Category: medicare

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Information medicare Medicare Plans

Medicare OEP vs AEP: When You Can Actually Switch Plans in 2026

Medicare has multiple enrollment periods with different rules, and confusing them can leave beneficiaries locked into the wrong plan for months.

The Annual Enrollment Period runs from October 15 to December 7, during which beneficiaries can switch between Original Medicare and Medicare Advantage, or change Part D plans.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31, but is more limited — beneficiaries can only switch from one Medicare Advantage plan to another, or drop Medicare Advantage and return to Original Medicare.

Outside these windows, Special Enrollment Periods may apply for beneficiaries who move, lose employer coverage, or qualify for a Special Needs Plan. Understanding which enrollment period applies can save beneficiaries from costly mistakes.

View enrollment periods on Medicare.gov.

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Information medicare Medicare Advantage Medicare Plans

Explore your Medicare coverage options

Choosing between Medigap and Medicare Advantage remains one of the most important decisions for new Medicare beneficiaries, and the tradeoffs have shifted in 2026.

Medigap plans offer predictable out-of-pocket costs and access to any Medicare provider nationwide, but premiums are higher and prescription drug coverage requires a separate Part D plan.

Medicare Advantage plans often feature low or zero premiums and include extra benefits like dental and vision, but provider networks are limited and prior authorization requirements can create care delays.

Financial planners recommend that beneficiaries who travel frequently or have complex medical needs consider Medigap, while those who prioritize low monthly costs and supplemental benefits may find Medicare Advantage more suitable.

Compare plans through Medicare.gov.

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medicare Medicare Advantage Special Needs Plans

Special Needs Plans: The Fastest-Growing Part of Medicare Advantage

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Special Needs Plans, known as SNPs, are now driving the majority of Medicare Advantage enrollment growth as they serve beneficiaries with specific health conditions, institutional care needs, or dual Medicare-Medicaid eligibility.

Three types of SNPs are available: Chronic Condition SNPs for conditions like diabetes or heart disease, Institutional SNPs for nursing home residents, and Dual Eligible SNPs for those on both Medicare and Medicaid.

These plans tailor provider networks, drug formularies, and care coordination to the specific needs of their members, often including benefits traditional Medicare Advantage plans do not offer.

Beneficiaries who qualify for an SNP can enroll at any time during the year, not just during the Annual Enrollment Period, making them an important option for those with changing health needs.

Learn more about SNPs from CMS.

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Market Trends medicare Medicare Benefits & Services Medicare Plans Medicare Policy & Trends Medicare Updates & Policy

CMS Proposes Nearly Flat Medicare Advantage Payment Increase for 2027

Federal health officials have proposed only a small increase in payments to Medicare Advantage insurers for 2027. The modest proposed adjustment, far lower than in previous years, could impact plan benefits, premiums, and insurer participation as the government seeks to control federal healthcare spending.

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information medicare Medicare Policy & Trends

Research Highlights Impact of Medicare Advantage Plan Exits

A new research letter in JAMA analyzes the impact of Medicare Advantage plan exits, finding that millions of enrollees are forced to select new coverage when insurers withdraw. The study notes that such disruptions can complicate care coordination, especially for seniors with complex medical needs, fueling debate over marketplace stability.

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information medicare Medicare Benefits & Services Medicare Policy & Trends

CMS Halts Enrollment in Some Elevance Medicare Advantage Plans

Federal regulators have ordered a temporary halt on new enrollments in certain Elevance Health Medicare Advantage plans after identifying compliance issues. The action reflects growing federal scrutiny of private insurers to ensure they meet program requirements and protect beneficiaries.

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medicare Medicare Advantage

DOJ Reaches Settlement With Aetna Over Medicare Advantage Billing

The U.S. Department of Justice has reached a settlement with Aetna over allegations that the insurer used inaccurate diagnostic coding to improperly increase Medicare Advantage payments. The case underscores federal efforts to ensure accurate reporting of patient health conditions for payment accuracy.

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information medicare Medicare Benefits & Services resources

CMS Proposal to Change Medicare Advantage Payments Sparks Industry Debate

A proposed update to Medicare Advantage payment rules has generated a record number of public comments from insurers, providers, and advocacy groups. The proposal aims to refine insurer reimbursements and address concerns about the risk-score calculations used to determine payments.

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medicare Medicare Plans

Some Medicare Plans May Exceed $50 Monthly Cap for Weight-Loss Drugs

Pharmaceutical company Eli Lilly recently warned that some Medicare drug plans may charge more than the expected $50 monthly cap for certain weight-loss medications. The issue highlights the complexity of how new drug pricing policies interact with Medicare prescription drug coverage. While reforms aim to reduce costs for seniors, experts say the rollout may vary depending on how insurers structure their formularies.

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medicare Medicare Plans

2026 Medicare Advantage Plans Reviewed

A group of senior men and women are outdoors in a park. They are doing exercise with lights dumbbells.

NerdWallet’s 2026 picks include UnitedHealthcare, Aetna, HealthSpring (formerly Cigna), Humana and Devoted Health. Via Nerdwallet