Medicare Advantage

Section 1115 Medicaid waivers are reshaping coverage rules in nearly every state — and if you rely on Medicaid alongside Medicare, these changes can directly affect your benefits, eligibility, and care options.

October 17, 2026 · Michael Spitaleri

Humana's reported acquisition of MaxHealth, a value-based primary care network, could reshape how Medicare Advantage members access doctors — here's what to watch for and when.

October 16, 2026 · Michael Spitaleri

Prior authorization denials, shrinking networks, and vanishing benefits are pushing millions of enrollees to reconsider their coverage. Here is a clear, step-by-step guide to your real options — and the timing traps you need to avoid.

October 14, 2026 · Michael Spitaleri

A Johns Hopkins study finds millions of Medicare Advantage members may be involuntarily disenrolled as insurers exit markets and cut benefits — here's what that means for you and what to do right now.

October 13, 2026 · Michael Spitaleri

The expiration of enhanced premium tax credits triggered the first ACA Marketplace enrollment decline in seven years, cutting 2.6 million people from coverage and sending ripple effects into Medicare Advantage markets, hospital networks, and family budgets across the country.

October 10, 2026 · Michael Spitaleri

Artificial intelligence tools used by Medicare Advantage insurers are flagging and denying care requests at scale — here's what beneficiaries need to know to protect themselves.

October 9, 2026 · Michael Spitaleri

With hundreds of Medicare Advantage plans available nationwide in 2026, knowing which carriers consistently deliver on cost, coverage, and customer service can save you thousands of dollars and serious headaches at the doctor's office.

October 8, 2026 · Michael Spitaleri

With the 2027 Annual Enrollment Period running October 15 through December 7, 2026, Medicare Advantage and Part D enrollees face a changed plan landscape — here is what to review, what to compare, and what the broader federal budget environment means for your coverage.

October 8, 2026 · Michael Spitaleri

Enhanced premium tax credits have expired, new eligibility rules are tightening enrollment, and insurers are seeking 15% premium hikes for 2027 — here's what these shifts mean for Medicare beneficiaries and the people they live with.

October 6, 2026 · Michael Spitaleri

An AI system called WISeR is influencing prior authorization decisions for millions of Medicare Advantage enrollees — and internal records suggest it may be blocking medically necessary care. Here is what beneficiaries need to know to protect themselves and fight back.

October 6, 2026 · Michael Spitaleri

Millions of Medicare Advantage enrollees are hitting walls with prior authorizations, narrow networks, and unexpected costs. Here's a clear-eyed look at your options and how to fight back — or switch out.

October 5, 2026 · Michael Spitaleri

Federal changes to physician payment and quality reporting are coming in 2027 — here's how they may affect your access to doctors who accept Medicare, and what you can do now to protect your care.

October 5, 2026 · Michael Spitaleri

The healthcare workforce is growing faster than almost any other sector of the U.S. economy — and for Medicare Advantage enrollees, that shift in who delivers care, and where, has real consequences for access, costs, and plan networks.

October 2, 2026 · Michael Spitaleri

Nebraska became the first state to enforce Medicaid work requirements in May 2026. Early data shows 14% of new applicants lost coverage — and with a federal deadline of January 1, 2027, every state is next.

September 30, 2026 · Michael Spitaleri

A 2025 federal law mandates Medicaid work requirements nationwide by January 2027, with Nebraska, Montana, and Iowa moving faster. Dual-eligible Medicare beneficiaries and their families need to act before coverage gaps occur.

September 29, 2026 · Michael Spitaleri

Federal records reveal serious implementation problems in CMS's artificial intelligence experiment for Medicare Advantage prior authorization — here's what beneficiaries need to know about their rights and how to protect access to care.

September 28, 2026 · Michael Spitaleri

As paid family and sick leave policies expand across states, Medicare beneficiaries who still work or care for family members need to understand how these rules interact with their health coverage — and what gaps remain.

September 27, 2026 · Michael Spitaleri

National Medicaid enrollment has fallen to 73.2 million as of June 2026, driven by new work requirements and post-pandemic redeterminations. Here's what dual-eligible Medicare beneficiaries need to know about protecting their coverage.

September 27, 2026 · Michael Spitaleri

A rigorous August 2026 survey of 2,241 rural voters confirms what many rural Medicare beneficiaries already know: healthcare affordability is eroding fast, and thin Medicare Advantage markets are making it harder to find relief.

September 25, 2026 · Michael Spitaleri

Nearly every state now operates at least one Section 1115 Medicaid waiver, reshaping benefits, eligibility, and coverage options that directly affect Medicare-Medicaid dual enrollees and low-income seniors.

October 2, 2026 · Michael Spitaleri

New federal transparency requirements will force Medicare Advantage plans to disclose denial rates and approval times — but prior authorization itself isn't going away, and beneficiaries will still face delays and denials for care their doctors have ordered.

September 23, 2026 · Michael Spitaleri

Internal documents reveal serious flaws in Medicare Advantage's AI-driven claims review system — here's what beneficiaries need to know about protecting their care approvals.

September 30, 2026 · Michael Spitaleri

New research links Medicare Advantage prior authorization burdens to county-level social vulnerability, raising serious questions about care access for lower-income and rural beneficiaries.

September 22, 2026 · Michael Spitaleri

From cancer screenings to chronic disease management, Medicare Advantage plans vary dramatically by state — and women over 65 bear the biggest consequences of those gaps.

September 22, 2026 · Michael Spitaleri