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In this episode, Jakob Emerson, Associate News Director at Becker's Healthcare, joins Scott Becker to discuss the surprising projected drop in Medicare Advantage enrollment, the growing strain between payers and providers, and how rising costs and tighter federal oversight are reshaping the insurance landscape.
Are you ready to uncover the hidden legal blind spots in Medicare and get expert financial planning advice? Join Todd Marquardt on Talk Law Radio as he sits down with Steve Warren, President of Financial Planning HQ, and John Moore of Moore Wealth Advisors. Discover how to protect your legacy, avoid Medicare scams, and make smart choices for your future!Talk Law Radio with Todd Marquardt brings together top experts to help you navigate the complex world of Medicare and financial planning. •Steve Warren shares insights on fiduciary responsibility, working with client advisors, and the importance of always acting in your best interest.•John Moore reveals the hidden legal blind spots in Medicare, answers common questions, and explains the difference between Medicare Advantage and Medicare Supplement plans.•Learn about recent Medicare scams, how to avoid them, and what to do if you’re a victim.•Get tips on Medicare eligibility, open enrollment, and prescription drug coverage (Part D).•Plus, hear about legacy planning and how to make sure your financial future is secure.Don’t miss this episode!If you want to protect yourself and your loved ones, tune in on Facebook, YouTube, or your favorite podcast platform.See omnystudio.com/listener for privacy information.
Subscribe to UnitedHealthcare's Community & State newsletter.Health Affairs' Jeff Byers welcomes Troyen A. Brennan of Harvard T.H. Chan School of Public Health and former CMO at CVS Health to the pod to discuss his new book, Wonderful and Broken: The Complex Reality of Primary Care in the United States. The conversation touches on themes within the book, including the current state of primary care, the diffusion of ideas in the health care space, the paradox of value-based care driven by Medicare Advantage, innovation in the Medicaid space, and what opportunities there could be to improve health care outcomes. Subscribe to UnitedHealthcare's Community & State newsletter.
This show today is a continuation of our mission/margin series because I wanted to drag into my investigation here what clinical organizations are up to, especially ones that have brought in professional capital, as they say. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. Before I kick in here, let me just remind everyone of a few themes that we have been poking in the eyeballs in the past few months over here at Relentless Health Value. First, patients cannot afford care. Listen to the show with Mark Cuban and Cora Opsahl (EP488) mentioning middle-class wage stagnation. Listen to the show with Merrill Goozner (EP388). Listen to the show with Wayne Jenkins, MD (EP358). It is a crapshoot to get medical care these days. Roll the dice and hope you don't get a bankrupting bill at the end. There's no transparency (or very little) for patients. No accountability or interest from many. Not all but many take no responsibility for their financial impact on their patients or members. And look, I am in no way speaking for the vast majority of doctors or nurses or pharmacists or PAs or even really good administrators or anybody else involved in clinical care. In fact, if you listen to the show with Komal Bajaj, MD (EP458) about how many clinicians do not actually trust their leadership will do right by patients or even the clinicians themselves, then yeah. This is undeniably the broad stroke of this industry we all work in. Many take no responsibility for their financial impact on their patients or members. That is the first theme. Here's the second theme. It's this motto: If you can take it, take as much as you can get. And throwing no shade, but let's just get real about that. Right now, healthcare is an industry just like any other industry. And when I say industry, I mean the tax-exempt so-called nonprofits as much as anybody else. Said another way, corporate healthcare leaders, just like any other business leaders, have every incentive to see prices go up. That is just the way commerce works. Listen to the show with Jonathan Baran (EP483, Part 1), the ones with Kevin Lyons (EP487, Part 1 and Part 2). But what is different than most other commerce endeavors when it comes to healthcare, and Shane Cerone from Kada says this in an upcoming episode, he says, “We don't have a broken healthcare market. In many parts of the country, there is no healthcare market. The market does not exist.” And thus prices can go up like rocket ships, because self-insured employers—and also public plan sponsors a lot of times, like state health plans—are, on the whole, just such unsophisticated buyers, price elasticity is, like, nonexistent. No matter how high the price, plan sponsors still contract for who's ever in the network; and they and their members ante up and pay the price. Many good and maybe not-so-good reasons for this (not getting into them), but net net, the result is a nonmarket. Anyone who wants to debate my corporate healthcare entities or big consolidated healthcare entities act just like any other corporate entity, read the recent Substack by Preston Alexander. It's about hospitals raising capital with bonds. Preston Alexander wrote, “The financial design of the system has turned what should be a largely altruistic service, one designed for public good and societal benefit, and forced it to act like a financial institution.” And so, with those bonds, welcome Wall Street. What do Wall Street bankers think about patient care and access and community health? Oh, they don't think about those things at all. Municipal bond returns, baby. That's it. Bonds are an investment where people who invest in them, returns are expected, just like shareholders who want their dividends. Preston Alexander wrote, “Most larger health systems carry billions (that was a ‘b' back there) in bond liabilities.” It costs money to build buildings and add beds and consolidate, yo; but now they are subject to the same pressures as publicly traded companies. So then I got my hands on Dan Greenleaf, CEO of Duly, a multispecialty group in Chicago. I was absolutely intrigued from the starting gate because Dan told me that mission can actually beget margin in his view, and he even, at Duly, has private equity investors. So, yeah, I was all ears. Dan Greenleaf, who is my guest today, by the way, if you haven't figured that out, told me that because of, but not limited to, the trends above wildly high prices, high premiums, high deductibles, more consolidation, fewer options, scared, confused, and maybe outraged patients—listen to the show with Peter Hayes (EP475)—Dan said that, given this backdrop, actually focusing on mission is a huge competitive advantage. Justina Lehman (EP414) actually also said this in a show from a few years ago. Dan told me, Dan Greenleaf, when you succeed at mission, you can get yourself decent margin these days. So, in this first episode, we will talk about this mission of which Dan Greenleaf speaks; and then in part 2 coming at you next week, we'll get into how that all spells margin. Here's what I thought was super important about this whole mission/margin conversation, and Mick Connors, MD, in a show coming up, also touches on this: To achieve mission, you really have to define what mission means. Ben Schwartz, MD, MBA (EP481) said this, too, in so many words in the show from last summer. And that doesn't mean just have a gloriously well-written Web page, and you just can't have spreadsheets of random quality metrics either. You have to treat the mission like you treat any strategic imperative. You gotta break it down and figure out how you're gonna measure what you're actually doing. Rik Renard (EP427) talked about this one, too. At Duly, which Dan Greenleaf talks about in this episode, the focus is on four quadrants of mission: (1) affordability, (2) access, (3) consumer experience, and (4) quality. In this conversation, Dan emphasizes that achieving these four quadrants reduces friction for patients and clinicians and leads to better care outcomes and financial stability. To be noted with one big fat fluorescent highlighter marker is this: A big part of this mission, in almost each of these quadrants, is about making prices reasonable and predictable and transparent for patients. In today's world, that's what customer experience must include—not just, like, lemon water in the waiting room. That struck me the most. And all this focus on affordability really adds up across the community. In Chicago, lower-cost alternatives to hospital services can save up to $2 billion. That is also with a “b.” And the communities are also healthier. Crazy. Hey, make sure patients and members can afford and have access to quality healthcare, and the community gets healthier. Who would've thought? Dan Greenleaf, CEO of Duly, my guest today, has been in healthcare for 30 years. This podcast is sponsored by Aventria Health Group, but I do just wanna mention that Duly so kindly offered Relentless Health Value some financial support, which we truly, truly appreciate. So, call this episode also sponsored with an assist by Duly. Here's my conversation with Dan Greenleaf, and do come back next week for part 2 like I said earlier. Today we talk mission. Next week we talk margin. Also mentioned in this episode are Duly Health and Care; Merrill Goozner; Wayne Jenkins, MD; Komal Bajaj, MD; Jonathan Baran; Kevin Lyons; Shane Cerone; Kada Health; Preston Alexander; Peter Hayes; Justina Lehman; Vivian Ho, PhD; Mick Connors, MD; Benjamin Schwartz, MD, MBA; Rik Renard; Mark Cuban; Dave Chase; Patrick Moore; Sam Flanders, MD; and Tom Nash. You can learn more at Duly Health and Care and follow Dan on LinkedIn. You can also email Dan at dan.greenleaf@duly.com. Daniel E. Greenleaf is the chief executive officer of Duly Health and Care, one of the largest independent, multispecialty medical groups in the nation. Duly employs more than 1700 clinicians while serving 1.5 million patients in over 190 locations in the greater Chicago area and across the Midwest. The Duly Health and Care brand encompasses four entities—DuPage Medical Group, Quincy Medical Group, The South Bend Clinic, and a value-based care organization. Its scaled ancillary services include 6 Ambulatory Surgery Centers, 30 lab sites, 16 imaging sites, 39 physical therapy locations, and 100 infusion chairs. Its value-based care service line provides integrated care for 290,000 partial-risk and 100,000 full-risk lives (Medicare Advantage and ACO Reach). Dan has nearly 30 years of experience leading healthcare services organizations. He is a six-time healthcare CEO, including prior roles as president and CEO of Modivcare; president and CEO of BioScrip, Inc.; chairman and CEO of Home Solutions Infusion Services; and president and CEO of Coram Specialty Services. Dan graduated from Denison University with a bachelor of arts degree in economics (where he received the Alumni Citation—the highest honor bestowed upon a Denisonian) and holds an MBA in health administration from the University of Miami. A military veteran, he was a captain and navigator in the United States Air Force and served in Operation Desert Storm. 08:32 What should mission be in multispecialty? 08:54 Are mission and margin mutually exclusive? 10:47 What are the four “vectors” of Dan's mission? 11:32 Why does affordability matter? 12:11 EP466 with Vivian Ho, PhD. 12:40 EP488 with Mark Cuban and Cora Opsahl. 13:32 Who are the three payers in the marketplace? 17:31 EP388 with Merrill Goozner. 19:19 How does access play into mission? 20:28 EP464 with Al Lewis. 21:07 EP467 with Stacey. 22:56 Why price transparency is important to consumer experience. 24:16 LinkedIn post from Patrick Moore. 29:06 EP481 with Benjamin Schwartz, MD, MBA. You can learn more at Duly Health and Care and follow Dan on LinkedIn. You can also email Dan at dan.greenleaf@duly.com. @d_greenleaf of @dulyhealth_care discusses #mission and #margin in #multispecialtycare on our #healthcarepodcast. #healthcare #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Mark Cuban and Cora Opsahl, Kevin Lyons (Part 2), Kevin Lyons (Part 1), Dr Stan Schwartz (EP486), Dr Cristin Dickerson, Elizabeth Mitchell (Take Two: EP436), Dave Chase, Jonathan Baran (Part 2), Jonathan Baran (Part 1), Jonathan Baran (Bonus Episode), Dr Stan Schwartz (Summer Shorts)
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
“We don't view a person with chronic pain as someone who has a chronic illness and the effect of that is we can't follow patients continuously over prolonged periods of time,” says Dr. Jacob Hascalovici, a neurologist and pain specialist based in New York City. In co-founding Bliss Health, Dr. Jacob, as he is known, has set out to create a continuous care model for chronic pain treatment that matches the approach taken for patients with diabetes or high blood pressure. The Bliss Health formula includes an initial meeting with a physician that produces a care plan; remote therapeutic monitoring on an ongoing basis; and a monthly meeting with a nurse to review data and determine next steps, including additional appointments with physicians as needed. All of this occurs via a digital platform which provides a welcome option for patients with mobility issues and can fill gaps in access to specialists, especially in rural areas. Dr. Jacob is also hoping to make chronic pain patents feel respected, which is not always the case in their encounters with the healthcare system. “Because pain is not something that can be seen or measured, oftentimes patients feel marginalized, dismissed and disempowered by providers.” Join Raise the Line host Lindsey Smith for a valuable conversation that also touches on policy changes that could strengthen telemedicine, and has details on the first non-opioid based pain medication to receive FDA approval in over 20 years.Mentioned in this episode:Bliss Health If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
In this episode, Scott Becker discusses major systems expanding their ambulatory footprint and private equity acquisitions to widespread job cuts, Medicare Advantage exits, funding challenges, and more.
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
In recent months, public health advocates in the United States have raised concerns about proposed changes to vaccine policy, cuts to food assistance programs, rollbacks of environmental protections and reductions in public health staffing. Chief among them has been Dr. Georges Benjamin who, as executive director of the American Public Health Association (APHA) since 2002, has led national efforts to create a healthier America. Raise the Line host Lindsey Smith recently sat down with Dr. Benjamin to understand more about the current state of public health and explore the path forward, and learned that a top priority for APHA is battling the misinformation that Dr. Benjamin believes is fueling support for many of these changes. “The challenge we have right now is that as a society, we've gone into our little corners and live in our own ecosystems. More people are getting their information from a single source and they're not validating that information to make sure that it's true.” Tune into this thoughtful and timely conversation to hear Dr. Benjamin's advice for curbing the spread of misinformation, how APHA is trying to help people understand the value of public health initiatives, and what the U.S. can learn from other countries about improving public health. Mentioned in this episode:American Public Health Association If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Medicaid and Medicare Advantage may seem like programs for specific groups, but the choices made in these public plans ripple across the entire insurance system. This episode explores how coverage churn, capped benefits, and financing reforms in public programs ultimately shape commercial premiums, provider networks, and patient access for everyone. We unpack why what starts in Medicaid and Medicare Advantage rarely stays there, and how those shifts end up reshaping all of our coverage.
Discover some of Vermont Public staff's favorite fall foliage drives. Plus, Private insurers pull out of Vermont's Medicare Advantage market, the Scott Administration asks the USDA for a statewide disaster declaration because of ongoing drought, how a helicopter can help the state respond to potential wildfires, and Vermont plans to add more short-term homeless shelters this winter.
CMS released their 2026 Medicare Advantage and Medicare Part D projections this week. Join Sarah as she highlights info for agents, from estimates on enrollment and premiums to plan accessibility and more! Get Connected:
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
Choosing the right Medicare plan isn't easy. In this episode of The Matt Feret Show, Matt talks with Bob O'Connor, a Medicare veteran who led one of the largest Medicare Advantage markets in the country. They unpack the difference between Medigap vs. Medicare Advantage, how star ratings actually affect benefits, and why prior authorization may soon appear in Original Medicare Part A and Part B.With millions of people facing coverage changes in 2026, this episode helps you avoid common mistakes and make smarter Medicare choices this fall.The Matt Feret Show is Back with Bob O'Connor [2:03]Understanding Medicare Plans – What Consumers Don't See [3:42]Bob O'Connor's Helpful Tips for the Annual Enrollment Period [12:39]Common Mistakes When Choosing Medicare Plans [12:40]Bob O'Connor's Best Advice for Choosing a Medicare Plan [1:03:56]Connect with me via the podcast website, LinkedIn, Facebook, and Instagram.Check out Bob O'Connor LinkedInThe Matt Feret Show is about thriving in midlife, retirement, and beyond. Each week, Matt shares smart conversations on Medicare, Social Security, retirement planning, health, wealth, wellness, caregiving, and life after 50.Explore more episodes and sign up for The Matt Feret Newsletter: TheMattFeretShow.comNeed Medicare help? Book a no-obligation consultation: BrickhouseAgency.comWatch full episodes on YouTube: The Matt Feret ShowSubscribe on Apple, Spotify, or YouTube for more insights on wealth, wisdom, and wellness in retirement. Hosted on Acast. See acast.com/privacy for more information.
“Probably the most exciting thing I've seen in gene therapy over the last ten years is we now have a lot of tools for selective delivery, which will hopefully make treatments more safe and a lot more successful,” says Dr. Jessica Duis, a geneticist and pediatrician focused on the management of individuals with complex, rare disorders. Dr. Duis, who has worked on several gene therapies that are now approved or progressing through the accelerated approval pathway, is currently VP of Clinical Development at GondolaBio, a clinical-stage biopharmaceutical company focused on developing therapeutics for genetic diseases. As you'll learn in this Year of the Zebra episode with host Lindsey Smith, Dr. Duis is encouraged by other recent advances in genetic technology as well, and thinks momentum will grow as breakthrough treatments emerge. “I think we're hopefully going to continue to see companies that are working in rare disease be more successful and really drive how regulators think about making decisions in terms of bringing treatments to patients. I think we're at the tip of the iceberg in terms of the future of truly transformational therapies.” This wide ranging conversation also explores Dr. Duis' team approach to patient care, her work on clinical endpoints, the importance of patient communities, and her book series, Rare Siblings Stories.Mentioned in this episode:GondolaBioRareDiseaseDocElsevier Healthcare Hub on Rare DiseasesRare Sibling Stories If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast
Telehealth coverage for SLPs under Medicare expired on October 1, 2025. In this episode, Dr. Jeanette Benigas, SLP, and Katie Brown, SLP, explain what this means for the provision of Telehealth services for traditional Medicare Part B beneficiaries, the nuances for Part A beneficiaries, and the allowance of private pay. They also unpack the government shutdown's impact on claims processing, what remains unchanged for Medicaid and Medicare Advantage plans, and why employers shouldn't issue blanket telehealth bans without checking payer rules. Get clear, practical guidance plus the free Telehealth Toolkit to support your patients and advocate for continued access.Find all of the advocacy tools you need here to participate in the telehealth call to action, or check out Katie's SLPs Blueprint to Medicare Success and get $100 off with the code FixSLP.If you missed it, catch Katie and Jeanette's earlier conversation on Medicare telehealth in Episode 96. It sets the stage for what's happening now.Stop paying to track ASHA-approved CEUs. Save your money and set up for a FREE CEU/PDH tracker with Speech Therapy PD. While you are there, get $10 off a professional subscription with the code FixSLP10!
Every year, I attend Converge, the annual conference of the National Association of Dental Plans (NADP). It's where I explore the latest issues and challenges faced by carriers and providers. I've watched the evolving partnerships between carriers and DSOs and observed the increase in network leasing concerns, I wanted to share my observations with you. I listened to compliance updates, discussed the expanding role of Medicare Advantage, and other issues shaping the future of dental coverage. What am I sharing? My thoughts on the amount of audits and fraud in our industry. Are you at risk? Multi-factor authentication is becoming a priority for both small practices and large DSOs. Plus, I'll highlight the questions to ask before outsourcing billing or revenue cycle management in today's third-party–driven market. Let me know if you like this kind of reporting. It was a lot more fun than I expected! Resources & Links: NADP – The National Association of Dental Plans, representing dental insurers and advocating for better dental benefits. https://www.nadp.org/ Unify Dental – A platform helping DSOs and practices streamline operations and improve efficiency. https://www.unify.dental/ Cotiviti – A leading analytics and payment accuracy company serving healthcare and dental organizations. https://www.cotiviti.com/ Fluent Dental – A technology-driven solution for simplifying dental revenue cycle management. https://fluent.dental/ Connect with Teresa Website: https://www.odysseymgmt.com/ Email: teresa@odysseymgmt.com Instagram: treeduncan Facebook: Odyssey Management Dental Speaking & Consulting LinkedIn: Teresa Duncan, MS ------------- Beyond the Operatory Career Workshop: Have you ever wondered what career opportunities in dentistry exist beyond clinical care? Whether you're a dentist, hygienist, assistant, or manager, this full-day, in-person workshop is your chance to explore new paths in speaking, coaching, consulting, and more. Join Teresa and Angela on March 6th 2026 in Northern Virginia. Limited to just 20 attendees. Registration is open. Secure your spot today:
Summary del Show: • Wall Street sube mientras el shutdown entra en su segundo día y Challenger reporta despidos en baja. • UnitedHealth, CVS y Humana recortan cobertura en Medicare Advantage para 2026. • Amazon $AMZN lanza Amazon Grocery para competir con Costco $COST y Walmart $WMT. • Berkshire Hathaway $BRK.A compra OxyChem de Occidental $OXY por $9.7B.
In this episode, which was recorded live from the HR Tennessee Conference in Nashville, David welcomes Misty Bolt, also known as "Medicare Misty." Misty demystifies the complexities of Medicare, explaining what it is and how it's funded, and she explains the critical differences between it and Medicaid. She also discusses the current state of Medicare, common misconceptions employees have as they approach retirement, and why early and continuous financial education is essential for ensuring a secure future. [0:00] Introduction Welcome, Misty! Today's Topic: Demystifying Medicare and Planning for a Secure Retirement [3:16] The Current State and Future of Medicare How recent legislation is impacting Medicare Advantage plans and doctor's funding. Navigating disruptions as some insurance plans are terminated, and the importance of open enrollment. [7:03] Why Employees Are Unprepared for Retirement Decisions How to navigate being "thrown out to the wolves" with no transitional support after decades of your company making healthcare decisions for you. The challenge of suddenly having to make complex decisions about Medicare, Social Security, and long-term care all at once. [15:58] Proactive Steps for Financial Wellness and Retirement The importance of engaging a financial advisor early in your career to plan for the future. Using financial tools like Health Savings Accounts (HSAs) as a retirement tool, not just for medical expenses. [18:15] Closing Thanks for listening! Quick Quote “[When you retire] you're thrown out to the wolves and [navigating Medicare] is . . . so hard and so complicated that nobody understands it.”
10 KEY MEDICARE CHANGES TO KNOW IN 2026 FROM BALTIMORE WASHINGTON FINANCIAL ADVISORS with Thad Ismart | CFP®, ChFEBC, CEPS Senior Financial Planner Medicare is changing in 2026, and the updates will impact premiums, drug costs, and benefits. In this episode, BWFA's Thad Ismart, CFP®, ChFEBC, CEPS, breaks down the 10 most important changes retirees and families need to know to stay prepared. Full Description Medicare plays a central role in retirement planning, but the program is constantly evolving. Beginning in 2026, significant changes are scheduled that will affect millions of Americans. Some updates may help retirees save money, while others could increase costs or reduce benefits. In this episode of Healthy, Wealthy & Wise, BWFA's Thad Ismart, CFP®, ChFEBC, CEPS, Senior Financial Planner, explains the 10 biggest Medicare changes coming in 2026 and what they mean for you. Among the most notable: Part B premiums are projected to increase by more than 11%, making healthcare more expensive for many retirees. On the other hand, prescription drug costs are expected to drop as new pricing rules take effect, and out-of-pocket caps will help limit spending. Thad also highlights program adjustments that may surprise beneficiaries. Medicare Advantage plans could scale back supplemental benefits, while Original Medicare is introducing new pre-authorization requirements in pilot states. These changes underscore the need for proactive planning to ensure coverage continues to align with your healthcare and financial goals. Listeners will gain practical strategies to navigate these shifts. Thad explains how to budget for rising premiums, how to take advantage of reduced drug prices, and why reviewing coverage annually is more important than ever. By understanding these changes in advance, retirees can avoid unpleasant surprises and adapt their plans to maintain stability. At BWFA, we integrate healthcare costs into every financial plan, helping clients prepare for Medicare updates and the long-term expenses of retirement. This episode offers clear guidance on what's ahead in 2026 and how to protect your financial future. For more resources, visit BWFA's Financial Planning Services.
You've probably heard that partnering with a field marketing organization is a great idea for independent agents. Today, we're diving into the WHY. Learn more about Ritter Insurance Marketing: a national FMO offering resources and support for agents like you. Read the text version Get Connected:
Retirement planning isn't just about finances; it's about healthcare too. With Medicare enrollment approaching, many retirees wonder how Medicare works and what coverage they really need.In this episode, we break down Medicare Parts A, B, C, and D, explain the differences between Medicare Advantage and Medigap plans, and walk through key enrollment periods to help you avoid costly penalties. We also cover premiums, deductibles, IRMAA surcharges, and common misconceptions about Medicare coverage. Whether you're turning 65, continuing to work past retirement, or exploring your healthcare options, we think you'll enjoy this podcast episode. Thanks for listening!For more details we recommend that you check out our blog post covering the same topic at: https://pw-wm.com/learn/financial-planning/medicare-what-you-need-to-know/
Navigating risk adjustment across multiple lines of business isn't just complex, it's a balancing act of shifting regulations, diverse populations, and evolving models. In this episode, we break down the key differences between Medicare Advantage, Medicaid, and ACA, and explain why understanding these nuances is crucial for health plans that manage all three simultaneously. Whether you're grappling with audits, coding accuracy, or technology gaps, this conversation offers real-world insight and practical strategies for managing multiple lines of business (LOB).About Our Guest:Amanda Proctor has over 13 years in risk adjustment coding and specializes in risk mitigation, coding quality and education. She holds multiple certifications in coding and is an AAPC approved instructor.
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
Maximizing Your Annual Enrollment Success | Medicare Sales Strategies & Industry InsightsIn this crucial final episode before the 2026 Annual Enrollment Period kicks off, Dan and Mike Hardle discuss the latest updates from carriers, the struggles agents and agencies face in a turbulent insurance industry, and provide valuable tactical tips for making the most out of the enrollment periods. Listeners can expect insights on industry-wide challenges, how to stay motivated and avoid complacency, and essential strategies to navigate the ebb and flow of AEP. Whether you're a seasoned agent looking to up your game or new to the field, this episode offers indispensable advice and the mindset needed to succeed. Tune in and get ready to roll up your sleeves and conquer the selling season!Article Referenced: https://www.cms.gov/newsroom/press-releases/medicare-advantage-medicare-prescription-drug-programs-expected-remain-stable-2026Need to take your AHIP certification to sell Medicare Advantage plans? Use our official Agent Boost link to get started today. It's accepted by all major carriers and includes the $50 discount—bringing your cost down to just $125.
Your money soundtrack—what plays on repeat in your head—will either help or hinder your financial decisions. We all know the power of overthinking—but the good news is, you can change the tune of those money soundtracks playing in your mind. Jon Acuff joins us today to show you how.Jon Acuff is a New York Times bestselling author, speaker, and podcaster who helps people overcome overthinking, change their mindsets, and achieve goals. He's written 10 books, including Soundtracks: The Surprising Solution to Overthinking.What Are “Soundtracks”?Soundtracks are the repeated thoughts that play in our minds—like music on loop. They can be helpful or harmful, but either way, they shape our lives.If you'd like to change the soundtracks that you have been listening to, this framework is simple yet profound:Retire the broken soundtracks that hold you back.Replace them with healthier, truthful ones.Repeat them until they become second nature.It's not enough to get rid of the old. You have to replace it with the new.Retiring Broken SoundtracksThe first step is to identify what's holding you back. Write down a financial goal—such as paying off debt, buying a home, or supporting missionaries—and then pay attention to your immediate thoughts.Are they encouraging or discouraging? Many people quickly hear internal voices saying things like:“Who are you to think you could do that?”“You'll never make more than your parents.”“Money isn't for people like you.”These are broken soundtracks—thoughts that undermine God's best for your life. Sometimes, they're inherited.Here are several unhealthy financial soundtracks that many people believe:“Mo Money, Mo Problems.” Popularized by a hip-hop song, this belief ties success to stress. But lacking money doesn't eliminate problems either—it often magnifies them. “I'll give when I'm successful.” Many delay generosity until they feel financially “ready.” But giving is a practice best learned in small amounts now, so it grows with you over time. “I'm not a money person.” Labeling yourself this way shuts the door on growth. Money management is a skill, not a fixed identity.These soundtracks don't just affect finances; they limit your potential. In one survey that Jon conducted with 3,000 people, a staggering 96% reported not living up to their full potential—often due to limiting beliefs.Replacing Soundtracks with TruthOnce you identify the lies, it's time to replace them. That can mean flipping the negative thought on its head, seeking wisdom in Scripture, or learning from mentors.Some examples of healthier money soundtracks include:“I can do amazing things with money.”“I can make more than my parents, and that's okay.”“I am my own biggest venture capitalist—my day job is funding my dream.”But what if you feel stuck? We encourage you to start small. Too often, people believe they must overhaul their entire lives overnight. Instead, try carving out 15 minutes a day to take one positive step forward. Over time, those mustard-seed-sized efforts compound into meaningful change.The truth is that the thoughts you repeat about money directly influence how you use it. Broken soundtracks can sabotage generosity, stunt growth, and even cause you to reject God's gifts. However, by retiring lies and replacing them with truth, and repeating them faithfully, you can align your mindset with God's wisdom.If you change the thought, you'll change the actions, and then the results will follow.On Today's Program, Rob Answers Listener Questions:I'm looking at Medicare Advantage plans. They seem cheaper upfront, but I'm concerned about high out-of-pocket costs if something serious were to happen. My wife is just starting Medicare, and we want to know the best option.I'm nearly two years into my job and haven't yet started contributing to the company's 401(k). My concern is making sure my investments align with my Christian values.What's the difference between a living trust and a will, and which one is better for estate planning?Resources Mentioned:Faithful Steward: FaithFi's New Quarterly Magazine (Become a FaithFi Partner)Soundtracks: The Surprising Solution to Overthinking by Jon AcuffJon AcuffList of Faith-Based Investment FundsWisdom Over Wealth: 12 Lessons from Ecclesiastes on MoneyLook At The Sparrows: A 21-Day Devotional on Financial Fear and AnxietyRich Toward God: A Study on the Parable of the Rich FoolFind a Certified Kingdom Advisor (CKA) or Certified Christian Financial Counselor (CertCFC)FaithFi App Remember, you can call in to ask your questions most days at (800) 525-7000. Faith & Finance is also available on the Moody Radio Network and American Family Radio. Visit our website at FaithFi.com where you can join the FaithFi Community and give as we expand our outreach. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
A recent case filed by the U.S. Department of Justice (DOJ) reveals how an insider was able to detect fraud in a large managed care organization (MCO).Although the topic of medical loss ratio (MLR) might be arcane to some, when the subject involves millions of dollars of potential fraud, it quickly becomes a large blip on the government's fraud detection radar.More on this topic will be reported during the next live edition of Monitor Mondays. That's when whistleblower attorney Max Voldman returns to the long-running Internet broadcast to report on how a payer, Inland Empire Health Plan, miscalculated its MLR in a scheme to rebate less money to the government than to which it was legally obligated.The weekly broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Cate Brantley, senior legislative affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.
But first, how about our regular episode segments? Medicare Advantage Minute: Hospitals aren't the only ones stepping back from Medicare Advantage! Your Medicare Benefits 2025: Preventive and screening services From the Q & A folder we address the following subjects: 1) How are prescription drugs covered when one is in an emergency room? Hint: Toni King provided an answer but I believe she displayed a little bit of confusion by overlooking an important fact presented in the question. 2) Does Medicare cover annual (routine) physical examinations? Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: BARE BONES!" For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to help future readers. Official website: https://www.MedicareForTheLazyMan.com.
In this episode, Jakob Emerson, Associate News Director at Becker's Healthcare, discusses major payer trends including Health Care Service Corporation's rapid growth in Medicare Advantage and the uncertain future of ACA premium tax credits. He also shares insights on rising healthcare costs and the challenges they create for patients, providers, and insurers alike.
On this episode of Behind the Shield, Georgi Minoungou and Sabra Bryant join Brad Evans to discuss their journeys and work in the community. Georgi gives the full story on how he ended up on the Sounders, recovering and adjusting to a medical issue affecting his eye, and how he's been able to overcome what many would have considered an insurmountable obstacle. Sabra Bryant helps lead Regence BlueShield teams that deliver exceptional health care experiences for Medicare members. Her Customer Service and Membership teams support Medicare Advantage and Supplement members with expert guidance, seamless enrollment, and responsive coverage solutions. Their commitment ensures older adults receive the care and support they need to live healthier lives.Based in Southwest Washington, Sabra holds bachelor's and master's degrees in business administration and management from Western Governors University.
September 26, 2025 In this episode, Scott, Mark, and Ray discuss the looming federal government shutdown and how it could impact urology practices—especially telehealth services. They explain the latest developments in Washington, what Medicare and Medicaid payments will look like during a shutdown, and offer practical guidance for handling telehealth visits, front-office operations, and prior authorizations. Mark shares specific strategies and options for practices, including use of ABNs and billing considerations for Medicare Advantage and traditional Medicare patients. The episode wraps with insights on how the shutdown might delay CMS's final rule and the broader implications for AI, reimbursement, and practice management.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner. https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/
Medicare Advantage Minute: Judge overturns rule limiting broker payments in Medicare Advantage plans. Your Medicare Benefits 2025: Pressure reducing support surfaces. The podcast producer gets to select the general source of content for the rest of the episode. The subject in question? The ten states with the highest rates of Alzheimer's Disease! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+) Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; SIMPLEST & EASIEST GUIDE EVER!" "MEDICARE DRUG PLANS: A SIMPLE D-I-Y GUIDE" "MEDICARE FOR THE LAZY MAN: BARE BONES!" For sale on Amazon.com. After enjoying the books, please consider returning to leave a short customer review to help future readers. Official website: https://www.MedicareForTheLazyMan.com.
In this episode, we'll walk through the key differences and pros and cons of Original Medicare vs Medicare Advantage plans.ResourcesIt's Not That Complicated (pdf): https://drive.google.com/file/d/1Hqs4...Medicare & You 2026 (pdf): https://www.medicare.gov/publications...2025 Medicare Parts A & B Premiums and Deductibles: https://www.cms.gov/newsroom/fact-she...Medicare Part A Costs: https://www.medicare.gov/basics/costs...Medigap Plans: https://www.medicare.gov/health-drug-...KFF Medigap Article: https://www.kff.org/medicare/key-fact...Compare Medicare Plans: https://www.medicare.gov/plan-compare...Join the Newsletter. It's Free:https://robberger.com/newsletter/?utm...Get free guidance on Medicare from Chapter, a company I've partnered with, by calling 410-220-5494. If you call Chapter, please let me know about your experience.
Bridging Home, Family, and Health Plans: Avanlee Christine on Caregiver-First Health Innovation StartUp Health community member Avanlee Christine, CEO & Co-founder of Avanlee Care, joins Unity Stoakes on StartUp Health NOW to share how a pivot from fundraising to customer development unlocked product traction, investor interest, and partnerships with innovative health plans. From Billings, Montana, Avanlee explains why integrating unpaid family caregivers into care workflows improves outcomes, raises satisfaction, and helps Medicare Advantage plans do more with less. In this episode: How shifting focus from pitching to building sparked inbound VC interest, including the first venture investor Why 60% of Medicare Advantage members rely on informal caregivers, and how formalizing that communication closes gaps Practical ways caregiver engagement boosts stars, adherence, annual wellness visits, and CAHPS Lessons from scaling a health tech company in Montana, with support from mentors and investors like Esther Dyson Real talk on resilience, motherhood, team building, and staying alive through tough cycles What health plan leaders, quality and risk teams, and investor partners should know about Avanlee Care right now Listen for: Simple, structured steps health plans can take to bring caregivers into the loop A founder's playbook for surviving early years, finding product-market fit, and creating momentum outside traditional tech hubs Are you ready to tell YOUR story? Members of our Health Moonshot Communities are leading startups with breakthrough technology-driven solutions for the world's biggest health challenges. Exposure in StartUp Health Media to our global audience of investors and partners – including our podcast, newsletters, magazine, and YouTube channel – is a benefit of our Health Moonshot PRO Membership. To schedule a call and see if you qualify to join and increase brand awareness through our multi-media storytelling efforts, submit our three-minute application. If you're mission-driven, collaborative, and ready to contribute as much as you gain, you might be the perfect fit. » Learn more and apply today. Want more content like this? Sign up for StartUp Health Insider™ to get funding insights, news, and special updates delivered to your inbox.
With nearly one in ten newborns in the US requiring care in a Neonatal Intensive Care Unit, the importance of NICUs has never been more clear. On today's episode of Raise the Line, we're shining a light on the extraordinary world of NICUs with Lindsay Howard, a veteran nurse with over 17 years of experience caring for premature and critically ill infants. She currently works in a Level IV NICU at Children's Memorial Hermann Hospital in Houston, one of the most advanced neonatal units in the country. “We call ourselves ‘the ER of the neonate world' because we're never full. We have to make space no matter what comes in off the street, and at the biggest medical center in the world, we see all the things,” she explains. In this enlightening conversation with host Lindsey Smith, Howard describes how advances in medicine have made it possible to provide more types of care for younger and smaller babies, creating a need for NICU nurses to develop subspecialties. In her case, Howard is on a dedicated team that handles the placement and maintenance of all central line IVs, and has earned certifications in neonatal and pediatric chemotherapy and biotherapies. “We see babies that we may not have seen before being born with cancerous tumors who need chemotherapy to try and eliminate it, or just give them more time with their family.” This is a revealing look inside the workings of a top tier NICU where you'll learn about approaches to care that support healthy neurodevelopment, how clinical staff handle the emotional challenges of the job, and how her own experience as a mother with twins needing NICU care impacted her work. Mentioned in this episode:Children's Memorial Hermann Hospital If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast
Medicare open enrollment is almost here, and this year it's shaping up to be one of the most dramatic seasons ever. Millions of retirees are about to lose their Advantage plans or face major changes, while even those with traditional Medicare supplements could see higher costs ahead. In this episode, Don breaks down the why, what, when, and how of the Medicare shakeup. Here's some of what we discuss in this episode:
Hi there! Here's a quick look at our top local stories for Wednesday, Sept. 24. Find these articles and much more in today's print edition and online at https://www.iolaregister.com/.
Are you or a loved one managing a chronic health condition? Chronic Condition Special Needs Plans (C-SNPs) are specialized Medicare Advantage plans designed to provide personalized, coordinated care for specific health needs. In this episode, we break down who qualifies, explore the unique benefits of C-SNPs, and guide you step-by-step on how to enroll. Tune in to discover how these plans can make managing your health easier and more effective.
Learn how to prepare your finances for fall and support aging parents who have limited retirement savings. How can you check in on your finances this fall? What's the best way to help parents with little savings retire? Hosts Sean Pyles and Elizabeth Ayoola explain how you can give yourself a fall financial check-in before they answer a listener's question about supporting aging parents. They begin with a discussion of fall planning and open enrollment season, with tips for using this year's health costs to choose next year's plan, reviewing IRA/401(k) contributions and allocations, and setting a realistic holiday budget while tracking travel prices. Then, NerdWallet lead writer Kate Ashford joins Sean and Elizabeth to discuss how a listener can support their aging parents who haven't saved much. They discuss how to start sensitive money talks, navigate Medicare vs. Medicare Advantage (plus SHIP and Medicaid resources), and practical ways to help, including how to cover specific bills, explore subsidized senior housing, and avoid raiding your own retirement fund in order to help. See the latest rates in NerdWallet's roundups of the best high-yield savings accounts: https://www.nerdwallet.com/m/banking/standout-online-savings-accounts-2 Read NerdWallet's 2024 Financially Assisting Aging Parents Report: https://www.nerdwallet.com/article/finance/2024-financially-assisting-aging-parents-report Want us to review your budget? Fill out this form — completely anonymously if you want — and we might feature your budget in a future segment! https://docs.google.com/forms/d/e/1FAIpQLScK53yAufsc4v5UpghhVfxtk2MoyooHzlSIRBnRxUPl3hKBig/viewform?usp=header In their conversation, the Nerds discuss: open enrollment, Medicare vs Medicare Advantage, Social Security benefits, holiday budget, IRA contribution limits, 401(k) contribution limit, high-yield savings accounts, emergency fund, claiming parents as dependents, subsidized senior housing, State Health Insurance Assistance Program (SHIP), retirement planning checklist, talking to parents about money, healthcare plan comparison, out-of-pocket maximum, Summary of Benefits and Coverage, Roth IRA vs Traditional IRA, SSA account estimate, travel prices Thanksgiving, Christmas flight prices, budget for gifts, avoid 401(k) loans, elder law attorney, support aging parents financially, pay parents' bills vs cash, cost of Medicare Advantage networks, housing downsize for retirees, public benefits for seniors, SNAP for seniors, utility assistance programs, property tax relief seniors, high-yield savings rate 4 percent, set savings buckets, wedding budget overrun, and school-year child care costs. To send the Nerds your money questions, call or text the Nerd hotline at 901-730-6373 or email podcast@nerdwallet.com. Like what you hear? Please leave us a review and tell a friend. Learn more about your ad choices. Visit megaphone.fm/adchoices
Medicare at risk due to lobbyists. Proposed law mandates enrollment in Medicare Advantage. Top 20 Hospitals in the United States. United American is most stable, including rates.
In this episode of Dollars & Sense, Joel Garris and Rob Field take listeners on a practical journey through two crucial areas that impact your wallet—Medicare Advantage and the financial aftermath of divorce. Joel shares real-life insights about enrolling in Medicare Advantage plans, revealing common myths, what to watch out for during the enrollment period, and how to avoid costly mistakes. The duo also dives into the often-overlooked pitfalls of divorce finances, outlining typical errors like overspending, missing hidden assets, and letting emotions drive decisions. With relatable stories and expert advice, Joel and Rob break down why it pays to be proactive in both your healthcare and financial planning. If you want to learn how to protect your assets, sidestep common traps, and get the most out of your hard-earned money, click to listen and discover how to make smarter, more confident choices for your future!
“When you think about where we were as a country before Medicare and Medicaid were created and where we are now, it's an incredible story,” says Chiquita Brooks-LaSure, who until earlier this year was the administrator for the Centers for Medicare and Medicaid Services (CMS). In a recent essay for The Century Foundation, where she is now a senior fellow, Brooks-LaSure used the 60th anniversary of enactment of those foundational insurance programs to help put their impact on individual Americans, the healthcare system and society at large in perspective. One prominent example is the desegregation of hospitals, which was achieved in part by withholding reimbursements for care unless facilities served Blacks as well as whites. Another is making it possible for more people with disabilities to live at home instead of in institutional settings. But as you'll hear in this probing Raise the Line conversation with host Lindsey Smith, Brooks-LaSure worries that many gains in coverage and other progress made over the years through Medicare, Medicaid and the Child Health Insurance Program (CHIP) are at risk because of a new federal law that calls for a trillion dollar decrease in spending, resulting in potentially millions of people losing their coverage, cuts to clinical staff and medical services, and the closure of hospitals and clinics, especially in rural areas. “Most rural hospitals in this country are incredibly dependent on both Medicare and Medicaid to keep their doors open and there's an estimate that over 300 hospitals will close as a result of this legislation, so that, I think, is a place of incredible nervousness.” Whether you are a patient, provider, policymaker or health system leader, this is a great opportunity to learn from an expert source about the range of potential impacts that will flow from changes to critically important insurance programs that provide coverage to 40% of adults and nearly 50% of children in the U.S. Mentioned in this episode:The Century FoundationEssay on 60th Anniversary of Medicare & Medicaid If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast
Are you turning 65 soon or starting to think seriously about healthcare in retirement? This week, I discuss the complicated world of Medicare—with a focus on the seven most costly mistakes people make when enrolling. From missing crucial deadlines and underestimating penalties, to overlooking the true costs Medicare doesn't cover and getting tripped up by income-related surcharges, I give practical advice to help you avoid expensive pitfalls and make confident choices for your health and your wallet. Whether you're working past 65, exploring Medicare Advantage and Medigap, or just want to sidestep penalties, this episode unpacks the essentials so you can enter retirement feeling prepared and protected. Let's get into the key rules, deadlines, and decisions every retiring listener needs to know! You will want to hear this episode if you are interested in... [04:17] Medicare enrollment guidelines & penalties. [09:35] Understanding Medicare coverage gaps. [11:55] Medicare enrollment and switching plans. [17:15] Medicare premiums based on income. [19:50] Avoid high medicare costs. [23:16] How you can use HSA funds. [24:56] Medicare costs and supplemental plans. 7 Medicare Mistakes that Could Cost You Making the transition to Medicare at 65 is a big step for retirees. While the program does have plenty of benefits, it also comes with a few key complexities and deadlines that can trip up the unprepared. 1. Not Enrolling on Time Despite common belief, Medicare enrollment isn't always automatic when you turn 65. You're only auto-enrolled if you've begun collecting Social Security at least four months before your 65th birthday. Otherwise, you must actively sign up to avoid lifelong late enrollment penalties—10% annually for Medicare Part B and 1% per month for Part D, the prescription drug plan. Remember, if you're not covered by qualifying employer insurance (typically from a company with 20 or more employees), you must enroll during your Initial Enrollment Period (IEP), which starts three months before and ends three months after your 65th birthday month. 2. Misunderstanding Late Enrollment Penalties Enrollment deadlines carry not just inconvenience, but long-term financial consequences. For every year you delay Part B, a 10% penalty is added to your premium—for life. For Part D, missing timely enrollment adds a 1% penalty per month delayed. Even if you don't currently take prescription drugs, failing to enroll in Part D or lacking “creditable” drug coverage will trigger this penalty. Many people only find out about these charges after it's too late, so mark your calendar and stay ahead of these key windows. 3. Not Comparing Original Medicare and Medicare Advantage Original Medicare doesn't cover everything, leaving you responsible for 20% of costs and lacking extras like dental or vision. Medicare Advantage, on the other hand, often bundles additional services and may come with lower or even zero premiums, thanks to how the government pays private insurers. However, these plans have different provider networks and coverage rules, so compare carefully based on your health needs, preferred providers, and annual costs. 4. Waiting to Enroll in a Medigap Policy Failing to evaluate supplemental Medigap coverage during your initial eligibility window could lead to denial or much higher premiums later, especially if you develop health conditions. During the first six months after enrolling in Part B, you're guaranteed acceptance into any Medigap plan regardless of health. Afterward, insurers can impose restrictions or deny coverage. States like Connecticut, New York, and Massachusetts offer more flexibility, but most don't—making early action essential. 5. Ignoring IRMAA: Higher Premiums for Higher Incomes Many retirees are surprised by IRMAA—the Income-Related Monthly Adjustment Amount—which increases Part B and D premiums if your income exceeds certain thresholds. These adjustments are based on your tax returns from two years prior. Even a minor one-time income bump (like a large IRA withdrawal) could propel you into a higher bracket, doubling your premiums. Be proactive: monitor your adjusted gross income and consider strategies like Roth conversions, careful withdrawal timing, or appealing based on life-changing events like retirement. 6. Making HSA Contributions After Enrolling in Medicare Once you sign up for Medicare Part A or B, both you and your employer must stop making contributions to a Health Savings Account (HSA) six months before enrollment. Over-contributing subjects you to a 6% excise tax for every year the excess remains. However, you can continue to use existing HSA funds for eligible medical expenses tax-free throughout retirement. 7. Underestimating Out-of-Pocket Costs Even with Medicare, you'll face deductibles, co-pays, and services not covered (like long-term care, dental, and vision). Part A hospital stays have significant deductibles per benefit period, and Part B leaves you covering 20% of outpatient expenses. Medicare Advantage and Medigap plans can help limit these expenses, but each comes with specific limits, provider restrictions, and rules. Without a supplemental plan, your maximum out-of-pocket exposure could reach $9,350 (in-network) or higher, depending on your plan. Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE Connect With Morrissey Wealth Management www.MorrisseyWealthManagement.com/contact Subscribe to Retire With Ryan
Welcome to another insightful episode of the Agent Boost Marketing Podcast! This week, Rich steps in for Dan to discuss significant events affecting the insurance industry and the community in Lehigh, Utah, including the tragic incident involving Charlie Kirk. The episode dives into Agent Boost's national kickoff event, major industry shifts, non-commissionable plans for 2026, and strategies for succeeding during AEP. Listen in for essential tips on defending your book, diversifying your portfolio, and preparing for industry disruptions. Whether you're a seasoned pro or new to the game, this episode is packed with vital information to help you navigate these challenging times. Need to take your AHIP certification to sell Medicare Advantage plans? Use our official Agent Boost link to get started today. It's accepted by all major carriers and includes the $50 discount—bringing your cost down to just $125.
Healthcare compliance just shifted fundamentally.Traditional whistleblowers who needed inside access are being replaced by artificial intelligence (AI)-powered relators who mine public datasets and flag statistical anomalies that could signal fraud.The U.S. Department of Justice (DOJ) logged 979 qui tam cases in 2024, many of which were reportedly triggered by mathematical outliers, rather than insider tips. Government agencies, such as the Centers for Medicare & Medicaid Services (CMS), have already recovered $820 million using algorithmic detection.During the next live edition of Monitor Mondays, senior healthcare analyst Frank Cohen will reveal a possible solution for hospitals, health systems, and physician practices.The weekly broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, senior government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
It seems there are news stories every week about the accelerating pace of innovation in gene therapy, but only about 50 therapies have been approved so far by the US Food and Drug Administration. Our guest today, Dr. Bobby Gaspar, leads a UK-based biotech company, Orchard Therapeutics, that developed one of those treatments using gene-modified stem cells in your blood that self-renew, so a single administration can give you potentially a lifelong effect. “Our approach is about correcting those hematopoietic stem cells and allowing them to give rise to cells that can then correct the disease,” explains Dr. Gaspar. The therapy in focus is lenmeldy, the first approved treatment for metachromatic leukodystrophy, also known as MLD, a devastating inherited disorder that affects roughly 600 children worldwide. But Dr. Gaspar is optimistic that learnings from Orchard's work on MLD could be useful in treating much more common disorders including frontotemporal dementia, Crohn's disease and others. This highly informative conversation with host Lindsey Smith also explores the importance of newborn screening, community collaboration in advancing clinical trials for rare diseases, and a future in which each gene therapy will be used as a tool for specific applications. “There will be many gene therapies available, some of which will become the standard of care for certain diseases, but it won't be for every disease.”Mentioned in this episode:Orchard Therapeutics If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast
In this episode of the Secure Your Retirement Podcast, Radon Stancil and Murs Tariq sit down with Medicare specialist Shawn Southard to unpack the recent developments around Medicare Advantage brokers, broker compensation, and the impact of a federal court ruling on CMS Medicare rules. With Medicare open enrollment and aggressive Medicare marketing campaigns happening every year, understanding how brokers get paid and how it may influence the advice you receive has never been more important. Shawn explains how the recent court decision effects Medicare plan comparison, Medicare star ratings, and the role of brokers in guiding retirees. If you're planning retirement or reviewing your options during Medicare open enrollment, this episode provides practical insights and unbiased Medicare advice to help you make informed choices. Listen in to learn about: How Medicare broker compensation structures may impact your coverage decisions and what questions you need to ask to protect yourself from Medicare scams. Whether you're seeking SHIP counseling, comparing plans, or building your retirement checklist, this discussion will help you confidently navigate your Medicare options and secure your retirement. In this episode, find out: The details behind the CMS rule, the court ruling, and what it means for Medicare Advantage beneficiaries. How broker compensation can influence recommendations and why questions to ask brokers are critical. Why aggressive Medicare marketing and commercials may increase — and how to stay vigilant. How to leverage Medicare plan comparison tools and SHIP counseling for unbiased Medicare advice. Steps you can take today to make smart, confident decisions for retiring comfortably. Tweetable Quotes: “Understanding how Medicare brokers are compensated empowers you to make better decisions and avoid being swayed by marketing tactics.” — Radon Stancil “Medicare open enrollment is your opportunity to make informed choices — but only if you ask the right questions and focus on what's best for you, not the broker.” — Murs Tariq Resources: If you are in or nearing retirement and you want to gain clarity on what questions you should be asking, learn what the biggest retirement myths are, and identify what you can do to achieve peace of mind for your retirement, get started today by requesting our complimentary video course, Four Steps to Secure Your Retirement! To access the course, simply visit POMWealth.net/podcast.
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