News and analysis on Medicare Advantage (Part C) plans, star ratings, CMS rules, and enrollment.
A major Medicare Advantage clinic chain has agreed to pay $60 million to settle federal allegations that it paid illegal kickbacks to recruit patients. Here's what beneficiaries need to know about their rights and protections.
August 30, 2026 · Michael Spitaleri
Medicare Advantage
Humana's CFO has signaled additional Medicare Advantage market withdrawals coming in 2027, meaning hundreds of thousands of beneficiaries may need to find new coverage — here's how to prepare before it's too late.
August 30, 2026 · Michael Spitaleri
Medicare Advantage
Premiums are shifting, out-of-pocket limits are rising, and prior authorization rules are tightening in 2026 Medicare Advantage plans — here's what every beneficiary needs to know before their next enrollment decision.
August 29, 2026 · Michael Spitaleri
Medicare Advantage
National Medicaid enrollment has fallen to 73.9 million as of April 2026, with new work requirements on the horizon. Here's what Medicare beneficiaries who also rely on Medicaid need to know right now.
August 26, 2026 · Michael Spitaleri
Medicare Advantage
Federal regulators are cracking down on Medicare Advantage plans that improperly deny care. Here's what beneficiaries can do right now to protect their coverage.
August 26, 2026 · Michael Spitaleri
Medicare Advantage
As states loosen childhood vaccine requirements and delink from CDC guidance, Medicare beneficiaries face real risks — from measles exposure to gaps in their own Medicare Advantage preventive coverage.
August 22, 2026 · Michael Spitaleri
Medicare Advantage
New federal restrictions on how states fund Medicaid could reduce benefits, shrink provider networks, and squeeze state budgets — here's what Medicare-Medicaid dual enrollees and low-income seniors need to know.
August 21, 2026 · Michael Spitaleri
Medicare Advantage
New KFF analysis reveals that more than 1 in 6 prior authorization requests are denied by Medicare Advantage insurers — here's how to protect yourself and fight back if it happens to you.
August 20, 2026 · Michael Spitaleri
Medicare Advantage
The federal program that rewards high-rated Medicare Advantage plans with billions in extra payments is under growing scrutiny — here's what it means for your benefits, your premiums, and your choices this fall.
August 20, 2026 · Michael Spitaleri
Medicare Advantage
A major retail partnership could soon let millions of Costco members shop for Medicare Advantage plans at the warehouse giant — here's what that means for your coverage decisions and what to watch for before you enroll.
August 18, 2026 · Michael Spitaleri
Medicare Advantage
Federal subsidy reductions to Medicare drug plans may push Part D premiums higher in 2026 — here is what beneficiaries need to know before the October 15 enrollment window opens.
August 18, 2026 · Michael Spitaleri
Medicare Advantage
New federal caps on Medicaid directed payments threaten billions in hospital funding — and dual-eligible seniors enrolled in both Medicare and Medicaid may face narrower networks and reduced access to care.
August 15, 2026 · Michael Spitaleri
Medicare Advantage
The Medicare Advantage Quality Bonus Program is sending record dollars to insurers — but research shows many beneficiaries aren't seeing proportional improvements in care quality or out-of-pocket savings.
August 14, 2026 · Michael Spitaleri
Medicare Advantage
The Trump administration's foreign aid freeze has disrupted the world's largest HIV program — and the ripple effects on Medicare drug costs, global health infrastructure, and domestic HIV care deserve your attention.
August 14, 2026 · Michael Spitaleri
Medicare Advantage
Federal data shows Medicare Advantage insurers denied 12% of prior authorization requests in 2025, yet two-thirds of appealed denials were overturned — meaning seniors who don't push back may be forfeiting care they're entitled to receive.
August 13, 2026 · Michael Spitaleri
Medicare Advantage
A proposed federal rule would force Medicare Advantage insurers to speed up and justify prior authorization decisions for prescription drugs — here's what it means for your medications and your appeal rights.
August 23, 2026 · Michael Spitaleri
Medicare Advantage
Federal data reveals dramatic variation in how Medicare Advantage plans use prior authorization — and beneficiaries have more appeal rights than most realize.
August 10, 2026 · Michael Spitaleri
Medicare Advantage
The Trump administration's freeze on U.S. support for CEPI, the global vaccine development coalition, may have long-term consequences for Medicare beneficiaries — from future pandemic drug costs to Part D coverage gaps.
August 9, 2026 · Michael Spitaleri
Medicare Advantage
The dismantling of USAID and the freeze on global health funding may seem worlds away, but the effects on drug supply chains, vaccine pipelines, and Medicare costs are closer than most beneficiaries realize.
August 8, 2026 · Michael Spitaleri
Medicare Advantage
Research links county-level poverty and social vulnerability to heavier prior authorization demands — meaning seniors in economically distressed areas may face the most administrative barriers to care.
August 8, 2026 · Michael Spitaleri
Medicare Advantage
The Trump administration's foreign aid overhaul has disrupted U.S. support for the Global Fund to Fight AIDS, TB, and Malaria — and the ripple effects may reach American seniors managing HIV and infectious disease costs through Medicare.
August 7, 2026 · Michael Spitaleri
Medicare Advantage
A KFF analysis finds that Medicaid pays as little as $162 or as much as $869 for the same abortion procedure depending on the state — and frozen reimbursement rates are quietly shrinking provider networks that dual-eligible Medicare beneficiaries also depend on.
August 7, 2026 · Michael Spitaleri
Medicare Advantage
The 2025 Reconciliation Law introduces Medicaid work requirements that could affect dual-eligible beneficiaries and low-income seniors who rely on both Medicaid and Medicare for coverage.
August 6, 2026 · Michael Spitaleri
Medicare Advantage
Federal regulators have paused rules requiring Medicare Advantage plans to publicly disclose denial rates — here's what that means for your coverage and exactly what to do before the next enrollment period.
August 4, 2026 · Michael Spitaleri
Medicare Advantage