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Home 2025 December (Page 2)
Understanding Medicare Deductibles for 2026

Understanding Medicare Deductibles for 2026

By Ed Crowe | General Articles | 0 comment | 5 December, 2025 | 0

What to Know About Medicare Deductibles in 2026

Each year, Medicare updates its premiums, coinsurance, and deductibles. Understanding Medicare deductibles for 2026 is very important for beneficiaries. There are some important changes; especially for Medicare Part A and Medicare Part B.

Medicare Part A (Hospital Insurance)

Part A helps cover inpatient hospital stays, skilled nursing facility care, hospice, and some home-health services. In 2026, the inpatient hospital deductible for Part A is $1,736 per benefit period.
A “benefit period” begins at admission to the hospital and ends when you’ve been out of inpatient care (hospital or skilled nursing) for 60 consecutive days. That means every time a new benefit period starts, the deductible resets.

If your hospital stay extends past 60 days, daily coinsurance for days 61–90 (and beyond) will apply. These additional costs can add up underscoring why understanding the deductible is important for budgeting.

Medicare Part B (Medical Insurance)

Part B covers doctor visits, outpatient services, durable medical equipment, and more. For 2026:

  • The standard monthly premium is $202.90.
  • The annual deductible is $283.00.

You only pay the Part B deductible once per calendar year (if you receive Part B-covered services). After that, Medicare generally covers 80% of approved costs; you pay the remaining 20% (assuming your provider accepts Medicare assignment).

Learn the differences between Medicare Advantage vs Medicare Supplements

What This Means in Practice

  • If you’re admitted to the hospital under Part A in 2026, you’ll need to pay $1,736 before Medicare begins to pay (for up to the first 60 days of a stay).
  • If you use outpatient services or see a doctor under Part B, you’ll first need to meet the $283 annual deductible; once met, most services are covered at 80%.
  • Because Part A’s deductible applies per benefit period (not per calendar year), multiple hospitalizations in one year could mean paying more than once.

Why You Should Care

Understanding Medicare deductibles is key to predicting out-of-pocket costs. For someone watching their budget, a hospital stay could require a substantial lump sum before coverage kicks in; for routine care under Part B, costs are more manageable, but still meaningful, especially for those on fixed incomes.

These 2026 changes also underscore the importance of evaluating supplemental coverage (like Medigap) or alternative plans to mitigate risk.

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Part B IRMAA Brackets 2026

Part B IRMAA Brackets 2026

By Ed Crowe | General Articles | 0 comment | 4 December, 2025 | 0

Part B IRMAA Brackets 2026: What You Need to Know

Medicare Part B is a cornerstone of health coverage for many retirees, but for higher-income beneficiaries, there’s an additional cost: the Income-Related Monthly Adjustment Amount, better known as IRMAA. Understanding the Part B IRMAA brackets 2026 and how those adjustments work can help you plan your income, taxes, and healthcare costs.

What Is IRMAA — and Why It Matters

IRMAA is a surcharge added to Medicare Part B (and Part D) premiums for people whose income exceeds certain thresholds. Rather than base your premium solely on your age or election timing, IRMAA considers your Modified Adjusted Gross Income (MAGI) from two years earlier. In other words: your 2024 tax return determines what you pay for Medicare in 2026,

MAGI for Medicare includes your AGI (Adjusted Gross Income) plus certain tax-exempt sources like municipal bond interest.

Because of this “look-back,” proper planning in advance is critical; a one-time income spike (for example, a large capital gain or Roth conversion) in 2024 could significantly increase your 2026 Medicare premiums.

The 2026 IRMAA Brackets for Medicare Part B

Here’s a breakdown of the 2026 IRMAA income brackets (based on 2024 MAGI) and what they mean for your monthly Medicare Part B premium.

MAGI (2024)Filing Status2026 Part B Premium Estimate
Up to $109,000Single$202.90 (no surcharge)
$109,001 – $137,000Single$284.10
$137,001 – $171,000Single$405.80
$171,001 – $205,000Single$527.50
$205,001 – $499,999Single$649.20
$500,000+Single$689.90 (top IRMAA tier)

For couples filing jointly, the thresholds roughly double (e.g., up to $218,000 for no surcharge).

Why 2026 Premiums Are Rising

  • The base Part B premium is increasing significantly: for 2026, it’s $202.90/month; up from $185 in 2025.
  • Surcharges (IRMAA) are also escalating. The top surcharge for Part B is projected around $487/month, putting the total premium at $689.90 for the highest bracket.
  • These adjustments are not just about inflation: the IRMAA brackets themselves are being re-indexed, which will pull more people into higher tiers over time.

Putting that in perspective: many beneficiaries on fixed incomes could face a bigger Medicare burden and it’s especially important for those with variable or investment income.

Watch a YouTube video on Medicare and employer coverage

Strategies to Manage or Reduce IRMAA

Because IRMAA hinges on reported MAGI from two years prior, you may have opportunities now (for your 2024 tax year) to influence your 2026 Medicare costs. Here are some strategies:

  1. Mind your MAGI
    • Prioritize tax-efficient withdrawals in retirement (e.g., Roth conversions, IRA/401(k) distributions) to control your AGI.
    • Consider timing of capital gains: if you realize large gains in 2024, you may push yourself into a higher IRMAA bracket.
  2. Use strategic charitable giving
    • Qualified Charitable Distributions (QCDs) from your IRA can lower your taxable income without affecting your MAGI in the same way as other income sources.
  3. File an SSA-44 (Life-Changing Event)
    • If your income drops significantly (due to retirement, unemployment, or other life events), you can file a Form SSA-44 to request a re-determination of IRMAA.
    • But note: you need documentation, like proof of reduced income, to support your case when submitting.
  4. Plan ahead for Medicare Advantage vs Medigap
    • Higher IRMAA could make certain Medigap (supplement) plans less attractive; it may also influence whether Part D surcharges make a zero-premium Medicare Advantage plan more favorable.

Things to Consider

  • Your 2024 income matters – a lot. What you earned (or didn’t) in 2024 directly impacts your 2026 Medicare Part B costs.
  • IRMAA is rising. Even modest increases in MAGI could push you into a higher surcharge bracket.
  • You have agency. With smart tax planning and proactive strategies, you may be able to mitigate how much IRMAA you pay, but timing and strategy matter.

Are you a licensed Medicare agent; join our team at Crowe – click here for online contract

Agents; click here for updated events and information.

Stand Alone Dental Plans

Stand Alone Dental Plans

By Ed Crowe | General Articles | 0 comment | 4 December, 2025 | 0

Stand-Alone Dental Plans – Why Medicare Agents Should Offer Them

Stand-alone dental coverage has become one of the most valuable add-ons for Medicare beneficiaries and a smart cross-sell opportunity for agents. Because Original Medicare does not cover routine dental care, seniors face steep out-of-pocket costs for services they use frequently. Offering stand alone dental plans fills this gap and strengthens your overall product portfolio.

Medicare Leaves a Major Dental Gap

Original Medicare excludes cleanings, exams, fillings, crowns, dentures, implants, and more. Beneficiaries often don’t realize this until they get the bill. Dental plans help you address this common pain point and provide solutions your clients genuinely need.

High Demand Among Seniors

Dental needs increase with age; gum disease, decay, cracked teeth, and periodontal issues. Stand-alone plans offer predictable costs and access to affordable care, making them an easy sell to clients on fixed incomes.

Preventive Care = Better Health

Most plans cover routine cleanings and X-rays at 100%. This encourages regular checkups and helps prevent expensive problems later. Clients appreciate plans that improve long-term health and reduce medical complications.

Affordable Premiums and Strong Benefits

Stand-alone dental plans typically offer:

  • Low monthly premiums
  • Basic and major service coverage
  • Large provider networks
  • Options to keep their current dentist

These features make dental plans simple to explain and highly attractive during enrollment discussions.

Medicare agents; learn how to sell ancillary products with Medicare – watch a quick video.

A Reliable Cross-Sell Opportunity

Dental plans pair easily with Medicare Supplement, Medicare Advantage, and stand-alone Part D coverage. Adding dental boosts client satisfaction, increases retention, and creates additional commission opportunities; all while genuinely improving your clients’ coverage.

If you are ready to join Crowe team; click here for online contracting

Offering stand-alone dental coverage helps you close Medicare’s biggest gap, deliver real value, and grow your book of business. With strong consumer demand and affordable pricing, dental plans remain one of the easiest and most impactful products to present in every client conversation.

Agents, stay up-to-date on the our latest webinars an agent events.

Medicare Part B in 2026

Medicare Part B 2026

By Ed Crowe | General Articles | 0 comment | 4 December, 2025 | 0

Medicare Part B in 2026: What to Expect

Medicare beneficiaries will see several important changes to Medicare Part B 2026. Costs are rising again, and many retirees will feel the impact. Here is a simple breakdown of what’s changing and why it matters.

Key Cost Changes for 2026

The standard monthly Part B premium increases to $202.90 in 2026. This is a noticeable jump from the 2025 premium of $185.00. The annual deductible also rises. It increases to $283, up from $257 in 2025.

After you meet the deductible, you still pay 20% coinsurance for most Part B services. This includes doctor visits, outpatient care, therapy, lab work, and durable medical equipment. These basic cost-sharing rules do not change.

Why These Costs Are Going Up

Medicare adjusts Part B premiums each year. These changes reflect the rising cost of healthcare. More people are using outpatient services. Physician-administered drugs also continue to drive spending.

CMS noted that the increase could have been even higher. Cost-saving steps helped reduce the size of the jump. One example is new rules designed to slow spending on certain high-priced items, such as skin substitutes. Still, higher medical costs overall mean higher premiums for beneficiaries.

Click here to watch our YouTube video on Medicare Part B IRMA and IEP, SEP rules

What This Means for You

Higher premiums and a higher deductible mean higher yearly expenses. The extra $18 per month adds up. Over the course of a year, it is more than $200. This does not include the out-of-pocket costs you may pay when you receive care.

Budgeting becomes even more important in 2026. If you expect frequent doctor visits or outpatient treatments, you may face additional costs throughout the year.

For many people, supplemental coverage can help. Medigap plans can reduce out-of-pocket expenses. Medicare Advantage may also offer lower upfront costs. However, each option has different benefits and limits. It is important to compare them carefully.

Check Your Income Level

Some people will pay more than the standard premium. If your income is above certain thresholds, you may owe an Income-Related Monthly Adjustment Amount (IRMAA). This surcharge increases your monthly cost. It is based on your tax return from two years prior.

Medicare Part B costs will increase again in 2026. These changes affect almost every beneficiary. Reviewing your coverage now can help you avoid surprises later. Look at your budget, your health needs, and your income level. Then decide whether Original Medicare alone is enough or if a supplemental option makes sense for you.

Agents; want to join our team – click here for online contract

Stay up-to-date on agent events and information

2026 Social Security COLA

2026 Social Security COLA

By Ed Crowe | General Articles | 0 comment | 4 December, 2025 | 0

2026 Social Security COLA: What the 2.8% Increase Means for Beneficiaries

The Social Security Administration (SSA) has officially announced the 2026 Social Security COLA; beneficiaries will receive a 2.8% increase beginning in January 2026. This annual Cost-of-Living Adjustment is designed to help SSI recipients keep pace with inflation. Here’s a clear breakdown of what the new COLA means and how it affects monthly benefits.

How Much Will Social Security Benefits Increase in 2026

Thanks to the 2.8% COLA, millions of Americans will see higher monthly payments. Here are some average 2026 Social Security benefit amounts after the increase:

  • Retired worker: Rises from about $2,015 to $2,071 (+$56 per month)
  • Medicare aged couple (both receiving benefits): Increases to $3,208
  • Widow(er) living alone: Goes up to $1,919
  • Widowed parent with two children: Increases to $3,898

For SSI recipients, the 2026 federal benefit rate climbs to $994 per month for an individual and $1,491 for couples. In total, the COLA affects roughly 75 million beneficiaries nationwide.

These updated numbers are among the most searched details about the 2026 COLA, and they reflect the real-dollar impact on everyday retirees.

Understanding Other Social Security Changes in 2026

Beyond the COLA increase, beneficiaries should be aware of several important 2026 Social Security updates:

  • The maximum taxable earnings limit will rise to $184,500.
  • The 2026 earnings limit for individuals collecting benefits before full retirement age increases to $24,480.
  • For those reaching full retirement age in 2026, the earnings limit will be $65,160.

These figures matter for anyone still working while collecting Social Security, as well as future retirees planning ahead.

Do you need dental coverage; watch a quick Youtube video on Indicvidual dental plans

Why the 2026 COLA May Not Feel Like a Big Raise

Although the 2.8% COLA is larger than last year’s adjustment, many retirees may not feel the full benefit. That’s because:

  • Medicare Part B premiums are rising in 2026, reducing take-home Social Security checks.
  • Seniors face higher inflation in areas not reflected fully in the CPI-W, such as healthcare, housing, and utilities.
  • For retirees who rely heavily on Social Security, a $56 monthly increase may provide only modest relief.

What Beneficiaries Should Do Now

To prepare for the new year, beneficiaries should:

  • Review their 2026 net Social Security payment after Medicare deductions
  • Update household budgets to account for higher costs of living
  • Understand how the 2026 earnings limits may affect working retirees

Agents; are you ready to join our team – click here for online contract

Click here to stay up-to-date on agent events and information

The 2026 Social Security COLA provides helpful income protection, but rising expenses mean beneficiaries should plan carefully

CMS Proposes Star Ratings Change

CMS Proposes Star Ratings Change

By Ed Crowe | General Articles | 0 comment | 2 December, 2025 | 0

CMS Proposes Star Ratings Change for Medicare Advantage & Part D Plans

Federal regulators are moving to revamp the Medicare Advantage Star Ratings program, signaling a shift in how insurers’ performance is measured and rewarded. The Centers for Medicare and Medicaid Services CMS Proposes Star Ratings Change; they issued a draft regulation, opening the door for public input on potential changes to Medicare Advantage policies, risk adjustment, and even the Medicare Part D prescription drug program.

The proposed overhaul comes as insurers face mounting pressure from prior authorization requirements, audits, and marketing restrictions. By streamlining the Star Ratings system, CMS may offer plans some relief while keeping the focus on high-quality patient care.

Watch a YouTube video on the discontinued Medicare Advantage special enrollment period

What’s Changing in Star Ratings

The Star Ratings program has significant financial implications for insurers. CMS awards Medicare Advantage and Part D plans that score at least four stars with a 5% payment bonus. Under the draft rule, the agency proposes removing a dozen measures that focus on operational performance or administrative processes rather than clinical outcomes.

Of the changes, eight measures would affect only Medicare Advantage plans, two would apply only to Part D, and two would apply to both programs. Examples include removing metrics tied to appeal decision timeliness, customer service, and members’ decisions to leave a plan. CMS notes that these measures “don’t sufficiently convey variations in quality among plans.” Most of the changes would take effect for the 2029 plan year.

Health Equity Index Eliminated

CMS also proposes ending its Health Equity Index, a 2024 initiative that rewarded plans for improving care for marginalized populations. Instead, the agency would continue the existing reward factor that incentivizes high performance across measures.

Ready to join the team at Crowe and Associates, click here

New Focus on Clinical Care

The draft regulation highlights CMS’s intent to refocus Star Ratings on meaningful clinical outcomes. For example, the agency plans to add a depression screening follow-up measure to Medicare Advantage, reflecting an emphasis on behavioral health.

“These proposed changes aim to refocus the program on clinical care, outcomes and patient experience where there is meaningful variation in performance across contracts,” CMS said in a news release.

What This Means for Insurers and Beneficiaries

Insurers could benefit from a simpler Star Ratings system, with less emphasis on administrative metrics. For beneficiaries, the changes signal a stronger focus on health outcomes and patient experience rather than operational benchmarks. The public now has a chance to weigh in on the proposals before CMS finalizes the rule.

Agents, stay up-to-date on the our latest webinars an agent events.

Wellabe Hospital Indemnity Plan Sales

Wellabe Hospital Indemnity Plan Sales

By Ed Crowe | General Articles | 0 comment | 2 December, 2025 | 0

Wellabe Hospital Indemnity Plan Sales – An Opportunity for Medicare Agents

As Medicare Advantage benefits continue shifting and out-of-pocket costs trend upward, 2026 is shaping up to be a year where supplemental protection becomes more important than ever. That’s why Wellabe Hospital Indemnity plan sales are emerging as a strong add-on product. This is helpful for agents looking to boost client value, deepen relationships, and increase commissions all while solving real coverage gap issues for Medicare beneficiaries.

Below is an original, agent-focused breakdown of why Wellabe HI plans deserve a top spot in your sales strategy.

Why Hospital Indemnity Plans Matter in 2026

Even with Medicare Advantage coverage, your clients face unpredictable and sometimes steep costs when they’re admitted to a hospital. MA plans commonly include:

  • Daily inpatient copays
  • Emergency room copays
  • Observation stay costs
  • Ambulance fees
  • Rising maximum out-of-pocket (MOOP) limits

Hospital Indemnity plans fill these financial gaps by providing cash benefits paid directly to the member, which can be used for anything; copays, transportation, lodging for family members, or simply covering monthly bills.

With many MA carriers adjusting benefits and tightening budgets for 2026, more clients are feeling the strain of increased cost-sharing. This shift creates a prime selling opportunity for Wellabe’s Hospital Indemnity Plan.

Why Agents Love Wellabe’s HI Product

Wellabe (formerly Great Western Insurance Company) has structured their HI plan to be flexible, easy to present, and competitive nationwide.

Simplified Issue for Most Ages

Clients can often qualify without medical exams or lengthy underwriting. Fast approvals mean a smoother sales process for both you and the client.

Highly Customizable Benefits

You can tailor benefits based on a client’s specific MA plan design. Options include:

  • Daily hospital confinement benefits
  • Ambulance coverage
  • Observation stay riders
  • Skilled nursing facility benefits
  • ER coverage
  • Lump-sum outpatient surgery benefits

This allows you to build a package that aligns perfectly with their needs.

Join the team at Crowe – click here for agent contract.

Affordable Monthly Premiums

Wellabe’s pricing remains competitive, especially for clients in their late 60s and early 70s. HI plans are one of the easiest cross-sell items because premiums are low and the value is easy to demonstrate.

Ideal Cross-Sell with Medicare Advantage

Whenever you review a client’s MA plan and see hospital copays or multi-day confinement fees, you have a natural opening to present Wellabe HI as a cost-protection solution.

Learn how to cross sell – watch our quick YouTube video

Sales Positioning That Works

Here are proven strategies you can use during AEP, OEP, or everyday sales conversations:

Create Security

Highlight the unpredictable nature of hospital expenses with MA plans. Clients appreciate having fixed, guaranteed cash benefits.

Protect Your Retirement Income

Explain how a short hospital stay could wipe out a month, or more, of income. A low-cost HI plan helps stabilize finances.

Match Benefits to Plan Gaps

Show them the exact hospital copay amounts in their MA plan and how a Wellabe HI benefit can cover it dollar-for-dollar.

Bundle Approach for Agents

Many agents use wording similar to the following:
“If you choose an MA plan, you might wan to consider pairing it with a Hospital Indemnity plan so your hospital costs are fully covered.”

This increases client satisfaction and reduces future complaints or surprise bills.

Why Selling Wellabe HI Plans Builds Long-Term Business

  • Strong customer service and claims reputation
  • Additional commission without added complexity
  • Deepens your advisory role with every client and allows them to use one resources for their coverage needs

Clients who feel fully protected are less likely to shop around, helping you retain business year after year.

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Online Enrollment- Enroll prospects online without the need for a face to face appointment. Access to all major carriers with the ability to compare plan benefits and prescription drug costs. Link to recorded webinar https://attendee.gotowebinar.com/recording/2899290519088332033

All agents receive a personalized enrollment website. Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. Agents are credited for all enrollments. Click Here

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