute, you are being asked to confirm your Medicare number. What do you do?

Complaints about Medicare-related scam calls have climbed sharply over the past year. Reports to the Better Business Bureau indicate that these kinds of calls remain a major concern for people Medicare. Some have even described getting dozens of these calls in a single day. Enrollment season tends to make it worse, because legitimate outreach picks up at the same time criminals do.

Here is how these calls tend to sound, and how to protect yourself.

The Three Pitches You Are Most Likely to Hear

Many Medicare scam calls follow similar scripts. Once you recognize a few key patterns, the calls lose a lot of their power.

"You qualify for extra benefits"

A recorded voice says it is reaching out to make sure you receive unclaimed Medicare benefits. The recording asks whether you have Part A and Part B, then transfers you to a live person. The real goal is either to get your personal information or to switch you to a plan you did not ask for.

"Your card is expiring"

The caller warns that your Medicare card is about to expire, or that your coverage could be interrupted unless you verify a few details. Fear and urgency are the strategy here. If you hand over your Medicare number or Social Security number, criminals can use it to steal your identity or bill you for services you never received.

"Something free is on the way"

Free braces. Free hearing aids. Free gift cards or a free smartphone. The offered gift is bait. One woman in Texas received a large box of orthopedic braces she never ordered, and later learned Medicare had been billed more than $700 for them. Her secondary insurer was charged as well, and additional claims were filed for supplies she never requested.

Fraudulent claims can also leave inaccurate information in your medical records, including diagnoses for conditions you do not have.

Fake Agents Are Part of the Problem

Not every scammer sounds like a robot. Some present themselves as licensed insurance agents. They may reference a well-known carrier, quote a plan name, or offer to walk you through your options right now over the phone.

A few things a real agent will not do:

Pressure you to decide something during a first call
Refuse to give you a full name, license number, or office phone number
Ask you to pay by gift card, wire transfer, or a payment app
Tell you that you must act today or lose your coverage
Show up at your door uninvited to sell you a plan

Verifying an agent is simpler than most people expect. Ask for their name and license number, then hang up and call the agency's main office number yourself. You can also check the license with your state Department of Insurance. Anyone who is legitimate will not mind you doing this; they know you need to be careful.

Habits That Keep You Safe

Treat unexpected Medicare calls with skepticism, even friendly ones
Never give your Medicare number, Social Security number, or bank details to someone who called you
Remember that Medicare generally reaches out by mail first and does not call to ask for your Medicare number or banking information
Hang up on anyone who pressures you or claims your coverage is at risk
Read your Medicare Summary Notices and Explanation of Benefits statements and look for charges you do not recognize
Report anything unfamiliar right away

Hanging up may feel rude, but it is the single most effective thing you can do.

If You Think You Already Shared Something You Shouldn't Have

Act quickly, but do not panic. Write down what you shared and when. Review your recent statements. Then report it. You can contact the Senior Medicare Patrol program in your state, call 1-800-MEDICARE, or file a report with the Federal Trade Commission at ReportFraud.ftc.gov.

The Easiest Defense Is a Person You Already Know

Scam calls work because they catch people on their own and unsure. Having a licensed agent you already trust means you have someone in your corner. You have a number you can call to ask whether an offer is real before you respond to it. If you have questions about a call you received, or you want a second set of eyes on your current coverage, reach out to our office. We are here to help you!

It's Time to Prepare for Medicare Annual Enrollment

Wed, 02 Sep 2026 17:54:01 GMT

Plan Ahead for the Best Results

As we head into fall, it's time to think about an important Medicare milestone: the Annual Enrollment Period. If you're on Medicare, this is your chance to review your coverage and make changes if your needs have shifted, or if there will be changes to your current plan that you don’t like.

Key Dates for Annual Enrollment in 2026

October 1, 2026: Plan details for 2027 go live. You can start comparing Medicare Advantage (Part C) and prescription drug (Part D) options in your area, though you can't make changes yet.

October 15 – December 7, 2026: Enrollment is officially open. This is when you can:

Join a Medicare Advantage or Part D plan
Switch to a different plan
Drop coverage or switch back to Original Medicare

January 1, 2027: Any changes you made take effect. Make sure you review your new plan documents so you understand your coverage and costs.

What About Medigap?

If you have a Medicare Supplement (Medigap) plan, it works differently. The rules for joining or switching a Medigap plan are more complicated than those for Medicare Advantage and Part D plans. Reach out to us to discuss your options.

How to Get Ready Now

Between now and October, set aside some time to prepare.

Gather recent medical bills and receipts
Make or update your complete list of current medications and doses
List the doctors and hospitals you have used most over the past year
Check your current plan's summary of coverage
Watch for your Annual Notice of Changes (ANOC) from your health insurance company (usually arrives in late September)—this tells you what's changing in your coverage, costs, provider and pharmacy network, and benefits for 2027
Schedule a review session with our team starting October 1—slots fill up fast

The more organized you are, the easier it will be to make confident choices.

Let's Plan Ahead

Whether you want to stick with what you have or explore new options, we can help you understand your current plan, see what else is available, and make sure your doctors and prescriptions and other benefits are covered. Schedule now to meet with us starting October 1st.

If you have questions now about the process and what to expect, reach out anytime. We're here to help make the process as straightforward and successful as possible.

Understanding Chronic Condition Special Needs Plans (C-SNPs)

Wed, 19 Aug 2026 06:00:22 GMT

How Medicare Advantage Plans Built Around Your Condition May Support Your Care

Living with a serious chronic condition takes work. You juggle appointments, medications, and specialists. A Chronic Condition Special Needs Plan, called a C-SNP, is one type of Medicare plan built for people in exactly that spot.

Here's what a C-SNP is and who it may help.

What is a C-SNP?

A C-SNP is a type of Medicare Advantage Plan (Part C). Private insurance companies offer these plans, and Medicare approves them. They must follow Medicare's rules and cover what Medicare requires.

What sets a C-SNP apart is its focus. Each plan is built around one chronic condition or a group of related conditions. The benefits, provider network, and drug list are shaped to fit the people the plan serves.

How a C-SNP works

A C-SNP works much like other Medicare Advantage Plans. It includes:

Part A (hospital insurance)
Part B (medical insurance)
Part D (prescription drug coverage)

One point worth knowing: every Special Needs Plan must include Medicare drug coverage. So a C-SNP always comes with Part D.

The plan covers all medically necessary services that Original Medicare covers. Many plans add extra benefits on top of that.

Because these plans coordinate your care, you generally need to use doctors and providers in the plan's network. Emergencies, and urgently needed care or dialysis when you are outside the C-SNP's service area, are the exception. Some services may need prior approval before the plan pays. Rules vary from plan to plan, so check the details before you enroll.

Who can enroll?

To join a C-SNP, you must:

Have Medicare Part A
Be enrolled in Medicare Part B
Live in the plan's service area
Have a qualifying chronic condition, confirmed by your medical records

The 2026 Medicare & You handbook lists examples such as diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, chronic heart failure, and dementia. Some plans cover a single condition. Others cover a group of related conditions. Your eligibility depends on both your diagnosis and the plan's rules. You can stay enrolled in the C-SNP only if you continue to meet the condition served by the plan. If you no longer meet the plan's conditions, you may be eligible for a Special Enrollment Period to join another plan.

What makes a C-SNP different?

A standard Medicare Advantage Plan serves a broad group of people. A C-SNP narrows the focus to your condition. Depending on the plan, you may find:

A provider network experienced with your condition
A care coordinator to help manage your treatment plan
A drug list built around your condition
Programs that support medication use and day-to-day management

Every plan still follows Medicare guidelines and federal coverage rules.

What you might pay

Costs depend on the plan you pick. You may pay:

A monthly premium, in addition to your Part B premium
Copayments or coinsurance for services
Deductibles for medical care, drugs, or both

Every Medicare Advantage Plan, including a C-SNP, sets a yearly limit on what you pay out of pocket for Part A and Part B covered services. Once you reach that limit, you pay nothing for those covered services for the rest of the year. The limit amount is different from one plan to the next, so compare before you choose.

Is a C-SNP right for you?

A C-SNP may be worth a look if you:

Have a qualifying chronic condition
Want a plan built around that condition
Like the idea of a coordinated care team and focused support

It is not the only option. A regular Medicare Advantage Plan, or Original Medicare paired with other coverage, may fit you better. The right choice depends on your health, your doctors, and your budget.

Where to get help

C-SNPs can be confusing to navigate, but we're here to help. You can work with our team of licensed agents to find out about your options.

Medicare and Hearing Aids

Wed, 12 Aug 2026 06:00:09 GMT

What's Covered, What's Not, and Your Real Options

Before you spend a dollar, here's what you need to know: Original Medicare (Part A and Part B) does not cover hearing aids or the exams used to fit them. You pay 100% of those costs yourself.

This isn't a recent change. Hearing aids have been excluded since Medicare began in 1965, when they were treated as "routine" items rather than medical devices. Congress has introduced bills to change this, but none has become law.

The good news: this isn't the end of the story. You have several real paths to more affordable hearing care, along with the hearing services Medicare does cover.

What Original Medicare Does Cover for Your Hearing

While hearing aids are excluded, a few important services are covered.

Diagnostic Hearing and Balance Exams

If your doctor orders a hearing or balance test to diagnose a medical condition, Part B covers 80% of the approved cost after your annual deductible.

One Audiologist Visit Per Year

You can now see an audiologist once every 12 months without a doctor's order for non-acute hearing concerns. This helps with diagnosis, but still won't pay for the hearing aids themselves.

Cochlear Implants and Bone-Anchored Hearing Aids

These are surgically implanted and classified as prosthetic devices, not hearing aids. Medicare covers them when medically necessary—typically for severe hearing loss that conventional aids haven't helped.

Your Best Path to Covered Hearing Aids: Medicare Advantage

If hearing aid coverage matters to you, a Medicare Advantage plan (Part C) is the most common way to get it. These plans are offered by private insurers and are required to cover everything Original Medicare covers, but many also add extra benefits, and hearing is one of the most common.

A number of Medicare Advantage plans now include some kind of hearing benefit. Depending on the plan, that can include a hearing exam, a hearing aid fitting, and an allowance toward the cost of the hearing aids.

A few things to understand before you assume you're covered:

Benefits vary widely by plan and by location. Two plans in the same area can offer very different hearing benefits.
Allowances usually reset every year and do not roll over. If you don't use it, you lose it.
If your hearing aids cost more than the plan's allowance, you pay the difference out of pocket.
Some plans require prior authorization or limit how often you can get new aids.

To see exactly what a plan offers, you can review its Evidence of Coverage document, talk to your insurance agent, or call the plan directly.

One Thing to Know: Medigap Won't Help Here

A common point of confusion involves Medicare Supplement plans, also called Medigap. These plans only help pay your share of costs for things Original Medicare already covers, such as deductibles and coinsurance. Because Original Medicare doesn't cover hearing aids, Medigap plans generally don't cover them either. If hearing aid coverage is your goal, Medigap is probably not the route to take.

A More Affordable Option: Over-the-Counter Hearing Aids

If you have perceived mild to moderate hearing loss, over-the-counter (OTC) hearing aids may be worth a serious look. Since the FDA established this category in 2022, adults 18 and older can buy them without a prescription, hearing exam, or professional fitting.

You'll find them at retailers like Best Buy, Walmart, Costco, and Walgreens, as well as online. Prices often start around a couple hundred dollars per pair, compared with thousands for traditional prescription devices.

OTC aids aren't right for everyone. They tend to work best for adults with mild to moderate hearing loss who feel comfortable adjusting settings through an app or on the device itself. On the other hand, if your hearing loss is severe, came on suddenly, affects just one ear, or comes with pain, drainage, dizziness, or ringing, it's worth seeing an audiologist or doctor before buying anything. Those symptoms can point to a medical issue that a professional should evaluate and that the right prescription device can address far better.

Other Ways to Lower Your Costs

Even without direct Medicare coverage, several avenues can ease the expense.

Medicaid. If you're enrolled in both Medicare and Medicaid (dual-eligible), your state's Medicaid program may cover hearing aids. Coverage varies significantly by state.
VA benefits. If you're a veteran, the Department of Veterans Affairs often provides hearing aids and repairs at a reduced cost for those who qualify.
HSA or FSA funds. If you have a Health Savings Account or Flexible Spending Account, both OTC and prescription hearing aids are qualified medical expenses you can pay for with pre-tax dollars. However, it is important to note that once you are enrolled in Medicare (either Part A and/or Part B), the IRS prohibits you from contributing to a Health Savings Account, and imposes a 6% tax penalty for any contributions to the HSA made by you (or your employer, if applicable). You may, however, use funds in an HSA to help pay for hearing aids if those funds were deposited in the HSA prior to your enrollment in Medicare.

Hearing Aid Devices: An Important Investment

Original Medicare won't buy your hearing aids, but you are far from out of options. For most people, the practical choices come down to a Medicare Advantage plan with a hearing benefit, an over-the-counter device for milder hearing loss, or assistance through Medicaid, the VA, or health savings accounts. The best fit depends on your degree of hearing loss, your budget, and the plans available where you live.

Would you like help evaluating your options? Just reach out. We are happy to assist you.

Your ANOC Is Coming: Don't Throw This Medicare Letter Away!

Sat, 08 Aug 2026 06:00:00 GMT

What Your Annual Notice of Change Really Means for You

Every fall, if you're enrolled in a Medicare Advantage plan or a stand-alone Part D prescription drug plan, you'll receive an important piece of mail: the Annual Notice of Change, or ANOC. Many people glance at the envelope, assume it's routine paperwork, and tuck it away in a drawer, but this is a letter worth reviewing.

Your ANOC is your plan's official preview of what will change starting January 1 of the coming year. By law, plans must deliver it to you no later than September 30 each year, which gives you time to review it before Medicare's Annual Enrollment Period begins on October 15. Inside, you'll typically find details about premiums, drug coverage, copayments and coinsurance, provider networks, and any coverage changes starting January 1.

Why This Letter Deserves Your Attention

Many people assume that if you've been happy with your plan all year, then you don’t need to do anything and nothing will change. But Medicare Advantage and Part D plans are permitted to adjust their costs and coverage from one year to the next. The monthly premium might go up or down, a medication you've taken for years may move to a different cost tier or no longer be covered at all, or prior approval may now be required. A doctor or specialist you see regularly may no longer be part of the plan's network.

These changes do not require your permission and can significantly impact your coverage. Reviewing your ANOC carefully gives you a critical head start, allowing you to identify specific concerns or areas to address, such as network or formulary changes, before annual enrollment arrives. This ensures that when it comes time to sit down with us after October 1 for your Medicare review, you and your agent can focus on evaluating the aspects of your plan that you already know need your attention.

What Can Actually Change

The ANOC covers more ground than most people expect. Along with monthly premiums and annual deductibles, it can outline new copayment or coinsurance amounts for doctor visits, specialist care, and hospital stays. It will also show whether your medications have moved to a different cost tier, been removed from the formulary altogether, or gained a new requirement like prior authorization or step therapy. Provider and pharmacy networks can change, too, meaning a doctor or pharmacy you rely on today might not be included next year. Even the maximum amount you'd pay out of pocket in a year, and benefits like dental, vision, or hearing can be adjusted, expanded, or reduced. The plan may even add new, additional supplemental benefits in the coming year.

A Quick Example

Consider a longtime Medicare Advantage enrollee named Margaret, who was satisfied with her plan, didn’t open her ANOC, and let her enrollment automatically renew during annual enrollment. It wasn’t until January that she realized her monthly premium had gone up slightly, and more importantly, a maintenance medication she'd taken for years had moved to a higher cost tier. She also discovered that one of her regular specialists was no longer in the plan's network. Had she caught these changes in October, she would have had time to compare plans and talk with a licensed agent before the Annual Enrollment Period closed. But now she was locked into her plan for the rest of the year.

What to Do When Your ANOC Arrives

The envelope will likely be marked with something like "Important Plan Information” or may be labeled “Annual Notice of Change.” Open it and read through the entire letter. Many ANOCs include a side-by-side comparison of this year's plan details versus next year's. Pay close attention to four things in particular: your premium, your specific medications, the providers you see most often, and the benefits you use most or expect to use in the coming year. If anything has changed in a way that concerns you, that's your cue to explore other options. Starting on October 1, you can work with one of our licensed insurance agents to compare plans and prepare for Annual Enrollment from October 15 - December 7.

Common Mistakes to Avoid

The most common mistake is simply not opening the envelope, and assuming that because nothing has gone wrong this year, nothing will change next year. Another is reading only the first page and missing details buried further in, such as formulary or network changes. Some people miss the window and open it too late to take action during the Annual Enrollment Period, which runs October 15 through December 7. Others focus solely on the premium and overlook drug coverage or network changes, which can end up costing far more over the course of a year.

Free, Unbiased Help Is Available

You don't have to sort through your ANOC alone. Starting on October 1, we can walk you through the changes and help you weigh plans that may better fit your needs in 2027. If you'd like more immediate assistance, your State Health Insurance Assistance Program, known as SHIP, offers free resources to help you understand your notice. Either way, any changes you decide to make during the Annual Enrollment Period will take effect on January 1.

Conclusion

Your ANOC may look like just another piece of mail, but it's one of the most useful documents Medicare sends you all year. Reading it carefully, checking your premium, your medications, and your providers, and comparing your options can help you make sure you’ve got a plan that truly fits your needs. Don't throw it away, and don't let it sit unopened. A little attention each fall can go a long way toward protecting your healthcare and your budget in the year ahead.

Medicare Advantage Plan Discontinuations in 2026

Mon, 29 Jun 2026 06:00:03 GMT

What Beneficiaries Should Know About Coverage Options and Enrollment Deadlines

If you received a notice last fall that your Medicare Advantage plan would not be available in 2026, you were among a large group of beneficiaries affected by a notable shift in the Medicare Advantage market.

Research published in the medical journal JAMA found that approximately 10% of Medicare Advantage (MA) enrollees nationwide had their plans discontinued for 2026, resulting in nearly 2.9 million people needing to find new coverage. For context, disenrollment rates averaged around 1% annually from 2018 through 2024, before rising to nearly 7% in 2025 and reaching 10% this year, according to research led by Dr. Mark K. Meiselbach of the Johns Hopkins Bloomberg School of Public Health.

The impact has varied considerably by state. In Vermont, more than 90% of MA enrollees received non-renewal notices. Wyoming, South Dakota, and New Hampshire were also among the states with larger shares of affected beneficiaries. Rural areas and regions with higher-cost populations have generally seen more plan exits than other parts of the country.

Why Are Some Plans Leaving the Market?

Several factors appear to be contributing to plan exits, and different stakeholders point to different causes.

Insurers have cited rising medical costs as a primary driver. One contributing factor is that many patients who delayed care during the COVID-19 pandemic have since sought that care, increasing utilization and costs. The cost of treatment has also risen broadly.

At the same time, some policymakers and researchers argue that federal payment rates to MA plans have historically been higher than what it would cost to cover the same beneficiaries under Original Medicare — and that recent regulatory steps to adjust those payments are a necessary correction. Insurers counter that the adjustments have not kept pace with their actual costs, making some markets difficult to operate in profitably.

Both perspectives are part of an ongoing policy debate. What is clear from the data is that carriers — particularly smaller insurers — have been pulling back from certain markets, and some larger carriers have also reduced plan offerings or benefits in specific areas.

What Happens When a Plan Is Discontinued?

When a Medicare Advantage plan stops participating in Medicare, coverage under that plan ends on December 31 of that year. According to the Medicare & You 2026 Handbook, your plan is required to send you a letter explaining your options.

One practical consideration when switching plans is that MA plans operate with their own provider networks and drug formularies, both of which can differ significantly from one plan to another. Depending on the new plan you select, your current doctors or specialists may or may not be in-network, and your prescription drugs may be covered differently — either in terms of whether they are covered at all or what cost tier they fall into.

Reviewing these details carefully before selecting a new plan can help minimize disruption to your care.

Coverage Options to Consider

Beneficiaries whose plans were discontinued generally have three main paths available. Each has its own structure, costs, and trade-offs.

Enroll in a different Medicare Advantage plan. You may be able to find another MA plan in your area that meets your needs. When comparing plans, it is worth checking whether your current providers are in the plan's network, whether your medications are on the plan's formulary and at what cost tier, differences in copayments and coinsurance from your current plan, and differences in supplemental benefit coverage such as gym memberships, transportation, and dental and vision benefits. Medicare's Plan Finder tool at Medicare.gov/plan-compare allows you to compare plans available in your area.

Return to Original Medicare (Parts A and B). Original Medicare is not tied to provider networks, which means you can generally see any doctor or specialist who accepts Medicare. However, Original Medicare does not include an out-of-pocket maximum, so you may be responsible for deductibles and coinsurance costs without a cap. Many people who return to Original Medicare also enroll in a stand-alone Medicare drug plan (Part D) to help cover prescription costs.

Purchase a Medicare Supplement (Medigap) policy. Medigap policies are sold by private insurers and are designed to work alongside Original Medicare, helping to cover costs such as deductibles, coinsurance, and copayments. Medigap plans carry a monthly premium in addition to the Part B premium, but they can provide more predictable out-of-pocket costs. Coverage and pricing vary by plan type and insurer.

Guaranteed Issue Rights: A Time-Sensitive Consideration

One important protection that applies when a Medicare Advantage plan is discontinued is the right to purchase certain Medigap policies without medical underwriting. Under federal law, insurance companies generally cannot deny you a Medigap policy, charge higher premiums based on pre-existing conditions, or impose pre-existing condition waiting periods during a guaranteed issue period.

According to the Medicare & You 2026 Handbook, if your plan stops participating in Medicare, you may have the right under federal law to buy certain Medigap policies within 63 days after your plan coverage ends. Depending on your state, additional rights may also apply.

This window is defined by federal (and in some cases state) law. If you are considering a Medigap policy following a plan discontinuation, it is worth understanding when your guaranteed issue rights apply and for how long, so you can make decisions within the applicable timeframe.

Enrollment Periods to Be Aware Of

Beyond the guaranteed issue window, there are several enrollment periods that may be relevant depending on your situation.

The Annual Enrollment Period runs October 15 through December 7 each year. During this period, you can join, switch, or drop a Medicare Advantage plan or Medicare drug plan, with coverage changes taking effect January 1. Your plan is required to send you an Annual Notice of Change by September 30, which outlines any upcoming changes to costs, coverage, or networks.

The Medicare Advantage Open Enrollment Period runs January 1 through March 31. If you are currently enrolled in a Medicare Advantage plan, you can use this period to switch to a different MA plan or return to Original Medicare. This period does not allow you to move from Original Medicare into a Medicare Advantage plan.

If you are unsure which enrollment periods apply to your situation, your State Health Insurance Assistance Program (SHIP) provides free, unbiased counseling to Medicare beneficiaries. A licensed insurance broker who specializes in Medicare may also be a helpful resource for comparing your options.

Looking Ahead

Medicare Advantage remains a significant part of the Medicare landscape, and the market continues to evolve. Plan availability, provider networks, benefits, and costs can change from year to year, which makes an annual review of your coverage a worthwhile habit regardless of whether your plan has been affected by recent market changes.

Understanding your options — and the timeframes associated with them — puts you in a better position to choose coverage that fits your health needs and financial situation.

8 Tips for a Healthy Summer Vacation

Thu, 25 Jun 2026 06:00:00 GMT

Safe Travel Starts at Home

Travel is one of life's greatest joys. Whether you're planning a weekend road trip or a long-awaited international adventure, the excitement of setting off somewhere new is hard to beat. But the best trips are the ones where the surprises are good ones. A little preparation before you leave home, especially when it comes to your health coverage, can mean the difference between a smooth journey and a stressful one.

Here's how to set yourself up for a healthy, worry-free trip.

1. Know What Your Health Plan Covers — and Where

Before you book anything, take a few minutes to review your health insurance coverage in the context of your destination.

If you have an individual health plan, check whether your insurer's network extends to where you're traveling. Some plans only cover in-network or in-state providers, while others include broader emergency coverage.

If you're on Medicare, here's what you need to know: Original Medicare (Parts A & B) typically doesn’t cover medical care outside the U.S., except in limited circumstances. If you have a Medicare Advantage Plan, it may include emergency and urgent coverage abroad, but this varies by provider. Check your plan’s Evidence of Coverage or speak to your plan provider before traveling.

If you have questions about your coverage, we can help review your policy and fill any gaps before you travel.

2. Consider Supplemental Travel Coverage

If your existing coverage has gaps, there are several supplemental options worth exploring:

International Travel Insurance covers emergency care during trips outside the U.S. and is generally affordable for short-term travel. Look for plans with medical evacuation coverage.
Medicare Supplement Insurance (Medigap) — certain Medigap plans cover foreign travel emergency care up to plan limits, generally after a deductible. If you have a Medigap policy, check your plan details to see if foreign travel emergency coverage is included.

We can help you sort through your options and find coverage that fits your trip.

3. Smart Packing: What to Bring on the Plane

When it comes to medications and medical devices, one rule applies: keep them with you. Always pack prescriptions, medical devices, and essential health supplies in your carry-on bag — never in checked luggage. Bags get delayed or lost, and being without critical medications can turn a vacation into a medical emergency.

A few things to know before you reach the airport:

Medications: Bring enough for your full trip plus a few extra days. Keep medications in their original labeled pharmacy containers when possible because it speeds up TSA screening and reduces customs questions.
Medical devices: CPAP machines, nebulizers, insulin pumps, and similar devices are permitted on most flights, but it is wise to carry a physician's letter explaining your need for the device. If you use a portable oxygen concentrator, notify your airline at least 48 hours in advance, as most carriers require it.
Implanted devices: Carry your device identification card and inform TSA officers before screening if you have a pacemaker, defibrillator, or similar device.

For specific questions, visit tsa.gov or call the TSA Cares helpline before your trip.

4. Have Easy Access to Your Medical Information

A health emergency is stressful enough without having to scramble for basic information. Before you leave, put together a simple travel health packet that includes:

Your insurance and/or Medicare cards
Emergency contact numbers, including country codes for international travel
A current medication list with dosages
A summary of any allergies or significant medical conditions. If you are traveling somewhere English isn't widely spoken, consider having it translated.

Keep the originals in a waterproof sleeve in your bag and leave a copy with someone you trust back home.

5. Take Care of Preventive Health Before You Go

Most insurance plans cover preventive care at no additional cost, so use it. Before your trip, make sure you're current on vaccinations, including flu, COVID-19, and tetanus. For international travel, check the CDC's destination-specific recommendations, which may include Hepatitis A or B, typhoid, yellow fever, or other vaccines depending on your destination.

6. Protect Yourself from Health-Related Fraud

Travelers are frequent targets for scams, and health information is no exception.

If you're a Medicare beneficiary, guard your Medicare number the same way you'd protect a credit card.

Only share Medicare or insurance information on official websites or with verified agents.
When you return home, watch your Explanation of Benefits for any claims you don't recognize.

7. Have an Emergency Preparedness Plan

A little research can go a long way if something goes wrong. Before you arrive at your destination:

Identify the nearest hospital or urgent care facility, confirm whether they accept your insurance, and understand the process if you need medical evacuation.
Know the medical emergency phone number at your destination. What is the equivalent of calling 9-1-1?
In international locations, remember that you may encounter language barriers, unfamiliar billing practices, and different standards of care. The U.S. Embassy or Consulate at your destination can often provide referrals to local English-speaking physicians and hospitals.

8. Keep Your Body in Good Shape Along the Way

It's very easy to leave good habits behind when you head out on a trip, but taking care of your body is important for a good vacation.

Move regularly: Stretch and walk every few hours, especially on long flights or car rides.
Hydrate, hydrate, hydrate! Drink plenty of water to counter the effects of extra activities, extra sun, and extra food and drink.
Eat balanced meals: Meals on the go tend to lack a healthy dose of fiber, which can lead to digestive distress. Be sure to seek out veggies and whole grains, and consider bringing a fiber supplement with you.
Rest: Fatigue lowers immunity. Don't skip on sleep.
Keep germs at bay: Use hand sanitizer, wash your hands frequently, and consider wearing a mask on crowded airplanes or mass transit.

Conclusion

A great trip starts long before you leave home. By reviewing your coverage, filling any gaps, organizing your health information, and taking a few smart precautions, you can travel with real confidence. Whether you're hiking the Rockies or relaxing on a beach abroad, being prepared means your focus stays where it belongs — on the adventure ahead.

Safe travels!

Medicare’s New Bridge Program for GLP-1s

Tue, 23 Jun 2026 06:00:00 GMT

Medicare Part D to Cover GLP-1s for Weight Los s

A significant shift in Medicare drug coverage is underway. Starting July 1, 2026, the Medicare GLP-1 Bridge program will temporarily allow coverage of certain weight-loss medications — including Wegovy, Zepbound (KwikPen formulation), and Foundayo — for eligible Medicare Part D beneficiaries.

For many seniors who have struggled with the high cost of these medications, this pilot program represents one of the most notable changes to Medicare prescription coverage in years.

Why This Program Matters

Historically, Medicare has been prohibited by law from covering drugs prescribed specifically for weight loss. That long-standing restriction has put GLP-1 medications financially out of reach for many beneficiaries, with cash prices that can range from roughly $150 to nearly $700 per month, depending on the drug and dosage.

The Bridge program is designed to fill that coverage gap on a short-term basis while the Centers for Medicare & Medicaid Services (CMS) studies whether broader access could improve long-term health outcomes.

How the Bridge Program Works

The Medicare GLP-1 Bridge will run from July 1, 2026, through December 31, 2027 . Here's a quick overview:

Covered medications (as of June, 2026): Wegovy (injection and tablets), the KwikPen formulation of Zepbound, and Foundayo
Monthly copay: A flat $50 per prescription, regardless of dosage
Eligibility requirement: Enrollment in a Medicare Part D standalone plan or a Medicare Advantage plan with drug coverage (MA-PD). See the next section for additional eligibility criteria.
Prior authorization: Required, submitted by your prescribing provider
Processing: Handled through a centralized CMS system rather than individual Part D plans

Because the program operates outside the standard Part D benefit, prescribers and pharmacies will route claims through a central processor designated by CMS.

Who May Be Eligible

Eligibility is based on body mass index (BMI) and related health conditions. According to CMS, a beneficiary must be at least 18 years old and fall into one of these clinical categories at the time GLP-1 therapy is initiated:

BMI of 35 or higher (no additional condition required); or
BMI of 30 or higher , plus a diagnosis of heart failure with preserved ejection fraction, uncontrolled hypertension, or chronic kidney disease (stage 3a or higher); or
BMI of 27 or higher , plus a diagnosis of pre-diabetes, previous heart attack, previous stroke, or symptomatic peripheral artery disease

The medication must also be prescribed alongside structured lifestyle modifications, including nutrition and physical activity guidance consistent with FDA-approved labeling.

It's important to note that beneficiaries already taking GLP-1 drugs for Medicare-covered health conditions such as Type 2 diabetes or certain cardiovascular indications will continue to access those medications through their existing Part D plan. The Bridge program is specifically for weight-loss prescriptions.

A Quick Look at GLP-1 Medications

This class of drugs, GLP-1 receptor agonists, mimic a hormone that helps regulate blood sugar and appetite. They slow digestion, help people feel full longer, and may support meaningful weight reduction when combined with lifestyle changes.

For beneficiaries with weight-related health concerns, sustained weight loss may help with:

Heart disease
High blood pressure
Type 2 diabetes
Sleep apnea
Joint problems

As with any medication, GLP-1 drugs carry potential side effects and aren't right for everyone. Conversations with a qualified provider are essential.

Important Limitations to Understand

While the Bridge program offers significant savings, there are a few notable trade-offs:

The $50 copay does not count toward the Part D deductible or the annual out-of-pocket prescription drug spending cap
Part D low-income subsidies (Extra Help) cannot be applied to these prescriptions
The program is temporary (for now), ending December 31, 2027
Studies suggest many people regain weight after stopping GLP-1 therapy, which raises important planning considerations once the program concludes

What Happens After 2027

CMS originally designed the Bridge as a transition to a longer-term initiative called the BALANCE Model (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth). However, the timeline and structure of that model are still evolving, and ongoing access to GLP-1s for weight loss beyond 2027 is not yet guaranteed.

Beneficiaries who benefit from the Bridge program will want to review their drug plan options carefully during future Annual Enrollment Periods to understand what coverage may be available.

Recap

The Medicare GLP-1 Bridge represents a temporary, targeted opportunity for eligible Part D beneficiaries to access weight-loss medications at a more predictable cost. Like any pilot program, the details may continue to evolve as CMS releases additional guidance.

If you think you may qualify, the best first step is a conversation with your health care provider about whether a GLP-1 medication fits your overall health picture. For program specifics, visit CMS.gov or Medicare.gov , or call 1-800-MEDICARE (1-800-633-4227).

Brain Health, Medicare, and You

Fri, 19 Jun 2026 06:00:03 GMT

Honoring Alzheimer's & Brain Awareness Month

Every June, the Alzheimer's Association invites us to recognize Alzheimer's & Brain Awareness Month. It’s a chance each year to learn and take meaningful steps toward better brain health. For Medicare beneficiaries and the loved ones who care for them, it's also a great time to understand how Medicare can support cognitive health at every stage.

What is Alzheimer’s Disease?

Alzheimer's disease is a progressive brain disorder that gradually destroys memory, thinking skills, and the ability to carry out everyday tasks. It is the most common cause of dementia in older adults, accounting for an estimated 60–80% of cases, and typically develops slowly over many years.

According to the Alzheimer's Association, an estimated 7 million Americans aged 65 and older are living with Alzheimer's disease, and that number is expected to grow as the overall population ages. And Alzheimer's isn't the only concern. Other forms of dementia, mild cognitive impairment, and reversible conditions like depression, anxiety, or medication side effects can affect memory and thinking.

While there is currently no cure for Alzheimer’s, early diagnosis can open the door to treatments, support resources, and planning options that may help individuals and their families navigate the condition.

How Medicare Supports Cognitive Health

Medicare includes several benefits designed to help beneficiaries stay on top of their brain health. Here are a few worth knowing about:

The Yearly "Wellness" Visit

If you've had Medicare Part B for longer than 12 months, you get a yearly Wellness Visit once every 12 months. This isn't a physical exam; it's a personalized visit to help you and your provider build a plan to prevent disease or disability based on your current health.

During this visit, your doctor will perform a cognitive assessment to look for signs of dementia, including Alzheimer's disease. Signs of cognitive impairment can include trouble remembering, learning new things, concentrating, managing finances, or making everyday decisions.

Under Medicare, you pay nothing for the yearly wellness visit if your doctor or other health care provider accepts Medicare assignment.

Cognitive Assessment & Care Plan Services

If your provider notices signs of possible cognitive impairment, Medicare covers a separate, more in-depth visit. During this appointment, your doctor or other health care provider may:

Perform a physical and neurological exam
Review your medical history, and look over your medications
Identify your support system and what caregivers may be able to help with
Create a care plan to address and manage symptoms
Refer you to a specialist, if needed
Share information about community resources, such as rehabilitation services, adult day health programs, and support groups

A spouse, friend, or caregiver is welcome to attend this visit to help share information and ask questions. The Part B deductible and coinsurance apply for this visit.

Additional Dementia Support

Some people living with dementia and their unpaid caregivers may be able to get additional support through the Guiding an Improved Dementia Experience (GUIDE) Model without paying coinsurance. This powerful program provides coordinated services that include care navigation, training and education for caregivers, connections to community resources for dementia, 24/7 access to a support line, and respite services up to $2,500 annually. Not every provider participates, so ask your health care provider whether this program is available to you.

For more information on covered treatments for Alzheimer's disease, visit Medicare.gov.

Brain-Healthy Habits Count, Too

Medical care is just one piece of the puzzle. Many health organizations also point to everyday habits that may support cognitive wellness, such as:

Staying physically active
Eating a balanced, nutritious diet
Getting consistent and quality sleep
Staying socially connected with friends, family, and community
Challenging your brain with reading, puzzles, learning, or new hobbies
Managing chronic conditions like high blood pressure, diabetes, and hearing loss

These habits don't replace medical care, but they can complement and support the preventive benefits Medicare offers.

For Caregivers: You're Not Alone

Caring for someone with memory loss is very demanding. If you're a caregiver, remember that Medicare-covered cognitive care visits are designed with you in mind, too. You can attend appointments, ask questions, and help your loved one develop a clear care plan together. Organizations like the Alzheimer's Association (alz.org) and the Eldercare Locator (eldercare.acl.gov) also offer free resources, support groups, and 24/7 helplines. Don’t neglect your own health, especially your mental health, as you go through this journey.

Take a Moment This June

Alzheimer's & Brain Awareness Month is a reminder to ask questions, schedule that wellness visit, and have honest conversations with the people you love. Brain health is part of overall health, and Medicare offers meaningful tools to help you protect it.

If you have questions about which services your specific Medicare coverage includes, reach out to us for a review.

Scammers Are Targeting Grandparents—Here’s How to Stay One Step Ahead

websitehelp@agencybloc.com (Agency Bloc) — Fri, 29 May 2026 15:35:31 GMT

Imagine getting a call in the middle of the night from someone claiming to be your grandchild, panicked and in trouble. They say they’ve been in an accident or arrested—and they desperately need money. Your heart races. You’d do anything to help. That’s exactly what scammers are counting on.

The Federal Communications Commission (FCC) has recently issued a warning about a rise in what's known as the “grandparent scam” —a sneaky and heartless scheme targeting older adults with urgent, emotional phone calls meant to trick them into sending money.

What Is the Grandparent Scam?

These scams usually start with a phone call from someone pretending to be your grandchild (or another close relative). They’ll say they’re in trouble—maybe stuck in jail or in a hospital—and they need money fast for bail, legal fees, or emergency expenses.

To make things even more convincing, they may hand the phone off to someone pretending to be a lawyer or a police officer. And they’ll likely ask you not to tell anyone—saying it’s a “private” or “sensitive” situation.

That sense of urgency is key to the scam. It’s meant to bypass your instinct to double-check and make you act fast—before you have time to think it through or talk to someone else.

Why It Works—and Why It’s Dangerous

These calls often come late at night or early in the morning, when you’re more likely to be caught off guard. The scammer might not even say who they are—just “Grandma, it’s me”—and hope you fill in the blank for them. From there, they use that information to sound more convincing.

Some victims have been asked to send money via wire transfer, cryptocurrency, gift cards, or even in cash via courier—all methods that are difficult or impossible to trace or reverse. According to the FCC, scammers using this method have stolen tens of millions of dollars from seniors across the U.S.

Watch for These Warning Signs

If you or someone you love receives a call like this, here are some red flags that it could be a scam:

High pressure and urgency – You’re told to act immediately

Vague or strange details – They may not identify themselves clearly, or hope you’ll say the grandchild’s name for them

Unverifiable location or story – They say they’re in jail overseas or in a place where you can’t easily check on them

Unusual payment requests – Gift cards, Bitcoin, wire transfers, or cash deliveries

Calls at odd hours – Scammers try to catch you when you’re less alert

What To Do If You Get a Suspicious Call

If something doesn’t feel right, trust your gut. Here’s what you can do to stay safe:

✅ Hang up and verify – Call your grandchild or their parent using a phone number you know is theirs

✅ Talk to someone you trust – A second opinion from a friend or family member can make all the difference

✅ Don’t rely on caller ID – Scammers often “spoof” numbers to make it look like someone you know is calling

✅ Block the number – Use your phone’s settings to block suspicious calls

✅ Report the scam – Contact the National Elder Fraud Hotline at 833-FRAUD-11 and file a complaint with the FCC

What If You’ve Already Sent Money?

First of all, don’t panic—and know that you’re not alone. Scammers are incredibly convincing, and even smart, cautious people have been tricked.

Here’s what to do:

Call your bank or payment service right away – They may be able to stop or reverse the transaction if it's recent
Report it – Contact the FCC, your local police, and the FBI’s Internet Crime Complaint Center at ic3.gov
Let your family know – They can help protect you and others from future attempts

Help Protect Others, Too

The more people know about this scam, the harder it becomes for criminals to succeed. Please share this information with friends, neighbors, and especially your older loved ones. A quick conversation now could prevent a heartache later.

And remember—if you ever get a call like this and aren’t sure what to do, don’t rush. Take a breath, hang up, and check in with someone you trust. Real family emergencies don’t come with secret demands or payments via gift cards.

7 Healthy Travel Tips

websitehelp@agencybloc.com (Agency Bloc) — Thu, 14 May 2026 15:35:31 GMT

Whether you’re planning a weekend getaway or a long-awaited international adventure, setting off on a trip is always exciting—but can also be unpredictable. That’s why preparing for the unexpected, especially when it comes to your health, is essential. Knowing what your medical coverage includes (and doesn’t) while traveling can help you stay healthy, avoid costly surprises, and soak up the unforgettable moments on your journey.

Let’s walk through some proactive steps you can take before packing your bags—from vaccinations and insurance to emergency planning and fraud protection.

1. Know What Your Health Plan Covers—And Where

Medical surprises aren’t on anyone’s itinerary—but it’s best to be prepared. Start by knowing how your insurance policy covers (or doesn’t) the region you’re traveling to.

Individual health policyholders, review your insurer’s network coverage. Some plans only cover in-network or state-specific services, while others offer broader emergency coverage or travel-specific riders. Consult your insurance agent to get help reviewing your policy.

Medicare beneficiaries, Original Medicare (Parts A & B) typically doesn’t cover medical care outside the U.S., except in limited circumstances. If you have a Medicare Advantage Plan, it may include emergency and urgent coverage abroad, but this varies by provider. Check your plan’s Evidence of Coverage or speak to your plan representative before traveling.

2. Consider Supplemental Insurance

If you're a frequent traveler or heading abroad, look into some options to help cover you. Some options include:

Travel Medical Insurance : Plans offer emergency coverage during trips outside the U.S. and tend to be affordable.
Evacuation Insurance : This covers transport to a qualified medical facility if the nearest care is inadequate. An evacuation clause is often, but not always, included in a travel insurance plan.
Medicare Supplement Insurance (Medigap) : Some Medigap policies cover emergency care abroad, typically up to plan limits and with a deductible.
Critical Illness Insurance : A lump-sum payout can provide financial flexibility in case you’re diagnosed with a covered condition like a heart attack or stroke during travel.

Be sure to read the fine print—some policies require you to be under a certain age, and preexisting conditions may not be covered. Your licensed insurance agent can help talk you through your options.

3. Keep Your Medical Info Handy

Consider using a secure health app or digital wallet to access all your health records quickly. But just in case your phone is inaccessible, bring physical copies of these important documents as well:

Your insurance or Medicare cards
Emergency contact numbers (include the country code +1 if you’re traveling abroad)
A medication list with dosages
Allergy and medical condition alerts

Pack all essential paperwork together in a waterproof sleeve in your luggage, and leave a second copy with someone back home.

4. Schedule Preventive Care Before Departure

Most insurance plans cover preventive care services like wellness visits, vaccinations, and screenings. Before your trip, check these tasks off your list:

Get vaccinated : Make sure you’re up to date on your flu, COVID-19, and tetanus shots. If traveling internationally, check the CDC recommendations for the region you’re visiting, which may include Hepatitis A/B, typhoid, or yellow fever vaccinations.

Rethinking Your Soft Drink Habits

websitehelp@agencybloc.com (Agency Bloc) — Thu, 07 May 2026 15:35:31 GMT

As the summer sun beckons and thirst levels rise, it's tempting to reach for a cold, fizzy beverage. But before you pop open that soda can, consider this: your drink choice has long-term implications for your health.

The Hidden Risks in Your Glass

A comprehensive study by the International Agency for Research on Cancer (IARC) analyzed data from over 451,000 individuals across 10 European countries over a 16-year period. The findings revealed that consuming two or more 250 ml glasses of soft drinks daily—whether sugar-sweetened or artificially sweetened—was associated with a higher risk of all-cause mortality compared to those who drank less than one glass per month.

Delving deeper:

Artificially Sweetened Beverages : Individuals consuming two or more glasses daily had a 26% higher risk of death compared to those who consumed less than one glass per month. Specifically, there was a 52% increased risk of death from circulatory diseases.
Sugar-Sweetened Beverages : Those consuming one or more glasses daily faced a 59% higher risk of death from digestive diseases.
All Soft Drinks : A notable association was found between soft drink consumption and increased mortality from Parkinson's disease.

Alternatives That Aren’t Any Healthier

Think fruit juice or energy drinks are a safer bet? A study involving 13,440 U.S. adults aged 45 and older found that each additional 12-ounce serving of sugary beverages, including 100% fruit juice, was linked to an 11% higher risk of all-cause mortality. Specifically, each additional 12-ounce serving of fruit juice was associated with a 24% increased risk. Watch the sugar content of iced coffee beverages and alcoholic cocktails as well.

Lifestyle Factors Matter, Too

It's essential to note that high soft drink consumption often correlates with other unhealthy lifestyle choices. The IARC study observed that individuals who drank more soft drinks typically had higher body mass indexes and were more likely to smoke. Even after adjusting for factors like diet, physical activity, smoking, and education, the association between soft drink consumption and increased mortality risk remained significant.

Refreshing Alternatives for the Season

Looking to quench your thirst without compromising your health? Here are some delightful, healthier options:

Infused Water : Add slices of citrus fruits, cucumbers, or berries to your water for a refreshing twist.
Herbal Iced Teas : Brew teas like hibiscus or mint, chill them, and enjoy over ice.
Sparkling Water with a Splash : Mix sparkling water with a splash of 100% fruit juice for a fizzy treat.
Homemade Lemonade : Use fresh lemons, water, and a touch of natural sweetener like honey or stevia.
Coconut Water : A natural source of electrolytes, perfect for rehydration.

Final Thoughts

Summer is a time for relaxation and enjoyment. By making informed beverage choices, you can savor the season while prioritizing your health. So, the next time you're reaching for a drink to beat the heat, consider these healthier alternatives. Your body will thank you!