About the time we think we have Medicare figured out, The Center for Medicare/Medicaid Services or ‘CMS’ changes it up!  The government agency usually announces changes to Medicare in the fourth quarter for the coming year.  We have little time to adjust to it or educate our clients about it, especially amid the busy Annual Enrollment Season.  The big ticket items to watch for in 2027 include rising Part D premiums, shrinking drug plan options and a new batch of negotiated drug prices.  In addition, we project another year of diminishing perks on the Advantage Plans.  Read on to get some confirmed numbers and some likely changes for 2027!  And stay tuned!

Anti-Obesity Medications (AOMs) or GLP-1s have been all the rage in the news, social media feeds and throughout the health and wellness community.  It has also been a huge topic of concern in the insurance and finance industry.  I have often been asked in the past year by clients whether their Part D drug plans cover GLP-1 medications.  And until now, my answer has always been that Medicare does not cover these medications unless you have a diagnosis of type 2 diabetes or other qualifying chronic conditions such as sleep apnea.  This has been frustrating to many of my clients who are on it for weight loss and to prevent those chronic diseases related to obesity.  Well, that has just changed!

Early in my blog writing, I shared information on how Medicare Part D plans worked.  For historical sake, see previous blog here:  https://www.cdi-cares.com/blog/how-to-decode-your-part-d-plan.  That blog detailed the four distinct phases of Medicare Part D, which is the prescription drug coverage.  The phases and details pertained to stand alone drug plans in addition to drug plans included in Advantage Plans or Part C.  Since that blog was written in 2021, there have been changes in the phases and structure of Medicare Part D.  Now is a great time to revisit and see how the coverage and plan design are different from those in the past.

You may think it is obvious that all preventive vaccines should be covered by Medicare.  Seniors are considered vulnerable, and thus, most preventive vaccines are recommended and covered.  However, where and how they are covered is not as obvious.  I had a client call recently and share that he was billed over $300 for a vaccine he received at a Minute Clinic by a provider, likely a Nurse Practitioner.  We discovered that the vaccine is covered through his Part D plan but not Part B.  The minute clinic staff later shared that he would not have owed anything if he had gotten that particular vaccine at the pharmacy rather than the minute clinic.  Read on to learn more and avoid this surprise bill!

The Indiana Birthday Rule was passed on March 25th, 2025.  It is House Bill 1226 and went into effect on January 1st, 2026, as it did with nine other states.  As we have learned to expect with all new initiatives and changes with Medicare insurance, it has been a bit of a bumpy road so far.  Read on for a recap of this new rule, how it can impact your coverage and budget and how agents are navigating the application process to serve our clients best!

Each year all the costs and benefits you finally seem to have figured out change!  The Center for Medicare/Medicaid Services or ‘CMS’ usually announces changes to Medicare in the fourth quarter for the coming year.  We have little time to adjust to it or educate our clients about it, especially amid the busy Annual Enrollment Season.  So read on to get a run down of all the new numbers for 2026.

This may be a simple review for many, and I have covered these topics in more detail on different blogs, newsletters and social media posts.  However, here is a brief summary of some important Medicare tidbits!  These are some good reminders and maybe just a pulse check on your knowledge of basic Medicare coverage, costs and pitfalls.  Let’s dive right in!

What is the Annual Notice of Change, otherwise known as an ANOC, and why should you pay attention to it?  I have made slight mention of the ANOC in other blogs, social medica posts and quarterly newsletters.  However, this document is so important to your Medicare coverage choices and the Open Enrollment Season, that is deserves its OWN blog!  Here you will find out what the ANOC means to you, when you will receive it and what you should do with it.  When the Open Enrollment season nears, this is of utmost importance!