The Medicare Supplement (Medigap) Birthday Rule is a state law that lets you switch Medigap plans or carriers once a year around your birthday without medical underwriting. As of September 2026, 15 states have a birthday rule, and one more state is pending to start in 2027. If you live in one of these states, […]
Short answer: No. If you are entitled to or enrolled in Medicare, you are categorically excluded from the new Medicaid work requirements. This exclusion is written directly into the federal statute and confirmed in CMS’s June 2026 interim final rule. Dual-eligible beneficiaries do not need to report work hours, volunteer hours, or school enrollment to […]
The Medicare GLP-1 Bridge Program is a temporary program from the Centers for Medicare & Medicaid Services (CMS) that allows eligible Medicare Part D beneficiaries to access certain weight-loss GLP-1 drugs for $50 per month from July 1, 2026 through December 31, 2027. It operates outside of Medicare Part D, meaning plans do not process […]
Many people assume Medicare works like traditional health insurance and includes dental care. Unfortunately, this is not the case. When you join Medicare, you will find that Original Medicare does not cover routine or comprehensive dental care. It only covers limited Medically necessary dental. If you need cleanings, filings, dentures, bridges, or other major dental […]
Did you get a notice about a Medicare Part D late enrollment penalty, but you had creditable coverage? Medicare often assesses a Part D penalty in error when people miss an attestation or fail to submit proof of prior creditable coverage. In this guide, we’ll walk you through how to appeal your Part D penalty, […]
If you’re on Medicare (or about to enroll), make sure you know what is coming to Medicare for 2026. Each year Medicare adjusts what you pay for premiums and coverage, but other changes could affect your overall costs. These include premium and deductible increases, changes to the Part D cap on maximum out-of-pocket costs, new […]
Discover how to review your 2026 Medicare Annual Notice of Change (ANOC) to stay informed about essential plan changes.
A diagnosis of End-Stage Renal Disease (ESRD) can feel overwhelming—not just medically, but also financially and logistically. If you or a loved one need dialysis or a kidney transplant, Medicare coverage becomes a major factor—even if you’re under age 65. Understanding how Medicare works with ESRD and how it coordinates with an employer group health […]
If you already receive healthcare through Indian Health Services, you may be wondering what happens when you become eligible for Medicare. Does it affect your Indian Health Services access or costs? Below, we breakdown if you need to join Medicare, how it works with Indian Health Services, and how you and your Tribe may benefit […]
Medicare Advantage plans have grown in popularity and availability. Some metropolitan areas can have as many as 50-70 different options. This can make it difficult to compare and find the perfect plan. A question we get regularly from beneficiaries is, “What is the best Medicare Advantage plan?” The answer to this question is complicated and […]
As a veteran, you’ve earned VA health benefits! Once you turn 65, you will likely also qualify for Medicare benefits. This is great news to ensure additional coverage! But did you know you can layer on even more coverage and benefits through a Medicare Advantage plan without an additional premium? Combining VA benefits with a […]
Medicare Supplement plan premiums continue to rise year after year! These annual hikes are making some plans unaffordable and hard to maintain. Many people are experiencing financial strain from steadily increasing costs—even when their health has remained stable. The good news? If you’re relatively healthy, you may have the option to switch your Medicare Supplement […]
Medicare Advantage (Part C) plans offer a convenient way to get your Medicare Part A and B benefits — often with extra perks. But these plans often come with copays and coinsurance that can quickly add up in the event of an emergency and hospital stay. This is where a hospital indemnity plan comes in. […]
Are you looking for low cost Medicare Supplements? Currently, about half of Medicare beneficiaries enroll in a Medicare Supplement plan when they become eligible for Medicare. This is a downward trend due to increasing Medicare Supplement premiums and lower Medicare Advantage premiums. Beneficiaries who are “Team Medicare Supplement” are generally looking for more freedom to […]
What you need to know when deciding between Medicare and your employer group coverage. It is more than just costs.
For many retirees, traveling is a long-awaited reward in their retirement years. Whether it’s a European river cruise, a tropical getaway, or visiting family overseas, international travel is a fun adventure where health care needs are one factor that often gets overlooked. Even though you don’t plan to seek general medical care when traveling abroad, […]
This blog has been updated on 12/18/2025 to reflect the new changes to Original Medicare new pre-authorization testing in 6 states. Most people who have had health insurance are familiar with pre-authorization requirements for medical services or prescription drugs. This practice has been widely implemented across the insurance industry. Traditionally, Original Medicare (Part A and […]
Eligibility for Part A is primarily based on an individual’s age and work history. Most people qualify for premium-free Part A when they turn 65. This is because they paid Medicare taxes for at least 40 quarters or qualify under a spouse’s work history. However, some people do not have enough work history and have […]
This blog was updated on 12/10/2025 to reflect the new 2026 Part B maximum out-of-pocket changes. The Part D cap goes up to $2,100 in 2026. Thanks to the Inflation Reduction Act, beneficiaries now spend far less on prescription drugs because it drastically lowered the maximum out-of-pocket amount. In 2025, all plans had a $2,000 […]
Learn how the new Medicare Prescription Payment Plan (M3P) can help you manage high prescription costs.