Big changes are coming to Medicare in 2025, and they could make a major difference in your prescription drug costs. Thanks to the Inflation Reduction Act, Medicare beneficiaries will see the most significant updates to the program’s drug coverage since it was first...

Last week, the Centers for Medicare & Medicaid Services (CMS) released information about Medicare costs in 2025, including the 2025 premium, deductible and coinsurance amounts for Medicare Part A and Part B. The agency also announced the income-related monthly...

Key components of the Inflation Reduction Act’s Part D reforms will be fully implemented for plans offered in 2025. These changes, including the total elimination of the “coverage gap” coverage period, the establishment of a $2,000 cap on beneficiary out-of-pocket...

Medicare payment rules prohibit coverage for a service if a beneficiary is not financially responsible for the care or if another government entity is obligated to provide or pay for the item or service. For years, the Medicare rules interpreting and implementing this...

A new report from the U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) examines trends in health care access and outcomes in rural America. While insurance rates in these areas are improving,...

The Inflation Reduction Act (IRA) made significant improvements to Medicare prescription drug access and affordability, including by restructuring the Part D benefit to limit enrollee expenses. Those changes began in January 2024, when the IRA eliminated cost sharing...

Now is the time for people who need health insurance in 2025 to shop for coverage. For those without employer, Medicare, or Medicaid coverage, Healthcare.gov or their state exchange is the place to shop for Affordable Care Act (ACA) plans. Most shoppers will be able...

When the Centers for Medicare & Medicaid Services (CMS) pays Medicare Advantage (MA) organizations, they increase the payments when plans enroll sicker people. This is called risk adjustment, and it is an important guardrail to ensure that all people with Medicare...

Medicare coverage is personal — and changes to those plans and benefits may feel unnerving as it affects one’s overall health and well-being. Originally passed in 2022, the Inflation Reduction Act brought about many changes to Medicare that are now being implemented...

Finding a doctor you like and trust can be a long process, so I understand that it can be frustrating when your doctor no longer accepts Medicare. If your doctor has “opted out” of Medicare, this means that he or she no longer accepts Medicare assignment...

It’s important to plan for your health care needs, but sometimes life throws unexpected curve balls. And when that happens, you’ll need to know what’s covered. Fortunately, there are ways you and your loved ones can get the necessary care at home. Here’s what you need...

The Wall Street Journal recently published a story regarding diagnoses and plan payments in Medicare Advantage. The story was fundamentally flawed and overlooked the value of Medicare Advantage for millions of American seniors. Here are the facts: More than 33 million...

Today, more Americans than ever are choosing Medicare Advantage for affordable, quality health care — with over 33 million seniors and people with disabilities enrolled in the program. BMA wanted to learn more about seniors’ views on Medicare Advantage and how...

How Medicare Advantage In-Home Health Assessments Keep Seniors Healthier Today, Medicare Advantage delivers affordable, high-quality care to more than 33 million seniors and people with disabilities, with better health outcomes than Fee-for-Service Medicare (FFS). One...

Whether you’re switching from one type of Medicare coverage to another, or you’re new to Medicare, you might be concerned about being able to continue seeing your health-care specialist. Will your specialist’s services be covered by Medicare? That may depend upon:...