Best Medicare Coverage for Travelers: What Agents Should Know
For clients who love to travel; whether across state lines or around the world, having the right Medicare coverage is essential. As an agent, helping beneficiaries understand what their plan does and doesn’t cover can prevent costly surprises and strengthen your value as a trusted advisor. Below is a breakdown of the best Medicare coverage for travelers and what makes them stand out.
One of the most common misconceptions is that Original Medicare offers extensive travel protection. While Part A and Part B provide nationwide coverage, they offer very limited benefits outside the United States. This is why many travelers lean on Medigap or specific Medicare Advantage plans for more robust protection.
Medigap Plans: The Gold Standard for International Travel
For clients who spend time abroad, certain Medigap plans; specifically Plans C, D, F, G, M, and N include limited foreign travel emergency benefits. These plans typically cover 80% of approved emergency medical costs after a small annual deductible, giving travelers peace of mind during unexpected situations. Medigap also shines for domestic travelers since it works with any provider who accepts Medicare, making it ideal for RVers, snowbirds, and retirees who move between states.
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Medicare Advantage Plans for Travel Flexibility
While Medicare Advantage plans can be restrictive due to network rules, some MA plans are designed with travelers in mind. PPO and Regional PPO plans often allow out-of-network coverage at higher cost-sharing, which can be helpful for clients who split time between locations. Some plans also include worldwide emergency or urgent care benefits, a valuable feature for international travel. Agents should review network strength, coverage areas, and emergency care provisions when guiding clients who are on the move.
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Part D and Prescription Access on the Road
Prescription drug access is another key consideration. Clients traveling domestically should choose a Part D plan with a broad pharmacy network or strong mail-order benefits. For travelers abroad, emphasize traveling with sufficient medication, since Part D does not cover drugs purchased outside the U.S.
Helping Clients Choose the Right Fit
Understanding a client’s travel habits helps you recommend the best Medicare option. Long-term international travelers may lean toward Medigap, while domestic travelers with predictable patterns may find strong value in certain Medicare Advantage PPOs.
By highlighting the coverage differences and asking the right questions upfront, agents can confidently guide their travel-savvy clients to Medicare solutions that protect their health no matter where the journey takes them.
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Avoiding Medicare Enrollment Mistakes: What Every Beneficiary Should Know
Enrolling in Medicare is one of the most important steps adults take as they approach age 65, yet it’s also one of the most common areas for costly mistakes. With multiple parts, deadlines, and coverage choices, it’s easy to feel overwhelmed. The good news is that with the right information, avoiding Medicare enrollment mistakes is easy. Here are the top mistakes to watch for and how to prevent them.
Missing Your Initial Enrollment Period
One of the biggest Medicare enrollment mistakes is missing the Initial Enrollment Period (IEP). Your IEP starts three months before your 65th birthday month and ends three months after. If you miss this window and don’t qualify for a Special Enrollment Period, you may face lifelong Part B late-enrollment penalties. To avoid this, mark your calendar early and begin evaluating your options at least three to six months before turning 65.
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Assuming Employer Coverage Automatically Delays Medicare
Many people continue working past age 65, but not all employer coverage allows you to delay Medicare. If your employer has fewer than 20 employees, Medicare becomes primary, meaning you must enroll in Part B to avoid coverage gaps. Always confirm whether your employer’s plan is considered creditable coverage before delaying enrollment.
Not Checking Creditable Drug Coverage
Medicare Part D also has its own late penalty if you go 63 days or more without creditable prescription drug coverage. Many people assume their employer or retiree plan counts, but not all do. Request a creditable coverage notice from your plan administrator each year and keep it for your records.
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Choosing a Plan Without Reviewing Networks and Formularies
Selecting a Medicare Advantage or Part D plan without checking provider networks and drug formularies can lead to higher costs and unexpected denials. Plans change annually, so a review during the Annual Enrollment Period (AEP) is essential; even if you’re happy with your current coverage.
Overlooking Out-of-Pocket Costs
Monthly premiums are only part of the equation. Deductibles, copays, and maximum out-of-pocket limits vary widely. Beneficiaries often choose the lowest-premium option only to discover higher costs later. Compare plans based on your actual health needs, not just the price tag.
Forgetting to Reevaluate Coverage Each Year
Your health needs and plan benefits change over time. Failing to review your coverage during AEP can lead to paying more than necessary or losing access to preferred providers or medications. A yearly comparison ensures your coverage stays aligned with your needs.
Not Working With a Licensed Medicare Agent
Medicare can be confusing, and many mistakes happen simply because beneficiaries don’t fully understand their options. A licensed Medicare agent can help you navigate enrollment periods, compare plans, and avoid penalties; all at no cost to you.
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Avoiding Medicare enrollment mistakes starts with awareness and preparation. By understanding your deadlines, verifying creditable coverage, reviewing networks and costs, and seeking expert guidance, you can make confident decisions that protect your health and your wallet.
GTL Hospital Indemnity Plans: A Smart Supplemental Solution for Agents
GTL hospital indemnity plans offer agents a practical way to help clients manage rising out-of-pocket healthcare costs while expanding their own product portfolio. Designed to pay cash benefits directly to the policyholder, these plans work alongside major medical coverage. This means; Medicare Advantage, or Medicare Supplement plans.
What Is a Hospital Indemnity Plan
A hospital indemnity plan provides a fixed cash benefit for covered events such as hospital admissions, daily confinement, ICU stays, and certain outpatient services. GTL’s hospital indemnity plans are known for simple plan designs, guaranteed renewable coverage, and predictable benefits. Because clients recieve payments directly, they can use funds for co-pays, deductibles or everyday expenses.
Why Agents Should Offer GTL Hospital Indemnity Plans
For agents, hospital indemnity plans are easy to explain and easy to position. As Medicare Advantage plans continue to shift cost-sharing to beneficiaries, clients are increasingly exposed to unexpected hospital expenses. Hospital indemnity coverage helps fill these gaps without replacing existing insurance.
Key agent-friendly advantages include:
- Straightforward underwriting with limited health questions
- Affordable premiums that appeal to budget-conscious clients
- Flexible use of benefits, increasing perceived value
- Year-round sales opportunities, not limited to AEP or OEP
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These features make GTL plans ideal for cross-selling to Medicare beneficiaries, individuals with high-deductible health plans, and clients concerned about hospitalization costs.
Ideal Clients for Hospital Indemnity Coverage
GTL hospital indemnity plans are especially effective for Medicare Advantage enrollees facing daily hospital copays, retirees on fixed incomes, and working individuals seeking extra financial protection. Agents can position the plan as a financial safety net rather than traditional insurance, which resonates strongly with today’s consumers.
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Final Thoughts
Adding GTL hospital indemnity plans to your product lineup allows you to address a real client need while generating consistent commissions. With simple benefits, broad appeal, and strong supplemental value, these plans can strengthen client relationships and help agents stand out in a competitive market.
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Understanding Life Insurance Basics: A Guide for Agents
Life insurance remains a cornerstone of financial planning, and as an agent, your ability to clearly explain its value is essential to helping clients make informed decisions. Whether you work with young families, retirees, or business owners, understanding life insurance basics and having the ability to explain them to potential cleints builds trust and supports sales. This overview highlights the key points agents should emphasize when educating clients on life insurance.
What Life Insurance Really Provides
At its core, life insurance is a financial safety net. Clients pay premiums, and in exchange, their beneficiaries receive a tax-free death benefit that can cover funeral expenses, mortgage payments, income replacement, debt, and other essentials. Agents should reinforce how life insurance provides long-term security and protects the financial stability of loved ones.
Term vs. Permanent Life Insurance
Helping clients choose the right policy starts with explaining the differences between the two main products:
Term Life Insurance
Term life offers affordable, straightforward protection for a set period; typically 10, 20, or 30 years. It’s ideal for families needing coverage during peak financial responsibility years. Agents should highlight conversion options, renewal features, and how term can complement other financial products.
Permanent Life Insurance
Permanent life insurance provides lifetime coverage and includes a cash value component that grows tax-deferred. Options like whole life, universal life, and indexed universal life offer flexibility, stable premiums, and long-term financial benefits. Agents can position permanent coverage as part of a broader wealth-building or legacy planning strategy.
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Matching Clients With the Right Coverage
Agents play a critical role in assessing client needs. Key factors to review include income replacement goals, outstanding debt, number of dependents, financial obligations, and long-term objectives. While the general guideline suggests coverage equal to 7–10 times annual income, personalized assessments help agents deliver tailored recommendations that strengthen client confidence.
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The Importance of Educating Clients
Today’s consumers want clarity and transparency. Agents who break down complex insurance concepts into simple, relatable explanations tend to build stronger relationships. This helps agents maintain their book of business. Emphasizing the real-life value of life insurance and how it fits into financial planning helps clients understand why the coverage matters.
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Understanding life insurance basics is essential for guiding clients toward the right protection. By explaining policy types, assessing needs, and positioning coverage as a long-term financial tool, agents can better serve their clients while growing their book of business.
Medicare Supplement Costs and Coverage: What Beneficiaries Need to Know
If you’re exploring ways to reduce out-of-pocket medical expenses, a Medicare Supplement Insurance plan (Medigap) can help fill the gaps left by Original Medicare. These standardized plans are designed to make healthcare costs more predictable, offering peace of mind and broader financial protection. We will go over the Medicare supplement costs and coverage and help you decide if this is right for you.
What Medicare Supplement Plans Cover
Medigap plans labeled A, B, D, G, K, L, M, and N offer the same benefits no matter which insurance company sells them. While the level of coverage varies by plan letter, most include:
- Part A coinsurance and hospital costs
- Part B coinsurance or copayments
- Blood (first 3 pints)
- Hospice care coinsurance
- Skilled nursing facility coinsurance (many plans)
- Part A deductible
- Foreign travel emergency benefits (select plans)
Today’s most popular option, Plan G, offers broad protection by covering nearly all Medicare-approved costs except the Part B deductible.
What Medigap Does Not Cover
It’s important to understand what Medicare Supplement plans exclude. Medigap policies do not cover:
- Prescription drugs (Part D is required separately)
- Routine dental, vision, and hearing care
- Long-term care or custodial care
- Services not approved by Medicare
Beneficiaries often pair Medigap with standalone dental, vision, and hearing plans for more complete coverage.
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How Much Medicare Supplement Plans Cost
Medigap premiums vary widely. The main factors that influence cost include:
Plan Type
Plans with more benefits typically cost more. Plans with cost-sharing features often come with lower premiums.
Age and Rating Method
Carriers price Medigap plans using:
- Community-rated premiums
- Issue-age-rated premiums
- Attained-age-rated premiums
The rating method affects how your premium changes over time.
Location
Medigap costs vary by state and even by ZIP code due to regional healthcare expenses.
Tobacco Use and Enrollment Timing
Carriers may charge higher rates for tobacco users or applicants enrolling outside their guaranteed-issue period.
Available Discounts
Household or multi-enrollee discounts may lower monthly premiums.
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Why Many Beneficiaries Choose Medigap
Medicare Supplement plans are favored for their predictable costs, nationwide provider access, and minimal out-of-pocket expenses. With no networks or referrals required, Medigap offers flexibility that many retirees value.
A Medicare Supplement plan can significantly reduce healthcare costs and eliminate many gaps in Original Medicare. Reviewing coverage options, comparing premiums, and pairing your plan with Part D ensures you get comprehensive protection tailored to your needs.
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Medicare Commission Dispute Update: CMS’ Repsonse What Agents Need to Know
The growing conflict between insurers and state regulators has caused federal officials to step in to clarify who controls Medicare Advantage (MA) marketing practices. The latest Medicare commission dispute update dives in to CMS’ response to the current status of broker commissions. Several insurers have reduced or eliminated commissions and restricted access to enrollment tools. Therefore, state commissioners are pushing back, arguing these actions harm both agents and beneficiaries. CMS’ latest memo signals that the debate is far from over.
Medicare Advantage Enrollment Suppression
In recent months, multiple insurers have attempted to limit what they view as costly Medicare Advantage enrollment by adjusting broker compensation and curbing access to online enrollment portals. These moves have prompted roughly a dozen states to urge insurers to reverse course. Some state departments even issued cease-and-desist orders, sparking lawsuits from carriers.
On December 4, CMS issued a memo stating; regulation of Medicare Advantage and Part D ultimately rests at the federal level. The agency emphasized that federal law likely preempts state law on matters related to MA compensation and marketing. CMS also reminded stakeholders that commissions are negotiable annually, as long as they fall within federal limits.
Access to Enrollment Forms
Importantly, CMS did clarify one requirement: enrollment forms must remain accessible on insurers’ websites. This comes amid concerns that restricted access to online tools could limit beneficiaries’ ability to make informed choices.
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Agent Compensation
While CMS’ memo reaffirmed federal authority, states are unlikely to stay silent. Several state regulators have said they lack the authority to mandate compensation changes but continue urging insurers to restore commissions. Industry observers expect states to keep applying public pressure, even if their legal power is limited. Some also suggest states could focus attention on the Medicare Supplement market, which is regulated at the state level, especially as some carriers consider commission changes in that space as well.
Agents and brokers have voiced growing frustration as certain insurers have reduced or eliminated commissions; sometimes even retroactively. Many argue that these cuts ultimately hurt beneficiaries by reducing access to professional guidance during enrollment.
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The dispute has escalated significantly. Insurers have filed lawsuits in response to state actions, claiming that limiting commissions is part of their strategy to maintain plan stability amid rising costs. Meanwhile, regulators in several states have urged insurers to reinstate compensation, warning of the broader impact on consumers.
Let’s Sum it Up
With the 2025 Annual Enrollment Period now over and the 2026 window on the horizon, the tension between state regulators, insurers, and federal authorities is shaping what could become a pivotal policy fight. CMS’ memo clarifies federal preemption but leaves the door open for continued pressure from states. For agents, the message is clear: the debate over Medicare Advantage commissions is far from settled. The outcome will have meaningful implications for how the industry operates moving forward.
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What Medicare Part D Covers: A Clear Guide for Medicare Beneficiaries
Medicare Part D is essential for millions of beneficiaries who rely on prescription medications to manage chronic conditions and maintain their health. Understanding what Medicare Part D covers can help you choose the right plan, avoid unexpected costs, and make the most of your Medicare benefits. This guide breaks down the key features of Part D coverage so you know exactly what to expect.
What Is Medicare Part D
Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. Beneficiaries can enroll in a stand-alone Prescription Drug Plan (PDP) with Original Medicare or choose a Medicare Advantage plan (MA-PD) that includes drug benefits. Every plan must follow Medicare’s minimum coverage rules, but formularies and pricing vary.
What Medicare Part D Covers
Prescription Drugs in Essential Categories
All Medicare Part D plans must cover drugs across major therapeutic classes, including medications for:
- Diabetes
- High blood pressure
- High cholesterol
- COPD and asthma
- Depression and anxiety
- Osteoporosis
This ensures beneficiaries have access to commonly used medications for chronic conditions.
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Protected Class Medications
Medicare Part D also requires plans to cover “protected class” drugs, which include:
- Antidepressants
- Antipsychotics
- Anticonvulsants
- Antiretrovirals
- Immunosuppressants
- Certain cancer medications
These protections ensure that people with serious or complex health needs can access the full range of necessary treatments.
Vaccines Not Covered by Part B
Part D covers many important vaccines, including the shingles (Shingrix) vaccine, RSV vaccines, and most travel immunizations. Under current Medicare rules, beneficiaries typically pay $0 out of pocket for recommended vaccines.
Insulin and Diabetic Supplies
Thanks to recent updates, Medicare Part D limits monthly insulin costs to $35 for covered insulin products. Many plans also cover diabetic supplies such as test strips, lancets, and pen needles.
Specialty and High-Cost Medications
Part D covers a wide range of specialty drugs used for conditions like multiple sclerosis, rheumatoid arthritis, and autoimmune disorders. These medications may fall into higher cost tiers but are included in most formularies.
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What Medicare Part D Does Not Cover
Medicare Part D does not cover over-the-counter drugs, vitamins and supplements, cosmetic medications, fertility treatments, or drugs for weight loss.
Medicare Part D provides comprehensive, affordable access to prescription medications. By reviewing your plan’s formulary, comparing costs, and choosing a plan that matches your medication needs, you can maximize your coverage and save money throughout the year.
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Medicare Advantage OEP 2026: What Beneficiaries Need to Know
As in previos years, the Medicare Advantage OEP 2026 runs from January 1 to March 31, giving Medicare beneficiaries a valuable second chance to fine-tune their health coverage. While the Annual Enrollment Period (AEP) in the fall gets the most attention, OEP is just as important; especially with the growing number of changes expected in Medicare Advantage benefits, Star Ratings, utilization management, and supplemental offerings in 2026.
Here’s an overview of what OEP is, how it works, and why 2026 may be an especially important year to review plan choices.
What Is the Medicare Advantage OEP
The Medicare Advantage OEP is a once-per-year enrollment window designed specifically for people already enrolled in a Medicare Advantage plan. It allows beneficiaries to:
- Switch to a different Medicare Advantage plan (with or without drug coverage)
- Drop Medicare Advantage and return to Original Medicare
- Enroll in a stand-alone Part D prescription drug plan if switching back to Original Medicare
However, OEP does not allow someone on Original Medicare to join a Medicare Advantage plan. It is strictly for current MA members who want to make a change.
Why OEP Matters in 2026
Medicare Advantage plans are expected to see continued adjustments in 2026, including:
More Care Management Controls
Many carriers are tightening prior authorization, utilization management, and cost-sharing rules. Some beneficiaries may find their 2026 MA plan more restrictive than expected once the new year begins.
Shifts in Supplemental Benefits
Non-medical extras like dental, vision, hearing, transportation, and OTC allowances are being closely reviewed by CMS. Some plans reduced benefits for 2026 to balance rising medical costs.
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Star Rating Modifications
With CMS proposing changes to the Star Ratings program, some plans entered 2026 with lower ratings than previous years. Lower ratings can mean reduced rebates, resulting in trimmed benefits or higher out-of-pocket costs for members.
Provider Network Adjustments
Every year brings hospital and physician network changes. Beneficiaries often don’t notice these changes until January, making OEP their opportunity to switch to a plan with more compatible providers.
With these shifts, OEP 2026 will be especially important for those who discover their new coverage doesn’t meet their expectations.
Who Should Consider Making a Change
A Medicare Advantage member may want to explore options during OEP if:
- Their plan dropped key doctors or specialists for 2026
- Prescription costs or formularies changed
- Supplemental benefits were reduced or removed
- Prior authorization requirements increased
- Their total out-of-pocket costs are higher than anticipated
- They enrolled in a new plan during AEP but are experiencing “buyer’s remorse”
Even a small change; like a different tier placement for a medication can significantly impact annual healthcare expenses.
How to Review Medicare Advantage Options During OEP
During OEP, beneficiaries should:
- Review their 2026 Evidence of Coverage (EOC) to understand changes.
- Compare local plan alternatives, focusing on doctors, drug coverage, and copays.
- Check Star Ratings, but also evaluate real-world factors like provider access.
- Consider switching back to Original Medicare if they prefer provider flexibility; though Medigap underwriting rules may apply depending on the state.
Working with a licensed Medicare agent is the quickest way to compare plans side-by-side and avoid unexpected coverage gaps.
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The Medicare Advantage Open Enrollment Period is a valuable opportunity for beneficiaries to correct course after the new plan year begins. With ongoing regulatory changes and shifting benefits in 2026, OEP gives Medicare members the flexibility to ensure their plan still aligns with their healthcare needs, budget, and preferred providers.
Whether it’s a minor adjustment or a full switch, the OEP helps ensure beneficiaries start the rest of 2026 with confidence in their coverage.
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Using Annuities for Retirement Income: A Simple, Reliable Strategy
For many Americans nearing retirement, one fear rises above all others: outliving their savings. With people living longer and traditional pensions becoming rare, retirees need income sources they can count on. That’s why using annuities for retirmenet income is gaining attention as a dependable way to create steady retirement income.
An annuity is a contract with an insurance company. You contribute a lump sum or make periodic payments, and in return, the insurer provides growth, protection, or guaranteed income. While annuities come in several forms, their main purpose is simple; turning savings into predictable income.
Types of Annuities
Fixed Annuities
Fixed annuities offer a guaranteed interest rate for a set term. They work like a secure, tax-deferred CD alternative and can later be converted into income.
Best for: Retirees who want stable, predictable returns.
Fixed Indexed Annuities
These annuities earn interest tied to a market index, such as the S&P 500, but protect your principal from market losses. Many include optional riders that provide guaranteed lifetime income.
Best for: People who want growth potential without risking their savings.
Immediate or Lifetime Income Annuities
These convert your investment into guaranteed monthly income that can last for life. They function like a personal pension.
Best for: Anyone who wants dependable, never-ending income.
Variable Annuities
Variable annuities invest in market-based subaccounts. They offer more growth potential but also market risk. Some add income riders for future stability.
Best for: Investors comfortable with market swings.
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Why Use Annuities for Retirement Income
Guaranteed Lifetime Income
Few financial products can provide income you cannot outlive. Annuities help create a reliable foundation for retirement.
Protection from Market Declines
For retirees, early losses can severely reduce long-term income. Many annuities protect your principal, which helps preserve your savings during downturns.
Tax-Deferred Growth
Earnings inside an annuity grow tax-deferred, making it easier for your funds to compound over time.
Complements Other Income Sources
Annuities can fill income gaps by working alongside Social Security, pensions, or withdrawals from retirement accounts.
Are Annuities Right for Everyone
Annuities may not be ideal for people who need high liquidity or want full access to their funds. They are best suited as part of a diversified retirement plan; not a replacement for all other investments.
In today’s retirement landscape, steady income matters more than ever. Annuities help retirees create predictable, long-lasting income while reducing risk. Whether you want stability, lifetime payments, or protection from market volatility, annuities can be an effective tool for building long-term financial security. A licensed agent can provide important guidance to create a long term strategy to secure your future income.
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Proposed Medicare Advantage Changes 2027
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule for the 2027 contract year that could reshape Medicare Advantage (MA) and Part D prescription drug coverage. The agency aims to “strengthen quality, improve access, and modernize benefits” while reducing administrative burdens on plans.
Here’s what beneficiaries, providers, and policymakers need to know.
Star Ratings Overhaul
CMS proposes removing 12 Star Rating measures that are largely administrative or show little variation between plans. The focus will shift to meaningful metrics, including clinical outcomes, preventive care, and patient experience.
- New focus on outcomes: Plans will be evaluated more on health results than paperwork.
- Mental health measure: CMS plans to introduce a “Depression Screening and Follow-Up” measure for future cycles.
- Health equity bonuses paused: The previously planned “Excellent Health Outcomes for All” bonus is postponed, though CMS invites feedback on equity initiatives.
Impact: Beneficiaries may find it easier to identify high-quality plans, while insurers may redirect resources toward improving actual care.
Enrollment Flexibility
The proposed rule adds a new Special Enrollment Period (SEP) for beneficiaries whose providers leave a plan’s network. This allows mid-year plan changes without waiting for the regular enrollment window. CMS also codifies other existing SEP policies, making the system more consistent.
Impact: This change ensures continuity of care for people with chronic conditions or preferred providers.
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Part D and Drug Coverage Updates
The rule formalizes Part D reforms started under prior legislation, including:
- Eliminating the coverage gap (donut hole) phase.
- Maintaining reduced out-of-pocket thresholds.
- Removing cost-sharing in the catastrophic phase.
- Adjusting how True Out-of-Pocket (TrOOP) costs are calculated.
Impact: Beneficiaries gain more predictable and affordable prescription drug coverage.
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Reducing Administrative Burden
CMS proposes measures to reduce paperwork and regulatory complexity, such as:
- Exempting certain account-based plans from creditable coverage disclosures.
- Lifting requirements for mid-year notices about unused supplemental benefits.
- Removing some health-equity reporting mandates for plans.
Impact: Plans may operate more efficiently, but some transparency and oversight could be reduced.
Why It Matters
- Patient-focused quality: More emphasis on outcomes and experience could improve care.
- Drug cost protection: Part D reforms continue to protect beneficiaries from high out-of-pocket expenses.
- Flexible enrollment: The new SEP enhances access to care when providers leave networks.
- Efficiency vs. oversight: Streamlined administration may improve plan operations but reduce some accountability.
- Future reform: CMS is constantly making changes to improve MA plans, and stakeholders have the chance to provide input.
CMS’s 2027 proposed rule could bring meaningful improvements for beneficiaries while easing administrative burdens for insurers. The Star Ratings overhaul, enrollment flexibility, and Part D updates are poised to enhance care and reduce costs. However, reduced oversight and postponed equity initiatives highlight areas to watch as the public-comment process unfolds.
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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: 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 Status | 2026 Part B Premium Estimate |
|---|---|---|
| Up to $109,000 | Single | $202.90 (no surcharge) |
| $109,001 – $137,000 | Single | $284.10 |
| $137,001 – $171,000 | Single | $405.80 |
| $171,001 – $205,000 | Single | $527.50 |
| $205,001 – $499,999 | Single | $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.
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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:
- 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.
- 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.
- 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.
- 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.