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Beware of Medicare Scams
Always a problem in the past, we are receiving an increasing number of client inquiries about phone calls, emails and texts they are receiving that promise to greatly improve their Medicare benefits. These communications usually make one of two promises: What is most alarming is that Medicare participants are not eligible to make a plan…
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New Medicare Coverage for GLP-1 Medications
As you might know, Medicare plans cover many GLP-1 medications for diabetes but currently do not cover them for treating weight control issues. Starting this July, Medicare will provide coverage for subscribers who are most overweight but could also have conditions like pre-diabetes or uncontrolled hypertension. Those who qualify will pay $50/month for any dosage amount…
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Drug Discount Plans like GoodRX
We often get questions from clients as to whether they should use their Medicare drug plan to pay for a prescription drug or, as an alternative, use a prescription drug discount program like GoodRx. It is true that sometimes in the crazy world of drug pricing, the GoodRx plan will provide a lower copay. So,…
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Potential Premium Increases to ACA Plans in 2026
If you currently enroll in health insurance through the Pennie Marketplace site, I want to make you aware of a situation that might dramatically increase your health insurance premiums in 2026. The enhanced ACA tax credits that were made available with the Inflation Reduction Act of 2021 will expire at the end of 2025 unless…
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Drug Discount Plans (like GoodRX)
We often get questions from clients as to whether they should use their Medicare drug plan to pay for a prescription drug or, as an alternative, use a prescription drug discount program like GoodRx. It is true that sometimes in the crazy world of drug pricing, the GoodRx plan will provide a lower copay. So,…
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Big Increase in Federal Payments to 2026 Medicare Advantage Plans
Medicare Advantage plans will get a $25+ Billion increase in federal payments for 2026. The more than 5% bump in payments comes as a surprise since there have been Medicare Advantage funding cuts in the last 2 years. We will not know how this 5+% increase in federal funding will affect 2026 benefits for another…
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Update on GLP-1 Drugs
You probably have been hearing about GLP-1 injectable drugs. The steep prices – and popularity – of Ozempic and other similar weight loss and diabetes drugs could soon make them a priority for Medicare drug pricing regulations. The retail price for a month’s supply of the drugs runs from$936 to $1,349! Most Medicare plans will cover them…
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2025 Medicare Advantage Plan Changes
We are beginning to take 2025 certification courses from all the Medicare Advantage carriers that we use. Although we will not know actual 2025 plan details for sometime yet, we expect that all insurance carriers will have significant plan changes. More than likely, premium rates will increase, and some benefits will decrease. Why such a gloomy…
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Many PA Medicaid Recipients Losing Eligibility in Spring 2024
Back in January 2020, when the COVID pandemic started, the federal government declared a Public Health Emergency (PHE). As a part of this PHE, anyone on Medicaid was allowed to stay on Medicaid without any income requirements until the end of the month in which the PHE ended. During this time, Medicaid recipients did…
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Medicare Options
Medicare can become effective as early as the first of the month in which you turn 65. You can apply 3 months before that date. Medicare Part A has no cost and Part B costs $170.10 (more at higher incomes). Because Medicare has lots of gaps and no prescription drug coverage, you need to purchase…
