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UNCOVERED: Medicare advantage - The Untold Story

Medicare Billing for Nursing Home Stays Is Trickier Than It Looks

Medicare covers lots of care for older adults. Yet, the rules for skilled nursing stays shock many families and stress out the staff dealing with paperwork. Each stay may go through different coverage stages, with unique billing needs too.

inkl

Prior authorization bill now eligible for House fast track

Legislation aimed at reducing delays when Medicare Advantage plans require preapproval for care could hit the House floor under fast-track rules for bills that have broad support. The bill, sponsored by Rep. Mike Kelly, R-Pa., targets use of prior authorization in Medicare Advantage — in which insurers approve or deny services…

Roll Call

What This Year's Biggest Medicare Changes Mean for You

Some drug prices are falling, other costs are climbing, and new rules abound. Here's what you need to know.

Kiplinger

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Wall Street Turns Bullish on Health Insurers: UNH Surges 5.7% as BofA Upgrades and Morgan Stanley Raises Target to $453

UnitedHealth Group was written off by many investors after five straight sessions of losses. Then Thursday morning arrived — with two simultaneous Wall Street upgrades, easing medical cost data, and a technical setup that had been coiling for a breakout. Here is what changed, what it means for patients, and…

Medical Daily

Why the Era of Chart Mining in Medicare Advantage Is Coming to an End

Chart mining, the practice of sending coders into historical medical records to find diagnosis codes that were clinically present but never submitted to CMS, has been a cornerstone of Medicare Advantage risk adjustment for nearly two decades. Health plans hired vendors to process millions of charts annually. Coders identified diagnoses.…

inkl

Medicare Alert: Why Your Next Statement May Show a Different Part B Deduction

A lot of retirees glance at their Social Security statement every month without expecting surprises. Then suddenly, the Medicare Part B deduction changes, and panic sets in before breakfast even finishes brewing. One small number can spark huge questions about healthcare costs, inflation, and whether a mistake slipped into the…

Everybody Loves Your Money

The Medicare “Benefit Boost” Claim Circulating on Facebook — and Why Experts Say Seniors Should Be Careful

If you have spent any time on Facebook recently, chances are you have seen advertisements promising seniors a huge new Medicare “benefit boost.” Some ads...

Saving Advice

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The Medicare Grocery Benefit Cutback: Why Some Seniors Could See Reduced Monthly Food Assistance

Many seniors have come to rely on Medicare Advantage grocery benefits to help stretch their budgets during a time of soaring food prices. These monthly...

Saving Advice

Insurers Are Exiting Some Medicare Advantage Markets—What to Do If Your Plan Is Terminating

Big changes are shaking up Medicare Advantage, and many enrollees now face unexpected notices about plan terminations. Insurers have started pulling back from certain counties and states, leaving members scrambling to figure out what comes next. These changes do not always signal a crisis for beneficiaries, but they do demand…

The Free Financial Advisor

The Medicare ‘Observation Status’ Problem: Why Some Seniors Are Still Receiving Unexpected Rehab Bills in 2026

Many seniors assume that if they spend several nights in a hospital bed, Medicare will automatically cover any rehab care they need afterward. Unfortunately, thousands...

Saving Advice

6 Medicare Advantage Changes That Could Surprise Seniors in the Next Enrollment Cycle

Medicare Advantage keeps evolving fast, and the next enrollment cycle could bring changes that catch many seniors off guard. Insurers adjust benefits, networks, and costs every year, often shifting value in ways that do not always look obvious at first glance. These updates can directly affect prescriptions, doctor access, and…

The Free Financial Advisor

CorMedix Eyes REZZAYO Expansion as DefenCath Reimbursement Shift Looms

CorMedix (NASDAQ:CRMD) CEO Joe said the company is preparing for several potential commercial and regulatory catalysts across its infectious disease and dialysis-related portfolio, including a possible expansion of REZZAYO into fungal infection prophylaxis and continued work to sustain DefenCath uti

MarketBeat

Medicare Advantage Company Alignment Healthcare Shows Huge, Unusual Call Option Activity

Alignment Healthcare, a fast-growing Medicare Advantage company, had strong Q1 revenue and adjusted EBITDA results. That may be the underlying reason for the huge, unusual call option activity today.

Barchart

7 Medicare Costs Rising Faster Than the 2027 Social Security COLA Forecast

Retirees across America face a financial squeeze as Medicare expenses continue climbing faster than projected Social Security COLA adjustments for 2027. Many households already stretch fixed incomes, and healthcare costs keep tightening that gap in frustrating ways. Inflation in medical services, prescription pricing, and insurance overhead drives much of this…

The Free Financial Advisor

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The Free Financial Advisor

Medicare’s Fast-Track Review Standard: Why Some Requests Must Be Approved or Denied Within 72 Hours

Medicare decisions don’t always move at a slow, predictable pace, especially when health needs suddenly turn urgent. Some requests fall under a fast-track review system that forces action within just 72 hours, creating a high-stakes window where delays can directly affect care. That tight timeline exists for situations where waiting…

Kiplinger

Medicare and Cruises: The 6-Hour Rule

Don't let a medical emergency ruin your retirement. We explain why Medicare might not pay for cruise ship virus treatments and how to fill the coverage gap.

The Free Financial Advisor

5 Medicare Services Seniors Are Losing Coverage For in 2026

Healthcare coverage keeps shifting, and Medicare continues to feel those changes in big ways. Seniors across the United States rely on Medicare not just for doctor visits, but for everyday support that keeps life manageable and healthy. New policy updates and Medicare Advantage adjustments heading into 2026 point toward tighter…

Saving Advice

Medicare’s 72-Hour Decision Rule Begins Now: What Seniors Must Know About Faster Approvals and Denials

Millions of seniors enrolled in Medicare Advantage plans have spent years frustrated by delayed prior authorization decisions for medical care, scans, procedures, and treatments. Some...

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MarketBeat

CorMedix Q1 Earnings Call Highlights

CorMedix (NASDAQ:CRMD) reported sharply higher first-quarter 2026 revenue and profit, driven by continued adoption of DefenCath and the addition of products from its Melinta acquisition, while management raised its full-year financial outlook and outlined key pipeline developments. Chairman and Chi

MarketBeat

Alignment Healthcare Backs Q2 Outlook as Stable Costs, New Markets Lift Margin Hopes

Alignment Healthcare (NASDAQ:ALHC) executives said the company remains confident in its second-quarter outlook, citing stable medical cost trends, continued visibility into utilization and opportunities to expand margins as it grows outside California. Speaking at an analyst-led question-and-answer

MarketBeat

Astrana Health Says Prospect Deal Is Ahead of Schedule as Q1 Trends Beat Expectations

Astrana Health (NASDAQ:ASTH) CEO and President Brandon Sim said the value-based care company is seeing early benefits from its acquisition of Prospect, while reporting stronger-than-expected first-quarter trends across medical costs, free cash flow and revenue. Speaking at a Bank of America healthc

MarketBeat

CVRx Q1 Earnings Call Highlights

CVRx (NASDAQ:CVRX) reported first-quarter 2026 revenue of $14.8 million, up 20% from the prior-year period, as U.S. growth in its Barostim heart failure business helped the company exceed the high end of its guidance range, executives said on the company’s earnings call. President and Chief Executi

The Free Financial Advisor

6 Medicare Rules That Will Hike Your Out-of-Pocket Costs in 2026

Medicare rarely stays still for long, and 2026 already looks packed with changes that could hit wallets harder than expected. Rising healthcare costs, updated coverage rules, and shifting insurance strategies have created a perfect storm for retirees trying to stretch fixed incomes.

Saving Advice

7 Documents You Must Remove from Your Home Office Before Your 2026 Medicare In-Home Assessment

More Medicare Advantage plans are conducting in-home assessments and wellness visits than ever before. These visits are often presented as convenient check-ins designed to evaluate...

Saving Advice

Medicare Advantage Plans Are Quietly Dropping Popular Senior Benefits in 2026

For years, Medicare Advantage plans aggressively advertised extra perks like dental coverage, grocery cards, free rides to appointments, gym memberships, and over-the-counter allowances to attract...

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