Medicare Advantage

Millions of Medicare Advantage members face prior authorization delays every year — here's what the data shows about how these requirements affect care, and what you can do about it.

July 16, 2026 · Michael Spitaleri

Extended postpartum Medicaid coverage now reaches 12 months in most states — here's why Medicare beneficiaries with younger family members should understand how these two programs interact, and what gaps still exist.

July 16, 2026 · Michael Spitaleri

Dual-eligible individuals face unique coverage rules, higher health burdens, and disproportionate spending — here's what every beneficiary in this situation needs to understand about their benefits.

July 15, 2026 · Michael Spitaleri

The wave of state abortion ballot measures since 2022 is quietly reshaping what Medicare Advantage beneficiaries can access at local providers — here is what that means for your coverage and how to protect yourself.

July 15, 2026 · Michael Spitaleri

The 2026 Medicare Trustees Report projects accelerating costs and a shrinking Hospital Insurance trust fund — here's what beneficiaries need to understand about their coverage and costs in the years ahead.

July 12, 2026 · Michael Spitaleri

Federal behavioral health policy is shifting under the current administration. Here is what those changes mean for your Medicare Advantage benefits, your access to therapists and psychiatrists, and the crisis services you may depend on.

July 11, 2026 · Michael Spitaleri

Federal Medicaid cuts, immigration policy shifts, and weakened labor protections are converging to shrink the workforce that millions of Medicare and Medicaid beneficiaries depend on for daily survival.

July 9, 2026 · Michael Spitaleri

Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024 — here's what that staggering number means for your care, your rights, and how to fight back if you're denied.

July 9, 2026 · Michael Spitaleri

Millions of Medicare-eligible seniors stay on employer plans without realizing the coordination rules and hidden costs that can leave them with unexpected bills. Here is what you need to know before making that choice.

July 8, 2026 · Michael Spitaleri

The Affordable Care Act made concrete, lasting changes to Medicare — closing the Part D donut hole, adding free preventive care, and reshaping the Medicare Advantage market. Here is what those changes mean for your costs and coverage today.

July 8, 2026 · Michael Spitaleri

CMS launched a Medicare App Library in April 2026 and a new payment model for chronic care — here's what beneficiaries need to know about accessing these tools safely and effectively.

July 7, 2026 · Michael Spitaleri

Artificial intelligence now influences prior authorization decisions, claims processing, and care coordination inside Medicare Advantage plans — here is what every beneficiary needs to know to protect their coverage.

July 7, 2026 · Michael Spitaleri

Millions of Medicare Advantage members are paying out-of-pocket for care they've already paid for — because they've never logged into the digital tools their plan provides. Here's what you're missing and how to fix it in one phone call.

July 6, 2026 · Michael Spitaleri

A clinic model built exclusively for Medicare Advantage members is expanding into Philadelphia — here is what it means for your provider network, your appointments, and what you will actually pay out of pocket.

July 3, 2026 · Michael Spitaleri

The 2025 reconciliation law is projected to reduce federal Medicaid spending by $911 billion over a decade — and millions of dual-eligible seniors who rely on both Medicare and Medicaid could feel the impact in their coverage and out-of-pocket costs.

July 2, 2026 · Michael Spitaleri

A wave of executive actions since January 2025 has reshaped federal health protections for LGBTQ+ Medicare enrollees. Here is what changed, what it means for your coverage, and how to protect your access to care.

July 2, 2026 · Michael Spitaleri

New KFF polling reveals a sharp trust gap between personal doctors and government health agencies — and it has real consequences for how seniors make Medicare decisions.

July 1, 2026 · Michael Spitaleri

A federal oversight investigation found that the largest Medicare Advantage insurers systematically denied medically necessary care — here is what that means for your coverage and the specific steps you can take to fight back.

July 1, 2026 · Michael Spitaleri

The U.S. is shifting billions in global health funding back to partner countries — and while that may sound distant, the ripple effects on Medicare Advantage drug coverage, vaccine access, and domestic health policy are worth understanding now.

June 30, 2026 · Michael Spitaleri

A new 18-month federal bridge program launching July 1, 2026 will cover Wegovy, Zepbound, and Foundayo for eligible Part D enrollees — but strict clinical criteria mean fewer than half of Medicare beneficiaries with obesity will qualify.

June 30, 2026 · Michael Spitaleri

New federal rules were supposed to speed up prior authorization decisions in Medicare Advantage plans, but early data shows delays and denials are still leaving beneficiaries waiting for care they urgently need.

June 28, 2026 · Michael Spitaleri

National Medicaid and CHIP enrollment has dropped sharply from a record 94 million in 2023, and new 2025 legislation is expected to push those numbers even lower — with real consequences for low-income Medicare beneficiaries who rely on dual-eligibility programs.

June 27, 2026 · Michael Spitaleri

CMS is testing artificial intelligence to speed up prior authorization decisions in Medicare Advantage — but without public outcome data, beneficiaries have no way to know whether algorithms are helping or hurting their chances of getting care approved.

June 27, 2026 · Michael Spitaleri

Millions of Medicare-eligible seniors stay on employer plans without running the actual numbers. Here is what the cost breakdown looks like in 2025 — and what to do before you retire.

June 26, 2026 · Michael Spitaleri