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Medicare Advantage Payment Proposal Sparks Industry Backlash

Washington Post Health Brief – Today
CMS has proposed a near-flat increase of just 0.09% in Medicare Advantage reimbursement rates for 2027 — far below insurer expectations. Insurers and policy groups warn this could lead to reduced supplemental benefits and higher premiums for beneficiaries. The comment period remains open until Feb 25 ahead of an April 6 final rule.

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Medicare hospital outpatient payment to increase 2.6% in 2026

Site neutral policy changes will cut spending by $290 million in 2026, CMS says.

By Susan Morse , Executive Editor

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CMS projects a 10 % increase in Part B premiums for 2026, raising the standard monthly cost to about $202.90 — a change that will affect millions of beneficiaries.

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Understanding Medicare: The Complete 2026 Parts Breakdown

What Medicare Is and Who It Serves Medicare is the federal health insurance program for people aged 65 and older, as well as certain younger individuals with disabilities or specific conditions like End-Stage Renal Disease. In 2026, it continues to serve as the primary health coverage for over 60 million Americans. The program is divided into distinct “parts,” each covering different services.

Medicare Part A: Your Hospital Insurance covers inpatient care in hospitals, skilled nursing facility care following a hospital stay, hospice care, and some home health services. For most beneficiaries, there is no monthly premium for Part A if they or their spouse have at least 40 quarters of Medicare-covered employment. However, cost-sharing does apply when you use services. The 2026 Part A inpatient hospital deductible is $1,736 per benefit period Source: CMS.

Medicare Part B: Your Medical Insurance covers outpatient care, doctor visits, preventive services, durable medical equipment, and ambulance services. Unlike Part A, Part B requires a monthly premium. The standard monthly premium for 2026 is $202.90. You must also meet the annual Part B deductible of $283 before coverage begins for most services Source: CMS.

Medicare Part C: The Medicare Advantage Alternative, also known as Medicare Advantage, allows private insurance companies approved by Medicare to provide your Part A and Part B benefits. These plans often include additional benefits like prescription drug coverage (Part D), along with dental, vision, or hearing services.

Medicare Part D: Your Prescription Drug Coverage is optional insurance to help pay for outpatient prescription medications. You can get Part D by joining a stand-alone Prescription Drug Plan (PDP) to add to Original Medicare, or by selecting a Medicare Advantage plan that includes drug coverage (MA-PD).

Where to Find Official Plan Information The definitive source for comparing all Medicare Advantage and Part D plans available in your area is the federal government’s Medicare Plan Finder tool at Medicare.gov/plan-compare. This tool allows you to input your medications and preferred pharmacies to see exact costs.

This website is privately owned. All information and advertisements are independent and are not associated with any state exchange, the federal marketplace, the Centers for Medicare & Medicaid Services (CMS), or the Department of Health and Human Services.

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US proposes slight rise in 2027 Medicare insurer payments, shares fall

Jan 26 (Reuters) – The U.S. has proposed an average rate increase of 0.09% in ​payments to private insurers next year for the Medicare Advantage plans they manage, the government said ‌on Monday, driving shares of the companies down more than 10%.

Shares of health insurers UnitedHealth (UNH.N), opens new tab, CVS Health (CVS.N), opens new tab and Humana (HUM.N), opens new tab were down between 8% and 13% in after-hours trading, while shares of Elevance Health (ELV.N), opens new tab, Centene (CNC.N), opens new tab and Molina Healthcare (MOH.N), opens new tab were down nearly 5%.
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Trump administration announces 15 new drugs for Medicare price negotiation program

NEW YORK (AP) — Drugs that treat Type 2 diabetes, HIV and arthritis are among 15 new medications chosen for a Medicare drug price negotiation program that allows the federal government to haggle directly with drug manufacturers, the Trump administration said Tuesday.

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8 Changes Shaping Your Medicare Coverage in 2026

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US names HIV, arthritis drugs for next Medicare price talks

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Medicare in Texas 2025: What You Need to Know

Introduction

If you’re a Texan approaching 65 or already on Medicare, understanding your options for 2025 is key. Texas offers a wide range of Medicare Advantage, Supplement, and Prescription Drug Plans — but not all are created equal.

Key Changes for 2025

  • Updated premiums and deductibles for Medicare Part B and D.
  • New Advantage plan benefits for dental, hearing, and vision.
  • Expanded coverage in rural Texas counties.

Enrollment Tips

  • Compare plans early — the Annual Enrollment Period (AEP) runs from October 15 to December 7.
  • Review your medications and doctor network each year.
  • Use licensed Medicare agents in Texas for personalized quotes.
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How to Know If You Have an Alcohol Intolerance: Tres Vistas Recovery : Addiction Medicine

For most people with this condition, symptoms will vary from one person to another. However, the most common symptoms to look out for are your skin flushing and feeling sick whenever you consume alcohol. If you have alcohol intolerance and consume an alcoholic beverage, the most immediate symptom you might notice is your skin going flush and feeling warm. If you drink a beverage that causes a mild reaction, over-the-counter antihistamines might help relieve symptoms. However, for a severe skin reaction, weak pulse, vomiting or trouble breathing, seek emergency help right away, as you could be having an anaphylactic reaction.

There’s not much someone can do to treat an alcohol intolerance. The best course of action is abstinence from alcohol, in general. Most people have no problem with histamines, but they cause issues for others. People who have problems with histamines likely doesn’t have enough of the enzyme DAO or diamine oxidase. Want to know another surprising thing people can be allergic to or at least could i be allergic to alcohol intolerant of? That’s right – that beer you had an hour ago may be the reason you can’t stop scratching that one spot on your legs, or why your face feels hot. Even so, if you have a severe corn allergy, you may want to avoid corn-based spirits, most especially bourbon. Gin, whiskey, brandy, and some vodkas may also use corn as an ingredient or flavoring, so be sure to check the label.

Sudden Alcohol Intolerance (And Differentiating From Alcohol Allergies)

It helps to read the product label, although many ingredients used in the fermentation or distillation process may not be included. These include grains like wheat, barley, and rye used to make beer, which can affect people with celiac disease, non-celiac gluten sensitivity, and wheat allergies. Red wine contains high levels of histamine and may cause headaches, congestion, and itching in people with histamine intolerance. Many foods, including red wine and aged cheese, are high in histamine. This is the same chemical involved in allergic reactions in the body. If drinking alcohol—also known as ethanol—gives you food allergy symptomssuch as flushing, itching, and diarrhea, you may have an allergy or an intolerance to alcohol. Bad reactions to alcohol and alcohol intolerance can be also characteristic of some diseases.

Alcohol intolerance is a relatively rare condition that causes a person to experience abnormal side effects after drinking alcohol. A person can be born with alcohol intolerance, but it can also be caused by certain medications or medical conditions. Alcohol intolerance will normally cause people to avoid alcohol, as the unpleasant symptoms are quite undesirable. The only way to avoid alcohol intolerance symptoms or an allergic reaction is to avoid alcohol or the particular beverage or ingredients that cause the problem. For a minor reaction, over-the-counter or prescription antihistamines might help reduce symptoms, such as itching or hives. If you have an alcohol allergy, your immune system over-reacts to alcohol. If you have alcohol intolerance, your digestive system doesn’t process alcohol properly. You might also react to certain alcoholic beverages if you have a histamine or sulfites intolerance.

Signs You’re Allergic To Alcohol

If you experience nausea, breathing problems or break out in hives after drinking alcoholic beverages, you might be allergic to alcohol. Alcohol intolerance symptoms are unpleasant but rarely actually dangerous. However, alcohol allergy symptoms can range from mildly unpleasant to life-threatening. Mild symptoms include rash, but more dangerous symptoms include swelling in the face and throat, which can affect the ability to breathe. If you suspect that you or someone you know is having a serious allergic reaction, immediately call 911. Alcohol intolerance, also known as alcohol sensitivity, is typically caused by a change that affects an enzyme called alcohol dehydrogenase. This enzyme is part of the body’s process for breaking down alcohol, and it converts a chemical called acetaldehyde to another chemical called acetate. The change caused by alcohol intolerance makes it impossible for the body to break down acetaldehyde as it should, causing this chemical to build up in the body.

Does alcohol give anxiety?

Alcohol changes levels of serotonin and other neurotransmitters in the brain, which can worsen anxiety. In fact, you may feel more anxious after the alcohol wears off. Alcohol-induced anxiety can last for several hours, or even for an entire day after drinking.

Avoid the beverage or beverages that seem to cause your reaction until your doctor’s appointment. The doctor may refer the person to an allergy specialist for further testing and treatment. Anaphylaxis is a life threatening condition that involves a series of symptoms, such as a rash, low pulse, and shock. An alcohol allergy can occur when a person with an alcohol allergy comes into contact with alcohol, Sober Home which is also known as ethanol. Hives, or urticaria, are itchy, raised welts that are found on the skin. If you’re taking medication, check with your doctor to see if it’s OK to drink alcohol while you take it. An enzyme called alcohol dehydrogenase helps metabolize the ethanol. Because there may be many different causes for a single symptom, it is best not to make a conclusion about the diagnosis.

When to see a doctor

Alcohol intolerance is sometimes referred to as alcohol sensitivity. Key personal information, including major stresses or recent life changes. Stress can sometimes worsen allergic reactions or sensitivities. A person experiencing a severe allergic reaction should go to the emergency room immediately.

What is the most common alcohol to be allergic to?

Red wine is more likely to cause a reaction than any other alcoholic drink. Beer and whiskey also can cause reactions because both are made from four common allergens: yeast, hops, barley, and wheat.