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Did Medicare Pay for a Test You Never Received? A New Fraud Crackdown Gives Seniors a Reason to Look
3+ day, 21+ hour ago (187+ words) If you’re unsure, call the physician who supposedly ordered the test and ask whether the office has a record of ordering it for you. If you still suspect fraud, Medicare says you can report it through 1-800-MEDICARE (1-800-633-4227) or its online…...
CMS Is Targeting Unauthorized Health Insurance Enrollments—Here’s What Consumers Should Check
3+ day, 22+ hour ago (566+ words) Editor’s Note: This article concerns Affordable Care Act Marketplace coverage, not Medicare plan enrollment. That’s significant because CMS says Enhanced Direct Enrollment platforms accounted for approximately 76% of active plan selections during 2026 Open Enrollment. The additional protection is intended to make…...
157 Lab Providers Lost Medicare Billing Privileges—Here’s Why Checking Your Medicare Statement Matters
3+ day, 23+ hour ago (192+ words) According to CMS, those systems look for abnormal combinations involving testing, results, billing, documentation, and relationships that could indicate fraud, waste, or abuse. The technology can help flag high-risk claims for additional review and potentially allow claims to be held,…...
Your Prescription Costs $8 One Month and $80 the Next. Here Are the Questions to Ask Before You Pay
1+ week, 6+ day ago (361+ words) You should also ask: “Was the prescription actually run through my insurance?” Before assuming your plan changed, ask the pharmacy to confirm that the prescription was processed through the correct insurance and that the plan information on file is current....
The Medicare Extra Help Program Could Be Worth Thousands — And Some People Still Don’t Know They Qualify
2+ week, 2+ day ago (228+ words) Also watch Medicare mail in September. A gray Loss of Deemed Status Notice means you won’t automatically qualify for Extra Help next year, but that doesn’t necessarily mean you can’t qualify. You can still apply through Social Security or your…...
Moving to Another State on Medicare? 7 Coverage Changes to Check Before You Go
3+ week, 2+ day ago (402+ words) Before moving, use Medicare’s Care Compare tool to identify nearby primary-care physicians, specialists, hospitals, and other providers rather than waiting until you need an appointment. For example, a retiree moving from Ohio to North Carolina may discover that the company…...
Costco Is Launching Medicare Plans — Here’s What Seniors Need to Know Before Open Enrollment
3+ week, 5+ day ago (443+ words) Costco is entering the Medicare market. The warehouse club (NASDAQ:COST) is partnering with nonprofit SCAN Health Plan to launch co-branded Medicare Advantage plans in three states. The companies announced the expanded partnership Tuesday. The initial markets cover roughly 5 million…...
Costco Is Getting Into Medicare — Here's What Older Adults Should Know
3+ week, 5+ day ago (500+ words) The biggest misconception to clear up is that Costco itself is not suddenly replacing UnitedHealthcare, Humana, or other insurers as a Medicare Advantage company. SCAN Health Plan is the insurance partner and is an HMO with a Medicare contract, while…...
Your Medicare Plan Will Send an Important Letter This Fall — Don’t Throw It Away
1+ mon, 2+ day ago (135+ words) Have you ever discovered an unexpected premium, prescription, or coverage change in your Medicare Annual Notice of Change? Tell us what you found in the comments. 7 Prescription Drug Costs to Compare Before Medicare Open Enrollment One High-Income Year Could Raise…...
CMS Finalizes Medicare Hospice Payment Increase and New Patient Disclosure Rules for FY 2027
1+ mon, 1+ week ago (357+ words) The Centers for Medicare & Medicaid Services (CMS) has issued a final rule updating Medicare hospice payment rates, the hospice wage index, and quality reporting program requirements for fiscal year 2027. According to an official announcement published in the Federal Register on…...