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News
Your Advantage Plan's Star Rating Counts Appeals Timing and Members Lost. CMS Just Decided to Drop Both.
2+ day, 1+ hour ago (734+ words) CMS just quietly removed two Medicare Advantage star measures that reveal what happens when your plan says no. Before they vanish from the scorecard, here is what those numbers actually show and how long you have left to use them....
Her Second Nursing-Home Stay Started on Day 41. Medicare’s 100 Days Reset Only After a 60-Day Break. She Had Been Home for 45.
6+ day, 19+ hour ago (433+ words) A 45-day gap between nursing-home stays felt like plenty of time, but Medicare's benefit period had other ideas, and the family discovered the difference when the second bill arrived. The Full Benefits Desk desk. Editor: Gerelyn Terzo. This post may…...
Open Enrollment Lets You Change Advantage Plans With No Questions Asked. It Does Not Promise You Medigap. That Application Still Asks About Your Health.
1+ week, 1+ hour ago (639+ words) Switching Medicare Advantage plans during Open Enrollment is simple, but the move back to Original Medicare with a Medigap supplement can collapse entirely depending on what your health history says about you now versus when you were 65. The Full Benefits…...
Starting in 2027, Your Advantage Plan No Longer Has to Remind You About the Benefit Money You Haven't Spent.
1+ week, 5+ day ago (705+ words) A federal rule required your Medicare Advantage plan to warn you about benefits you were leaving on the table. CMS quietly killed that requirement, and now the clock on your unused dental, OTC, and supplemental allowances is running without any…...
His Medicare Advantage Trial Right Lasted 12 Months. At Month 14, Medigap Could Say No.
3+ week, 3+ day ago (426+ words) New Medicare Advantage enrollees get a 12-month federal trial right to switch back to Original Medicare and buy any Medigap plan without medical underwriting. After month 12, Medigap insurers in most states can deny coverage or charge higher premiums based on…...
The Only Hospital in His County Left His Advantage Network in May. His Plan Said He Was Stuck Until January.
3+ week, 4+ day ago (484+ words) A hospital leaving a Medicare Advantage network mid-year can strand rural members until January, since the next regular plan-switch window starts then. Calling 1-800-MEDICARE directly, rather than just the plan itself, can unlock a Special Enrollment Period if Medicare deems…...
In All but Four States, a Diabetes Diagnosis Can Lock You Into Medicare Advantage
4+ week, 1+ hour ago (432+ words) Missing the 6-month Medigap enrollment window at 65 allows insurers to deny coverage or charge more based on pre-existing conditions like diabetes. Only 4 states offer meaningful Medigap protections beyond the federal window: Connecticut, New York, Massachusetts, and Maine. Most beneficiaries are…...
67-Year-Old Who Stayed on COBRA Discovers Medicare Premium Is Now Higher for Life
4+ week, 2+ hour ago (774+ words) COBRA coverage does not count as creditable for Medicare Part B, so retirees who rely on it miss the 8-month Special Enrollment Period and face a permanent penalty. The Part B penalty adds 10% of the standard premium for each year…...