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Turning 65 opens a new season of life—and with it comes some of the most important financial and healthcare decisions you'll ever make. In this episode of Finishing Well, Certified Financial Planner Hans Scheil and co-host Robbie Dilmore continue their Financial Plan Series by exploring Medicare, IRMAA (Income-Related Monthly Adjustment Amount), and how these choices fit into a comprehensive retirement strategy. Hans walks through the key Medicare decisions every retiree faces, including the differences between Original Medicare and Medicare Advantage plans, the importance of Medicare Supplement coverage, and why your initial enrollment period can create opportunities that may never come again. Using the real-life financial planning case of Tom and Susan, listeners will learn how Medicare decisions affect healthcare costs, retirement income planning, tax strategies, and long-term financial security. The discussion also covers Medicare Part D prescription drug plans, common enrollment mistakes, and strategies for managing or potentially reducing costly IRMAA surcharges. Through personal experiences and practical examples, Hans and Robbie highlight how choosing the right Medicare coverage can protect both your health and your retirement savings. Whether you're approaching age 65, already enrolled in Medicare, or helping a loved one navigate retirement healthcare decisions, this episode provides valuable insights to help you make informed choices and avoid costly mistakes. Topics Covered: Original Medicare vs. Medicare Advantage Medicare Supplement (Plan G) coverage Open enrollment opportunities and deadlines Medicare Part D prescription drug plans Understanding IRMAA and Medicare premiums Healthcare planning as part of a complete retirement strategy Real-world retirement planning case study Learn how thoughtful Medicare planning can help you finish well in retirement.
To mark PQA's 20th anniversary, PQS Managing Director Todd Sega sits down with Laura Cranston, the founding CEO who built PQA from a one-person shop into the most influential pharmacy quality measurement organization in the country.Laura traces PQA's origins to April 2006, just months after Medicare Part D launched, talks about the alliance's growth, the groundwork for what would eventually become the EQUIPP platform, and the broader pharmacy quality infrastructure in use today.The conversation turns to the seismic shift in the CY2027 Final Rule and what it means that pharmacy-accountable clinical measures now command roughly 50% of a Medicare Advantage plan's Star Rating. Laura calls it a game changer, arguing that health plans simply cannot navigate this new environment without doubling down on their partnerships with community pharmacy.The episode closes with a look ahead at where AI and technology are taking quality measurement from faster measure development to the shift from retrospective accountability toward proactive, near-real-time quality improvement.https://www.pqa.org/
Hospitals already have felt some of the effects of the Inflation Reduction Act on 340B savings, but with the IRA set to expand to more drugs in 2027, hospitals also are starting to project how it might affect their bottom lines next year. 340B Vice President of Pharmacy Services and Education Steven Miller joins us to explain how hospitals can be making those projections now.The IRA Will Expand to Another 15 DrugsNext year, an additional 15 drugs will be subject to Medicare price caps under Medicare Part D on top of the 10 drugs that saw caps this year. Steve says this will cut into 340B savings and overall margins even more — with some 340B discounts possibly dropping to their statutory minimums. These reductions also will translate to commercial and cash-pay dispenses, changing the overall financial outlook for hospitals.Hospitals Cannot Rely on Current 340B Savings Levels for 2027Steve says the 2027 changes are key for future budgeting. If hospitals do not adjust how they are budgeting for 340B drugs subject to Medicare price caps, they are likely to be short on their budget projections. He strongly recommends 340B teams have important conversations with finance teams now about how the IRA will affect their hospital or health system next year.Hospitals Can Be Planning NowFor the rest of 2026, Steve recommends hospitals monitor list pricing and 340B ceiling pricing regularly and to increase monitoring of purchases overall, given how drugmaker pricing behavior affects future 340B prices and savings. As the IRA continues to broaden over the next several years, including to Medicare Part B dispenses, he also recommends hospitals consider securing funding or support from other areas for any 340B-funded services that might see negative IRA impacts.Resources:Prepare Your Leadership for 340B Changes From 2027 Medicare Drug Price Caps
MEDICARE PLANNING: WHY MEDICARE COSTS MORE THAN MANY PEOPLE EXPECT Thad Ismart, CFP®, ChFEBC, CEPS Senior Financial Planner Tessa Hall Media and Communications Specialist LAWRENCE M. POST CPA, MST, CFP®, CIMA® Senior Tax and Planning Advisor About This Episode Tessa speaks with BWFA's Larry and Thad about Medicare costs, including premium increases, prescription drug coverage, deductibles, and out-of-pocket expenses. They explain how Medicare pricing changes over time and why many individuals underestimate healthcare costs in retirement. The conversation also covers Medicare Part D plans, IRMAA income adjustments, and why comparing plans each year can help reduce unnecessary expenses. To better understand how healthcare costs fit into your broader retirement strategy, visit our Financial Planning services page. Full Description Healthcare costs play a major role in retirement planning, and Medicare expenses continue to rise each year. In this episode of Healthy, Wealthy & Wise, Tessa speaks with BWFA's Larry and Thad about Medicare costs and what individuals should understand when preparing for healthcare expenses in retirement. They explain how Medicare premiums, deductibles, and prescription drug costs have changed and why many retirees underestimate what they may pay over time. The conversation also explores IRMAA, which stands for Income-Related Monthly Adjustment Amount. Individuals with higher incomes may pay additional Medicare premiums depending on their earnings. Prescription drug coverage is another important topic. The episode highlights why reviewing Part D plans each year matters, since pricing and coverage can vary significantly between providers. The discussion also explains how insurance works from a broader planning perspective. Healthcare coverage involves balancing premiums, deductibles, and financial risk, which means different approaches may make sense depending on individual circumstances. Ultimately, understanding Medicare costs can help individuals make more informed decisions and better prepare for healthcare expenses throughout retirement.
10,000 Nurses on the Edge, a Union Decertification & the GLP-1 Benefit Bomb Landing July 1Three stories in one week that cut across labor relations, trust, and total compensation strategy. Bo, Luke, and ASHHRA Executive Director Jeremy Sadlier break down what every healthcare HR leader needs to act on before July 1st — with ASHHRA26 in Savannah just days away.
TRumpRX joins other programs that can save you money on your prescriptions. Toni explains how best to use these programs. Yes, Medicare Fraud is Real! If you think your Medicare account has bee compromised - visit www.Medicare.gov where you can check claims against your Medicare account Medicare's telephone number: 800-633-4227 - Please call if you suspect that your account has been subject to fraud. Visit www.tonisays.com and receive a 10% discount when ordering an American flag, or the new America 250 flag using the code tonisays10 at checkout! Happy Birthday America! Toni's new Medicare Survival Guide Advanced Edition book is available now - pick up your copy at www.tonisays.com Want more information? Take advantage of Toni's brand new video series now a available at https://tonisays.com Remember - with Medicare it's what you don't know that will hurt you! There's so much good information in this podcast, please be sure to share this podcast with your friends! Recognized by feedspot.com as one of the best Medicare Podcasts in the nation! Write Toni - info@tonisays.com. Toni's book is available at www.seniorresource.com and https://tonisays.com You can call Toni at 832-519-8664 Toni welcomes all Medicare questions. Toni now offers informative Medicare Webinars for all of your Medicare needs at https://tonisays.com You can find Medicare Moments wherever you find your favorite podcasts, such as: Apple: https://apple.co/44MoguG Spotify: https://open.spotify.com/show/7c82BS4hb145GiVYfnIRsoAmazon Music: https://music.amazon.com/podcasts/884c1f46-9905-4b29-a97a-1a164c97546b/medicare-moments?refMarker=null You can find Medicare Moments at: https://podcasts.seniorresource.com/medicare-moments/ Toni's new book: Maze of Medicare is now available at www.tonisays.com Combining Scripture with Medicare, it is the only book of its kind. Toni's columns appear weekly in about 100 newspapers across America. If you would like Toni's column to appear in your local paper, or if you would like Toni to speak at an event - contact Toni King at 832-519-8664 Thank you for listening and be sure to tell your friends about Medicare Moments! Blessings! Toni KingSee omnystudio.com/listener for privacy information.
Senior Associate Editor Steve Hallo discusses his BestWire story detailing how The Centers for Medicare and Medicaid Services intends to suspend enrollment in Elevance Health Inc.'s Medicare Advantage Part D over persistent noncompliance with risk-adjustment data reporting rules.
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In 2026, FSBP changed its High Option prescription drug benefits. The result: many people are paying more out of pocket for their drugs. For those enrolled in Medicare Part A and/or Part B, there is an option available to save money: the FSBP-Express Scripts Medicare Prescription Drug Plan (PDP). We revisit this program in today's episode with Tavares Johnson from Evernorth/Express Scripts. Tavares began his career at Express Scripts in 2008 as a Patient Care Advocate, where he gained valuable experience supporting members, pharmacists, and physicians. His dedication and problem-solving skills led to a promotion to Resolution Team Lead, a role in which he partnered closely with account management and clients to resolve complex member issues.In 2013, Tavares was promoted to Senior Account Manager, where he began working with Medicare Part D clients and deepened his expertise in Medicare products and services. His comprehensive understanding of both member and client needs has been instrumental in driving successful outcomes.In 2024, Tavares was promoted to Senior Manager on the EGWP Market Strategy team, where he leads strategic initiatives to support Employer Group Retiree plans. His leadership and industry insight continue to make a meaningful impact across the organization.To learn more about the PDP and opt in to the program, please visit www.afspa.org/pdp. To review PDP drug pricing, please visit: https://www.express-scripts.com/frontend/medicare-open-enrollment/fsbp. To review High Option drug pricing, please visit: www.express-scripts.com/fsbp Join us for AFSPA Live on March 26 at 11 am. You can submit your questions in advance, here: https://forms.office.com/r/wM8t8HqvDMRegister for other upcoming events at www.afspa.org/events.
Learn how to sponsor the Seven Figure Medicare Agent Summit:https://sevenfiguremedicareagentsummit.com/ In this episode of the Seven Figures or Bust Podcast, the hosts are joined by Bill Hepsher of the Canadian Med Store to discuss the rising cost of prescription drugs and how it has shaped the Medicare landscape over the past two decades. Bill shares his personal journey into the industry, the impact of major policy changes like Medicare Part D and the Affordable Care Act, and how gaps in coverage continue to create challenges—and opportunities—for agents helping clients afford their medications.
Navigating Medicare can feel overwhelming—especially when you're faced with unfamiliar terms like deductibles, copays, coinsurance, and the infamous “donut hole.” In this educational webinar, From Deductibles to Donut Holes: Deciphering Medicare Costs for Retirees, we break down the real costs of Medicare in a clear, practical, and easy-to-understand way. Designed for retirees, pre-retirees, and financial professionals, this session walks through how Medicare actually works—not just in theory, but in real-life planning scenarios. We explore Medicare Parts A, B, C, and D, uncover hidden costs many retirees overlook, and explain how income-related adjustments like IRMAA can significantly impact your premiums. You'll also gain insight into: • The true out-of-pocket costs retirees face • How the Medicare Part D “donut hole” works and how to plan around it • Strategies to reduce lifetime healthcare expenses • Coordination between Medicare and retirement income planning • Common mistakes that can cost retirees thousands With decades of combined experience helping retirees navigate complex financial decisions, this session is built to educate—not sell—so you can make informed, confident choices about your healthcare in retirement. If you've ever felt uncertain about Medicare or want to better understand how it fits into your overall retirement strategy, this is a must-watch. #Medicare #MedicarePlanning #RetirementPlanning #HealthcareCosts #MedicarePartD #DonutHole #IRMAA #FinancialPlanning #RetirementIncome #SeniorPlanning #WealthManagement #MedicareEducation #PreRetirement #BabyBoomers #FinancialAdvisor #CPE #ContinuingEducation #MedicareCosts #RetireSmart #HealthcareInRetirement
Four of the six major programs run by the Centers for Medicare and Medicaid Services saw their improper payment rate increase in fiscal 2025. Medicare Part C, Medicare Part D and Medicaid all saw upticks in how much money went out the door that shouldn't have. While not all improper payments are considered fraud, CMS is planning an all out effort to reign in fraud specifically, and improper payments more broadly. For more on how CMS will take on this systemic challenge, Federal News Network executive editor Jason Miller joins me now.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Don't miss the 2nd round of Medicare Part D negotiated drug prices. Get the details on the prescriptions and savings for Medicare beneficiaries in 2027. Read the text version Get Connected:
On this episode of Astonishing Healthcare, Lloyd Fiorini, General Counsel & Chief Compliance Officer at Judi Health, returns to the studio for a discussion about the barrage of regulatory changes shaping the pharmacy benefit manager (PBM) landscape in early 2026. Within just two weeks, the Department of Labor announced new proposed rules, the Consolidated Appropriations Act of 2026 became law, and the FTC's announced a settlement with Express Scripts. Then, to top it all off, TrumpRx went live.Lloyd offers clear, helpful explanations of the key takeaways from each of these concurrent reforms aimed at improving transparency and how PBMs operate and interact with the other stakeholders in the supply chain, from independent pharmacies to patients and plan sponsors (employers). Whether you're responsible for a self-funded plan or overseeing a Medicare Part D plan, this episode provides the detail and insights about where the puck is going that you need. As Lloyd said, "I think we've made a great step forward, but the work isn't done."It's also worth giving a shoutout to previous guest Jim Winkler, as "Change is Imminent" is in the title of AH090!Episode HighlightsThe Department of Labor's historic proposed rules on PBM disclosures fills a gap left by the CAA of 2021The Consolidated Appropriations Act of 2026 redefines the financial alignment of pharmacy benefits beyond just Medicare Part Patient/plan member protection seems to be what the FTC's recent settlement was all aboutTrumpRx signals a broader shift toward transparent, cost-plus pricing models, but it's just for cash-paying customers, at least for nowDelinking and efforts to block vertical integration are hotly contestedRelated ContentAH095 - What's in Store for the New Year? A Special Round-Robin Episode of Astonishing HealthcareHow to obtain Rx data and what to do with itAH096 - A Quick Government Programs Update: The IRA & MPPP, Managing D-SNPs, and More, with Jason BarrettoSigns it is time to change your PBM vendor, and how to overcome common hesitationsReference LinksUS Department of Labor proposes historic pharmacy benefit manager fee disclosure rule (January 29)PBM Reforms Signed Into Law, Reshaping Medicare Part D Drug Pricing Transparency (February 3)FTC Secures Landmark Settlement with Express Scripts to Lower Drug Costs for American Patients (February 4)TrumpRx Launches (February 6)For more information about Judi Health and this episode, please visit Judi Health - Insights.
340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.For the third year in a row, we consulted 340B Health's experts on our staff to answer our listeners' most pressing 340B questions. As 2026 gets underway, we answer your questions about the CMS drug acquisition cost survey, what states are doing on 340B this year, and more. Some of the topics we cover:CMS Drug Acquisition Cost Survey Not MandatoryEarlier this year, the Center for Medicare & Medicaid Services (CMS) launched a new survey focusing on hospitals' outpatient drug acquisition costs, which could lead to Medicare Part B payment cuts for 340B drugs. Some hospitals recently saw materials suggesting they are required to complete the survey. Amanda Nagrotsky, vice president of legal and policy for 340B Health, notes that a CMS rule states there are no penalties under the Medicare statute for hospitals that choose not to respond. 340B Health and other groups sent a joint letter asking for the language to be corrected, citing the confusion it has caused.State Legislatures Are Becoming Major Battlegrounds for 2026Just over one month into 2026, statehouses are already shaping up to be one of the biggest venues to debate various aspects of the 340B. Two broad categories of bills are emerging: legislation protecting access to 340B pricing — including protections for contract pharmacy arrangements — and state-level reporting mandates. 340B Health Senior Vice President of Government Relations Tom O'Donnell says the proposed reporting mandates mirror other states' recently enacted requirements, and he argues they can be misleading, burdensome, or modeled on frameworks promoted by large drug companies.Medicare Announces More Drug Price Caps for 2028Medicare is phasing in maximum fair pricing – or MFP – for high-spending drugs over several years. CMS recently announced the next group of 15 drugs that will be subject to these types of price caps in 2028, adding to the 2026 and 2027 drug lists. Starting in 2028, these price caps will apply to both Medicare Part D and Part B drugs, including those purchased through Medicare Advantage. 340B Health Senior Manager of Pharmacy Services Gilda Yeboah says this means hospitals will see reduced 340B savings on certain drugs as Medicare prices move closer to existing 340B ceiling prices. Yeboah says the issue is complex and evolving, and 340B Health is working to share concerns about MFP implementation with federal agencies.Resources340B Health and Allies Urge CMS Contractor To Correct Statement Suggesting Hospitals Must Respond to OPPS Drug Cost SurveyStates Introduce New 340B Legislation in 2026 SessionsMaine Federal Court Rejects Drug Company Challenge to State 340B Contract Pharmacy LawMedicare Expands List of Drugs Subject to Price Caps, Decreased 340B Savings Starting in 2028Manufacturer Notices to Covered EntitiesHRSA Releases 340B Purchase Data for 2024FY 2025 Manufacturer Audit Results
In this week's episode of Medicine: The Truth, hosts Dr. Robert Pearl and Jeremy Corr look closely at the stories and controversies shaping U.S. healthcare at the start of 2026. From a severe flu season and resurgent vaccine-preventable diseases to drug pricing, autism research and the growing role of AI in medicine, the episode offers a data-driven look at where American healthcare is headed. The show opens with warnings about infectious disease. A dangerous H3N2 flu strain is driving hospitalizations, particularly among children, while measles and whooping cough outbreaks continue to spread among unvaccinated populations. To Dr. Pearl, these trends do not appear random. They reflect falling vaccination rates, weakened public-health messaging and growing political interference at federal agencies tasked with protecting the public. From there, the conversation turns to vaccine policy itself. Recent changes at the CDC (including a sharply reduced childhood vaccine schedule and new recommendations against universal newborn hepatitis B vaccination) raise serious concerns. Pearl explains why comparisons to countries like Denmark (with its reduced vaccine schedule) are deeply misleading, and why abandoning universal vaccination in a fragmented U.S. healthcare system risks reversing decades of progress. Here's a look at other must-know stories from this episode of Medicine: The Truth: Positive vaccine evidence: New CDC data show significant reductions in emergency visits among children who received COVID vaccines, reinforcing their safety and effectiveness. Pandemic lessons for children: Pediatric obesity rose during COVID lockdowns, while mental health outcomes improved after schools reopened, underscoring the tradeoffs of prolonged closures. Drug pricing deals with manufacturers: The administration's agreements with pharmaceutical companies apply narrowly to government purchases and exclude many high-cost drugs, limiting their overall impact. First oral GLP-1 approved: The FDA cleared the first pill version of a GLP-1 weight-loss drug, offering convenience but likely remaining unaffordable until prices fall closer to $200 per month. Autism research update: Rising autism prevalence is driven largely by broader diagnostic criteria and awareness. Large studies continue to show no link to vaccines or acetaminophen, while new research points to strong genetic factors and distinct autism subtypes. ACA exchange subsidy uncertainty: Congress has yet to prevent looming premium increases for millions of exchange enrollees. Pearl argues for avoiding coverage cliffs and capping household contributions as a share of income. Polypharmacy in seniors: One in eight Medicare Part D beneficiaries now takes eight or more medications, increasing the risk of side effects, falls and hospitalizations in a fragmented system. New dietary guidelines: Federal recommendations now emphasize animal protein alongside stronger warnings against sugar and ultra-processed foods, a shift that may conflict with earlier public-health messaging. AI's expanding role in healthcare: OpenAI's tools increasingly integrate health data from electronic records and consumer apps, signaling how quickly generative AI is becoming part of medical decision-making. Medicare and AI oversight: Traditional Medicare is moving toward AI-assisted prior authorization for certain procedures, a response to fraud and low-value care that Pearl says is inevitable as costs continue to rise. Tune in to Medicine: The Truth for more fact-based coverage and analysis of healthcare's biggest stories. * * * Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn. The post MTT #102: Vaccines under fire, rising disease & the cost of politics in medicine appeared first on Fixing Healthcare.
In this Episode of the Secure Your Retirement Podcast, Radon and Murs discuss why Medicare 2026 is shaping up to be one of the most impactful years for retirees and those approaching retirement. With major Medicare updates, rising Medicare costs 2026, and several Medicare new rules taking effect, understanding how these changes affect your overall Retirement Planning is more important than ever. From prescription drug reforms to premium increases and income-based adjustments, Medicare is not something you can afford to “set and forget” when you're planning retirement and working to secure your retirement.Listen in to learn about how Medicare Part B premium 2026 increases, IRMAA surcharges, and Medicare income limits 2026 can directly impact your cash flow in retirement. Radon and Murs also explore how Medicare planning fits into a comprehensive strategy to help you retire comfortably, avoid costly surprises, and align your healthcare decisions with your long-term retirement checklist and broader financial plan.In this episode, find out:How Medicare drug price negotiations and Medicare Part D changes 2026 are lowering costs for certain prescriptionsWhat the new Medicare out of pocket cap means for retirees with high prescription drug expensesWhy the increase in Medicare Part B premium 2026 matters for your monthly retirement incomeHow IRMAA surcharges and income from strategies like Roth conversions can affect your Medicare premiumsWhat Medicare does not cover, including the difference between a Medicare wellness visit and a traditional physical, plus updates on Telehealth MedicareTweetable Quotes:“Medicare isn't separate from your financial plan—it's interconnected with your taxes, income, and investment strategy.” — Radon Stancil“One decision, like a Roth conversion, can trigger higher Medicare premiums if you don't account for IRMAA.” — Murs TariqUnderstanding Medicare 2026 is a critical part of Retirement Planning, whether you're already enrolled or just beginning to plan for retirement. Staying informed about Medicare updates, knowing your coverage gaps, and proactively planning can make a meaningful difference in how confidently you approach Retirement.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.
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
Just one month after Congress moved to strengthen legislation around the hemp industry, a recent White House executive order supports marijuana research. The Trump administration says the drug may be an underlooked treatment for chronic pain. Healthcare experts say 2025’s Affordable Care Act open enrollment period was more confusing and stressful than usual. An estimated 400,000 Pennsylvania seniors are expected to save money on common drugs for diabetes, heart disease and cancer this year. Lower prices for 10 medications covered by Medicare Part D plans are going into effect in 2026. Pennsylvania lawmakers approved a number of new laws in 2025. Some of those new laws are taking effect in January. And a deeper dive: Political candidates are leaning on artificial intelligence to take increasingly pointed — and sometimes misleading — shots at their rivals. WITF’s Jaxon White reports as the technology gets more realistic, experts say voters will have to work harder than ever before to figure out what’s real. Lancaster County Commissioners passed a 2026 budget, on Christmas Eve, that includes a 10% property tax increase. York County Commissioners are disbursing more than $3 million to local organizations. The money is from the latest round of opioid settlement grants. Throughout the holiday season, there have been several stories of goodwill here in central PA. And the first federally funded electric vehicle charging station is now open along the Pennsylvania Turnpike. In uncertain times, our community counts on facts, not noise. Support the journalism and programming that keep you informed. Donate now at www.witf.org/givenow. And thank you! Support WITF: https://www.witf.org/support/give-now/See omnystudio.com/listener for privacy information.
Hi. It's Part Two of our George W. Bush series! This week, we look at No Child Left Behind, Medicare Part D, Surveillance, and how Bush's butchering of the law allowed Trump to be Trump. Fool me you can't get fooled again. Hosted by Cody JohnstonExecutive Producer - Katy StollDirected by Will GordhWritten by Thomas ReimannProduced by Jonathan HarrisEdited by Gregg MellerPost-Production Supervisor / Motion Graphics & VFX - John ConwayResearcher - Marco Siler-GonzalesGraphics by Clint DeNiscoHead Writer - David Christopher BellPATREON: https://patreon.com/somemorenewsMERCH: https://shop.somemorenews.comYOUTUBE MEMBERSHIP: https://www.youtube.com/channel/UCvlj0IzjSnNoduQF0l3VGng/join#somemorenews #GeorgeWBush #donaldtrumpFor a limited time, save on the perfect gift by visiting http://auraframes.com to get 35 dollars off Aura's best-selling Carver Mat frames – named #1 by Wirecutter – by using promo code MORENEWS at checkout.Pluto TV. Stream Now. Pay Never.Sign up for your $1/month trial and start selling today at https://shopify.com/morenewsSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
New coverage year, new changes to Medicare Part D! Don't miss our refresher on the Part D Redesign updates coming in 2026. Familiarize yourself with these changes now so you can be a helpful resource for your clients! Read the text version
December 2, 2025 - Dale Colee joined Byers & Co to talk about prescription assistance programs and the Medicare Part D deadline, and to preview Pharmacy Facts with Friends that will feature the real estate market and Giving Tuesday. Listen to the podcast now!See omnystudio.com/listener for privacy information.
November 25, 2025 - Dale Colee joined Byers & Co to talk about Medicare Part D and their holiday weekend hours and sales, and to preview Pharmacy Facts with Friends that will include a recap of the Thanksgiving Luncheon and the culinary program at Richland Community College. Listen to the podcast now!See omnystudio.com/listener for privacy information.
Cassandra Schmoll joined Wake Up Tri-Counties to talk about the Senior Center Cookie Fundraiser, Medicare Part D open enrollment, 2026 trips, home-delivered meals, weekly lunch, Tuesday dinner, and Cinnamon Roll Fridays. Enrollment for Medicare Part D is underway at the Henry County Senior Center, with the deadline coming up on December 7th. Staff are on hand to help residents compare plans—just bring your list of prescriptions for a free review that could save you money. The Senior Center is also launching a cookie kit fundraiser to support its home-delivered meal program; orders are open to all ages and needed by December 5th. Upcoming events for 2026 include trips to the Parade of Nations, Mount Rushmore, Mackinac Island, and Branson. For meals and more, call 309-853-8831. The Henry County Senior Citizens Center in Kewanee offers lunch at the center and delivers lunch to people in Henry County who are unable to leave their homes. The local community center offers nutritious lunches every weekday and a hearty supper on Tuesday evenings, with a modest suggested donation making it accessible to everyone over 60. Friday mornings feature homemade cinnamon rolls and coffee, creating a cozy start to the day. Beyond these gatherings, the program extends its reach with home-delivered meals, ensuring that seniors in Geneseo, Atkinson, Annawan, Cambridge, Orion, Kewanee, and Galva are not left out. For more details or to contribute to this cause, community members are encouraged to reach out to the center at 309-853-8831. They release a monthly menu on their Facebook and web pages. A suggested donation for the weekday noon lunch is $3.75, for the Tuesday night supper at 5 PM is $4.75, for Friday morning cinnamon rolls from 8 to 10:30 AM is $1, and for the meal delivery service is $4. A big fundraiser for the year for the Henry County Senior Citizens Center is underway, offering Christmas cookie decoration kits for $15 each. Each kit features a dozen cut-out cookies, three colorful frosting varieties, and an assortment of sprinkles, perfect for seasonal creativity. Orders are being accepted now through December 5th, with a scheduled pickup date of December 22nd, between 8 AM and 2 PM. Supporters are encouraged to participate and spread holiday cheer while contributing to a good cause. Organizers note that quantities are limited, so early reservations are recommended. Whether gifting to friends or enjoying at home, the kits promise fun and flavor for all ages. Contact the senior center at 309-853-8831 to order or for more information. The Medicare Annual Enrollment Period kicks off on October 15, 2025, offering a chance for Medicare recipients and those soon eligible to review and update their coverage. Everyone is encouraged to assess their Medicare Part D and Medicare Advantage plans to ensure the best fit for their healthcare needs. The Henry County Senior Citizens organization is providing free assistance to help individuals navigate their policy choices and select the most suitable Medicare Part D plan. Appointments can be made by calling 309-853-8831, but availability is limited as slots are filling quickly. Don't miss out on this essential opportunity.
November 18, 2025 - Lauren Young joined Byers & Co to preview Pharmacy Facts with Friends that will cover Medicare Part D, prescription price changes, the Pharmacists Fight Back Act, holiday hours, and a fundraiser for a Maroa-Forsyth student. Listen to the podcast now!See omnystudio.com/listener for privacy information.
Facing mounting financial pressures, insurance companies are changing the prescription drug coverage available to many consumers in Medicare Part D.Guests:Stacie Dusetzina, Professor of Health Policy, Vanderbilt UniversitySteven Hadfield, Medicare beneficiaryMark Newsom, Managing Director, Avalere HealthErin Trish, Co-Director, USC Schaeffer CenterCindy Trish, Medicare beneficiaryLeslie Walker, Senior Reporter, TradeoffsLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift. Hosted on Acast. See acast.com/privacy for more information.
Jump in the time machine with us as we travel back circa 2005 for the first Medicare Annual Enrollment Period, the debut of Medicare Advantage, Medicare Part D, two new Med Supp plans, and more! Read the text version Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail. Resources: 4 Ways PlanEnroll Will Make This Your Best AEP Yet 4 Reasons Why Ritter Insurance Marketing Should Be Your FMO Insurance Agency 5 Medicare Myths Your Clients May Believe 10 Tips to Submitting an Error-Free Medicare Enrollment Application 2026 Medicare Part D Bid Info Likely Means Higher Premiums & Plan Disruption — Here's Why A Review of Integrity's Top Medicare Quoting Tools How Insurance Agents Can Use AI Tools How Storytelling Helps Agents Quickly Connect with Clients ft. Don Connelly IntegrityCONNECT & PlanEnroll FAQs Register with RitterIM.com Risk Adjustment & Finding Value Beyond Coding Changes ft. Dr. Shannon Decker The Future of Medicare Part D: The Push Toward MAPD The Ultimate Agent Resource List Pt. 3: Staying Organized References: “2005 CMS Statistics.” Cms.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicaremedicaidstatsupp/downloads/2005_cms_statisticspdf. Accessed 21 Oct. 2025. “2025 Medicare Parts A & B Premiums and Deductibles.” CMS.Gov, Centers for Medicare & Medicaid Services, 8 Nov. 2024, www.cms.gov/newsroom/fact-sheets/2025-medicare-parts-b-premiums-and-deductibles. McManus, Melanie Radzicki. “A Short History of How Netflix Won World Domination in Streaming.” Entertainment.Howstuffworks.Com, HowStuffWorks, 21 Dec. 2018, entertainment.howstuffworks.com/short-history-netflix-world-domination-streaming.htm. “Beneficiaries with Special Needs Can Get Help from Medicare Managed Care Plans.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/newsroom/fact-sheets/beneficiaries-special-needs-can-get-help-medicare-managed-care-plans. Accessed 21 Oct. 2025. Laschober, Mary. “Estimating Medicare Advantage Lock-In Provisions Impact on Vulnerable Medicare Beneficiaries.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/05springpg63pdf. “IPod Shuffle (1st Generation).” Apple.Fandom.Com, Apple Wiki, apple.fandom.com/wiki/IPod_shuffle_(1st_generation). Accessed 21 Oct. 2025. “K & L Out-of-Pocket Limits Announcements.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/medicare/health-drug-plans/medigap/k-l-out-of-pocket-limits-announcements. Accessed 21 Oct. 2025. “Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable as CMS Implements Improvements to the Programs in 2025.” CMS.Gov, Centers for Medicare & Medicaid Services, 27 Sept. 2024, www.cms.gov/newsroom/press-releases/medicare-advantage-and-medicare-prescription-drug-programs-remain-stable-cms-implements-improvements. Freed, Meredith, et al. “Medicare Advantage 2025 Spotlight: A First Look at Plan Offerings.” KFF.Org, KFF, 9 Aug. 2025, www.kff.org/medicare/medicare-advantage-2025-spotlight-a-first-look-at-plan-offerings/. Freed, Meredith, Jeannie Fugleston Biniek, et al. “Medicare Advantage 2025 Spotlight: A First Look at Plan Premiums and Benefits.” KFF.Org, KFF, 9 Aug. 2025, www.kff.org/medicare/medicare-advantage-2025-spotlight-a-first-look-at-plan-premiums-and-benefits/. “Medicare Part B Immunosuppressive Drug Benefit.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/partbid-provider. Accessed 21 Oct. 2025. “Medicare Demonstration to Transition Enrollment of Low Income Subsidy Beneficiaries .” Cms.Gov, Centers for Medicare & Medicaid Services, 8 June 2006, www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Downloads/MemoLTCContracting_060806.pdf. “Medicare Part B Income-Related Monthly Adjustment Amount.” Federalregister.Gov, Federal Register, www.federalregister.gov/documents/2006/10/27/E6-17690/medicare-part-b-income-related-monthly-adjustment-amount. Accessed 21 Oct. 2025. Cubanski, Juliette, and Anthony Damico. “Medicare Part D in 2025: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing.” KFF.Org, KFF, 9 Aug. 2025, www.kff.org/medicare/medicare-part-d-in-2025-a-first-look-at-prescription-drug-plan-availability-premiums-and-cost-sharing/. “Medicare Program Description and Legislative History.” Ssa.Gov, Social Security Administration, www.ssa.gov/policy/docs/statcomps/supplement/2006/medicare.html. Accessed 21 Oct. 2025. “Medicare Program; Establishment of the Medicare Advantage Program.” Federalregister.Gov, Federal Register, https://www.federalregister.gov/documents/2005/01/28/05-1322/medicare-program-establishment-of-the-medicare-advantage-program. Accessed 21 Oct. 2025. “Part D / Prescription Drug Benefits.” Medicareadvocacy.Org, Center for Medicare Advocacy, 30 May 2025, medicareadvocacy.org/medicare-info/medicare-part-d/. “Pop Culture in Review for the Year 2005.” Mrpopculture.Com, Mr. Pop Culture , 29 Nov. 2023, mrpopculture.com/pop-culture-in-review-for-the-year-2005/. "The Medicare Advantage program: Availability, benefits, and special needs plans - Chapter 9." Medpac.Gov, Medpac.gov, www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/Jun06_Ch09.pdf. Accessed 21 Oct. 2025. Gold, Marsha. “The Landscape of Private Firms Offering Medicare Prescription Drug Coverage in 2006.” Modern.Kff.Org, The Henry J. Kaiser Family Foundation, www.kff.org/wp-content/uploads/2013/01/7474.pdf. Accessed 21 Oct. 2025. “The next Generation of Medicare Beneficiaries - Chapter 2.” Medpac.Gov, Medpac.gov, www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/chapter-2-the-next-generation-of-medicare-beneficiaries-june-2015-report-.pdf. Accessed 21 Oct. 2025. Crowder, Courtney. “Throwback: Pop Culture Trends of 2005.” Usatoday.Com, USA Today, 30 July 2015, www.usatoday.com/story/entertainment/2015/07/30/pop-culture-trends/30739417/. “Update to Medicare Deductible, Coinsurance and Premium Rates for 2006.” Cms.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R31GI.pdf. Accessed 21 Oct. 2025. “Variation and Trends in Medigap Premiums.” Aspe.Hhs.Gov, U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation, aspe.hhs.gov/sites/default/files/migrated_legacy_files/43721/index.pdf. Accessed 21 Oct. 2025. Hosch, William L. “YouTube.” Britannica.Com, Encyclopædia Britannica, inc., 19 Oct. 2025, www.britannica.com/topic/YouTube. Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/ Not affiliated with or endorsed by Medicare or any government agency.
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
November 4, 2025 - Dale Colee joined Byers & Co to talk about Medicare Part D, Brad Underwood's visit to Decatur, and to preview Pharmacy Facts with Friends that will feature the real estate market, a holiday open house, and a breakfast for veterans. Listen to the podcast now!See omnystudio.com/listener for privacy information.
Politicians argue about subsidies while families face premiums that can top $26,900 and deductibles big enough to delay basic care. We step past the slogans to map how the ACA exchanges actually work today—standardized benefits that reduce real choice, narrow networks that hide access problems, and a pricing spiral that subsidies struggle to catch. Along the way, we unpack ghost networks in mental health, why out-of-network showdowns hit consumers hardest, and how pharmacy benefit manager rebates can reward drug utilization even as patients fight for approvals.With Nate Kaufman of the Healthcare Bridge, we press on a practical blueprint: unify tax-funded programs into one baseline plan for everyone legally here, financed on a progressive scale. Then let private insurance sell optional add-ons that prove their value on access and outcomes, not marketing gloss. We argue for opening Medicare Part D-style drug purchasing to all, so payers and manufacturers compete in a fair arena. And we make a crucial point often skipped in policy talk: if clinicians aren't paid enough to say yes, coverage is a promise that collapses at the front desk. Raise rates for high-value services, shrink bureaucracy, and hold networks to transparent, enforceable standards.This conversation is candid, nonpartisan, and focused on patients and physicians rather than lobby talking points. If you've ever felt like the “chump at the table” in healthcare—paying premiums to an insurer incentivized to deny and taxes to a system that can't align incentives—you'll find both clarity and a path forward here. Dive in, share with a friend who's wrestling with open enrollment, and tell us: what's the first fix you'd make to rebuild access, quality, and affordability? Subscribe, leave a review, and help more listeners find the Common Bridge.Support the showEngage the conversation on Substack at The Common Bridge!
Open Enrollment season is here, and millions of Americans are hoping the latest formulary changes will help ease costs at the pharmacy counter. This month, the Alliance released several new resources, including an educational film, to help Medicare Part D beneficiaries make informed decisions for 2026.Today, I'm joined by Adina Lasser, the Alliance's Director of Public Policy and Government Relations, to discuss these new resources and break down what you need to know for this fall's Medicare Open Enrollment, which runs from October 15 through December 7.
Toni's new Medicare Survival Guide Advanced Edition book is available now - pick up your copy at www.tonisays.com Download your Free Guide: How Do I Enroll in Medicare? https://tonisays.com/free-download-how-to-enroll/ Remember - with Medicare it's what you don't know that will hurt you! There's so much good information in this podcast, please be sure to share this podcast with your friends! Recognized by feedspot.com as one of the best Medicare Podcasts in the nation! Write Toni - info@tonisays.com. Toni's book is available at www.seniorresource.com and https://tonisays.com You can call Toni at 832-519-8664 Toni welcomes all Medicare questions. Toni now offers informative Medicare Webinars for all of your Medicare needs at https://tonisays.com You can find Medicare Moments wherever you find your favorite podcasts, such as: Apple: https://apple.co/44MoguG Spotify: https://open.spotify.com/show/7c82BS4hb145GiVYfnIRsoAmazon Music: https://music.amazon.com/podcasts/884c1f46-9905-4b29-a97a-1a164c97546b/medicare-moments?refMarker=null You can find Medicare Moments at: https://podcasts.seniorresource.com/medicare-moments/ Toni's new book: Maze of Medicare is now available at www.tonisays.com Combining Scripture with Medicare, it is the only book of its kind. Toni's columns appear weekly in about 100 newspapers across America. If you would like Toni's column to appear in your local paper, or if you would like Toni to speak at an event - contact Toni King at 832-519-8664 Thank you for listening and be sure to tell your friends about Medicare Moments! Blessings! Toni KingSee omnystudio.com/listener for privacy information.
As select Medicare Advantage and Medicare Part D plans go non-commissionable, we've been hearing whispers about consulting fees. Rather than stay silent, we've got some words of caution and solutions for agents to consider. Read the text version Contact Us! Email ASGPodcast@Ritterim.com or reach out to Ritter's Sales Team near you! Resources: 7 Actions You Can Take If Your Medicare Plans Go Non-Commissionable 8 Reasons Why Insurance Agents Should Sell ACA Plans ACA 101: Selling Under-65 Health Insurance A Quick Guide to Cross-Selling Ancillary Insurance with Medicare Products Final Expense Insurance: How Much Can Clients Expect It to Cover? Register with Ritter Insurance Marketing Selling Hospital Indemnity with Medicare Advantage: Is It Worth It? References: Are Brokers Still in the Crosshairs? Policy and Market Updates for 2026 Medicare Advantage Program Regulations Medicare Part D Communication Requirements AEP Media Toolkit from NABIP Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/ Not affiliated with or endorsed by Medicare or any government agency.
The price you pay at the pharmacy isn't just about the drug—it's about the plan, the pharmacy network, and the rules hidden in the fine print. We break down a simple, repeatable method to shop Medicare Part D so you protect access to your doctors and treatment while cutting real costs. With Medicare's new $2,000 out-of-pocket cap, the math changes: premiums and pharmacy choice now drive your savings more than fear of runaway brand-name bills.We walk through Medicare.gov step by step—creating your account, reviewing your medication history, and adding every pharmacy you actually use, from your local favorite to the chain near your vacation home. You'll learn how to identify preferred pharmacies, interpret plan deductibles that often bypass generics, and compare total annual cost, not just the monthly premium. Along the way, we share client stories that show how zero-premium plans can deliver $0 copays on key generics and how pairing Part D with Mark Cuban's Cost Plus Drugs can slash prices on certain fills without sacrificing convenience.If you rely on insulin or name-brand medications, you'll hear how to prioritize plans that price your specific drugs best, why star ratings matter for service and fewer headaches, and the easiest way to enroll online. We also cover pro moves like setting premiums to auto-deduct from Social Security to avoid missed payments and ensuring your new card is on file before January 1 so refills don't stall. It's a clear, calm guide for you and the loved ones you help—because the right plan isn't the cheapest on paper, it's the one that fits your real life.If this helped, follow the show, share it with someone who needs it, and leave a quick review to help others find practical Medicare guidance. Envision Financial Planning. 5100 Poplar Avenue, Suite 2428, Memphis, TN 38137. (901) 422-7526. This communication is strictly intended for individuals residing in the United States. Advisory Services offered through Envision Financial Planning, a Registered Investment Adviser.
Cassandra Schmoll with the Henry County Senior Citizens Center joined Wake Up Tri-Counties to talk about the Baked Potato Fundraiser, Medicare Open Enrollment, Friday cinnamon rolls, Tuesday dinner, weekday lunch, and the 2026 trips. The Henry County Senior Center in Kewanee is inviting the public to its popular baked potato fundraiser happening on October 15th, from 11 AM to 1 PM. Attendees will enjoy a personalized baked potato meal, selecting from a variety of toppings, plus a cookie, for just $8. Just call ahead to ensure there are still baked potatoes available. The event offers dine-in, carry-out, and convenient drive-up service. Funds raised will help maintain vital home meal delivery programs for area seniors. For additional information or to secure your order, reach out to the Senior Center at 309-853-8831. The Medicare Annual Enrollment Period kicks off October 15th, offering a chance for current and soon-to-be Medicare recipients to review and update their coverage. This window is especially important for those considering changes to Medicare Part D prescription plans or exploring Medicare Advantage options. The Henry County Senior Citizens organization is offering personalized assistance to help you navigate these choices and understand your benefits. To ensure you get the best plan for your needs, they encourage scheduling an appointment soon, as spots are filling quickly. For guidance, contact 309-853-8831 and secure your spot for a Medicare review. Friday morning cinnamon roll and a bottomless cup of coffee for $1, or you can get a sausage biscuit for $1, from 8:30 to 10:30 AM. Lunch is at noon sharp each weekday and is the same menu as the home-delivered meals for only $5. Tuesday night dinner begins at 5 PM and includes a meat, potato, vegetable, dessert, and salad bar for $5. The Christmas cookie fundraiser isn't until November, but you can get a 6-inch cookie for 50 cents a cookie, or $3 for six, and you are welcome to add a donation to your order. They are made from scratch at the senior center! Orders of over two dozen suggest at least one week's advance notice to plan for a large order.
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 are listening to this prior to October 9, 2025, go to the 32BJ Changing the Playbook on Hospital Prices event, where Mark Cuban will be keynoting. Cora Opsahl will also be speaking, and I will be there listening. 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. So, trust, simplicity, and a chicken. Yeah, this is where this whole conversation with Mark Cuban and Cora Opsahl winds up. And it is a barnstormer because you know what some really good advice is for anybody trying to do right by patients and taxpayers and plan sponsors? It will take trust. It will take making the complicated as simple as possible. And also if you could pay with a chicken, like in the good old days, that would be messy—I can say with confidence, having grown up in Pennsylvania Dutch country, where there are many, many chickens—but also being able to pay with a chicken could also indicate that healthcare prices are reasonably chicken proportionate and that the doctor-patient relationship is good enough to break bread (or have chicken). That last part is really important, and Cora Opsahl says this at one point in the episode that follows. It doesn't matter how wonderful the transparency or the financing. If the prices are insane and there's no more reasonably priced options in any given market, then yeah. Shane Cerone says in an upcoming show, he says, “We do not have a broken healthcare market. We do not have a healthcare market. There is no market.” Okay … so, you could call this conversation a continuation of the episode with Ann Kempski (EP444), entitled “Two State Healthcare Laws Often Don't Go as Planned.” But it's not just healthcare laws that often don't go as planned. It's some very foundational constructs that we have built the healthcare sector upon that may also not go as planned. The healthcare sector is like a game of pachinko. You chuck an input into the mix, and it will bounce all around into all the perverse incentives and human beings and the non-market that we have. And who the heck knows what is gonna pop out the other side? It's like game theory at its most unpredictable. So, in healthcare, there are many, many examples of when the solution to a problem arguably creates worse problems than the problems the solution was trying to solve for. But we—Mark Cuban, Cora Opsahl, and I—are gonna shake our fists at two such solutions today: high deductible health plans (or just high deductibles in general) and then self-insured employers trying to solve the complexity of the healthcare industry by hiring consultants and middlemen, middle people, and other vendors to navigate the pachinko parlor (that is, our $4.9 trillion healthcare sector) on their behalf. Now, I am not in any way saying the spirit of these two endeavors—high deductibles and hiring consultants and middlemen—weren't wholehearted. They seem just like many other well-intentioned solutions: very logical on their face. What I am saying is there are many ways in the real world for even the most, again, genuine endeavor to turn into a money grab for those so inclined. While at the same time I'm saying all this, I'm also very much saying that there are some amazing consultants and middle folks such as independent third-party administrators, otherwise known as TPAs, and PBMs (pharmacy benefit managers) who are transparent and hold themselves accountable to the fiduciary responsibilities that their clients are held to in real terms—not just in marketing speak with 40 pages of disclaimers following. There are great folks out there, many of whom listen to this podcast and are part of our tribe on the regular. And to you, I say thank you for being here, because it takes all the knowledge and more from every one of the guests featured in these past 487 Relentless Health Value episodes plus treating every day like a school day to make sure that we all are not getting shanked from behind by some innocent-looking contract term that turns out to be anything but. The conversation that follows starts out talking about high deductibles; naturally segues into how third-party intermediaries can actually exacerbate the issues here; then we get into transparency, financing, clinical organizations taking on risk, and the benefits and challenges of direct contracts; then Mark lays out a vision for the future. Okay … I wanna get to this conversation. If you are a new listener here—and you might be because … yeah, Mark Cuban—let me just inform you that this podcast is largely listened to by those who work in the healthcare industry. So, you are going to encounter acronyms. You will also encounter me referencing earlier episodes because surveys say listeners really appreciate these callbacks to go get additional information about any given topic. You can get what amounts to a personalized Master's of Healthcare Administration curriculum if you follow the episode threads long enough. And that was a direct quote from a listener. About the acronyms: They are holy terrors, and we in the healthcare industry are chock-full of them. See the list of acronyms that come up so that you can follow along at home if this is your first day at our rodeo. Also in the show notes is a transcript of this show, along with links to all of the mentioned episodes. Okay … here's my conversation with Mark Cuban, who is Mark Cuban and also CEO and founder of Mark Cuban Cost Plus Drugs. Also, we have Cora Opsahl, who is health fund director of the 32BJ Health Fund and an expert in many things healthcare. Also mentioned in this episode are Shane Cerone; Ann Kempski; Mark Cuban Cost Plus Drugs; 32BJ Health Fund; Preston Alexander; Stanley Schwartz, MD; Elizabeth Mitchell; Kimberly Carleson; Andreas Mang; Jonathan Baran; Claire Brockbank; Dave Chase; Cristin Dickerson, MD; Green Imaging; Kevin Lyons; and Vivian Ho, PhD. You can learn more at markcubancompanies.com and costplusdrugs.com and follow Mark on LinkedIn, Bluesky, Threads, and X. You can follow Cora on LinkedIn. Mark Cuban, a native of Pittsburgh, PA; a graduate of Indiana University; and now a Dallas, TX, resident, has always been an entrepreneur. From selling and trading baseball cards, selling garbage bags and magazines door-to-door, to starting a business buying and selling stamps at age 16, there have been few years in his life when he wasn't starting or running a business. He got a job at one of Dallas's first retail software stores, Your Business Software. He spent nine months doing everything from learning how to code, supporting and installing every type of business software, and of course, making sure the store opened on time. That went well until he made the executive decision to turn over the store opening duties to a peer so he could pick up a check for a sale. He was fired. Mark decided it was time to start on his own. The next day, MicroSolutions was founded. Over the next seven years, MicroSolutions became a national leader in Systems Integration and custom applications for local and wide area networks. Growing to 80 employees, never having a losing month of operations and nearly $36M in annualized sales, in 1990, MicroSolutions was sold to CompuServe. At that point Mark “retired” to investing in public and private companies. His knowledge of the networking industry led to success and brought returns of 80% and more each year. Mark purchased the Dallas Mavericks for $285M. The Mavs would have the second-best record in the NBA during his ownership tenure. Mark sold majority control of the Mavs in 2023 but continues to be actively involved with the team. He first appeared as a “Shark” on ABC's Emmy Award–winning hit business show Shark Tank in 2011 and quickly established himself as one of the most popular and tough Sharks, investing millions of dollars in hundreds of small businesses. He's been nominated nine times for an Emmy for Shark Tank. His last appearance on the program was during season 16 in May 2025. In 2019, Mark co-founded costplusdrugs.com. Its launch on January 19, 2022, with transparent pricing and a limited markup, has fundamentally changed the pricing of medications in the United States. Cora Opsahl is the director of the 32BJ Health Fund, a self-insured Taft-Hartley benefit fund that sets comprehensive design parameters to ensure the 200,000 members and families of SEIU 32BJ have easy and sustained access to affordable, high-quality healthcare. Cora has prioritized a data-driven approach, focusing on reducing trend, solving the affordability challenge on behalf of union members, and, most important, keeping members at the center of every decision. Under her leadership, the 32BJ Health Fund has saved more than $35 million annually—which it has reinvested in new and better benefits, including the first fertility benefit for members—by removing NewYork-Presbyterian hospitals and physicians from its network, transitioning to a new pharmacy vendor and pharmacy group purchasing coalition, and establishing an expanded Centers of Excellence program. In 2024, Cora conducted an innovative medical request for proposal, stipulating that all finalists have a signature-ready contract drafted by the 32BJ Health Fund prior to award. As a result, the Fund negotiated an agreement that brought unprecedented visibility and increased accountability to its benefit. In 2025, the Health Fund is focused on direct-contracting opportunities that allow it to carve out key benefits and ensure quality while managing spend. Cora is regarded as an expert in pharmacy benefit management and was recently appointed to the Board of Governors for the National Alliance for Healthcare Purchaser Coalitions and the Purchaser Advisory Council for the National Quality Forum and Joint Commission. She previously worked at Express Scripts, where she held a variety of roles, ranging from Medicare Part D to operations, strategy, and acquisitions. Cora earned an MBA from Saint Louis University. 06:25 What was the original rationale behind high deductibles? 07:38 How high deductibles are creating a class of functionally uninsured people. 09:29 EP482 with Preston Alexander. 10:20 “We're using health insurance as a proxy for healthcare.” —Mark 12:30 How providers are now in the debt collecting business rather than the healthcare business. 12:55 EP486 with Stan Schwartz, MD. 15:16 “We have a fundamental reasonability problem.” —Cora 16:07 EP425 with Marshall Allen. 18:25 Direct contracting versus self-funded employers. 19:27 EP436 with Elizabeth Mitchell. 19:30 EP480 with Kimberly Carleson. 19:33 EP372 with Cora Opsahl. 23:53 Why the current system doesn't allow the accountability that is needed. 24:39 EP452 with Cora Opsahl. 26:34 How direct contracting gives strength back to independent practices that high deductible plans take away. 27:46 Who pays, what's the price, and where does the power lie? 31:24 EP419 with Andreas Mang. 34:45 How it comes down to power and leverage when controlling healthcare costs. 38:13 EP483 (Part 1 and Part 2) with Jonathan Baran. 38:35 Why putting together a network and just buying healthcare—not discounts—is not as difficult as it seems. 40:10 Why we need to stop talking about disruption and start talking about change. 40:56 EP453 with Claire Brockbank. 41:02 EP484 with Dave Chase. 43:07 EP485 with Cristin Dickerson, MD. 44:32 EP487 (Part 1) with Kevin Lyons. 46:34 EP466 with Vivian Ho, PhD. 47:40 Why it's the incentives that are different between American hospitals and hospitals in a single-payer program. 50:25 The main takeaways from the conversation. 51:08 Why you can't fix the problems in healthcare without transparency. You can learn more at markcubancompanies.com and costplusdrugs.com and follow Mark on LinkedIn, Bluesky, Threads, and X. You can follow Cora on LinkedIn. @mcuban of @costplusdrugs and Cora Opsahl discuss trust and simplicity in #healthcare on our #healthcarepodcast. #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! 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), Preston Alexander
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
This week, we tackle 5 Medicare myths that your clients may believe. Learn how to respectfully refute these myths, educate your clients, and empower them to make informed choices. The Content Library from Ritter Insurance Marketing
Drug pricing in America is a shell game where patients always lose. Healthcare Bridge host Nathan Kaufman and his guest Richard Helppie pull back the curtain on why Americans pay drastically more for the same medications than patients anywhere else in the world.At the heart of this problem lies a fragmented system where the United States—effectively operating the world's largest health insurance company—somehow lacks the ability to negotiate bulk purchasing deals. While pharmaceutical companies claim high prices fund critical research, the conversation reveals how your money primarily finances the endless parade of drug advertisements dominating television commercial breaks.The journey of a pill from factory to patient passes through multiple profit-extracting entities: manufacturers, wholesalers, and pharmacy benefit managers (PBMs). With three PBMs controlling 80% of drug distribution—all owned by insurance companies—conflicts of interest are baked into the system. Through revealing personal anecdotes, the hosts demonstrate how the same medication can cost $5 with one insurer, $330 with another, yet only $20 through Mark Cuban's pharmacy. Many Americans find it cheaper to purchase medications from Canadian pharmacies despite industry warnings about "dangerous" reimported drugs—even when those medications come from identical manufacturing facilities.Recent policy proposals offer potential paths forward. The Biden administration's efforts to cap Medicare drug expenses met immediate legal challenges from pharmaceutical companies, while Trump's "most favored nation" pricing concept aims to standardize global medication costs. Medicare Part D represents a partial success story by forcing drug companies to negotiate with insurers, maintaining 95% subscriber satisfaction while running 40% below projected costs.Healthcare policy requires informed leadership, but few politicians truly understand the system's complexities. If you or someone you love needs medical care, finding an insider who understands healthcare's nuances isn't just helpful—it could save your life. Subscribe to the Healthcare Bridge for more conversations that bridge gaps in our healthcare system and work toward solutions that benefit patients first.Support the showEngage the conversation on Substack at The Common Bridge!
Medicare's Annual Enrollment Period - AEP - is October 15th to December 7th every year. Toni explains Medicare Supplements and Medicare Advantage PPO Plans and the benefits each program offers. Toni explains Medicare Part A, Medicare Part B and Medicare Part D. There's so much good information in this podcast, please be sure to share this podcast with your friends! Recognized by feedspot.com as one of the best Medicare Podcasts in the nation! Write Toni - info@tonisays.com. Toni's book is available at www.seniorresource.com and www.tonisays.com You can call Toni at 832-519-8664 Toni welcomes all Medicare questions. You can find Medicare Moments wherever you find your favorite podcasts, such as: Apple: https://apple.co/44MoguGSpotify: https://open.spotify.com/show/7c82BS4hb145GiVYfnIRsoAmazon Music: https://music.amazon.com/podcasts/884c1f46-9905-4b29-a97a-1a164c97546b/medicare-moments?refMarker=null Toni's new book: Maze of Medicare is now available at www.tonisays.com Combining Scripture with Medicare, it is the only book of its kind. Toni's columns appear weekly in about 100 newspapers across America. If you would like Toni's column to appear in your local paper, or if you would like Toni to speak at an event - contact Toni King at 832-519-8664 Thank you for listening and be sure to tell your friends about Medicare Moments! Blessings!See omnystudio.com/listener for privacy information.
In the Medicare Advantage Minute segment We address the dangers of the "Medicare Advantage Trap" and learn how one should avoid it. The government publication "Your Medicare Benefits 2025" reveals the extent to which Medicare will (or will not) cover nursing home care. Is there an overhaul in the works for prior authorization regulations? According to another article, Medicare Part D prescription drug plans may face an "uncertain future". Weiss Memorial Hospital fails its quality inspection in several categories and so has been suspended from any Medicare revenue collection. Finally, we review the dangers, both hidden and otherwise, of untreated heartburn and acid indigestion. Not a condition to be taken lightly! 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.
This just in: CMS 2026 maximum broker commissions for Medicare Advantage and Medicare Part D. Listen to learn more about commission structure and the caps writing MA and PDP business in your market for the upcoming 2026 plan year. Read the text version Resources: AHIP 2026 Certification Dates: https://lnk.to/asgf20250516 Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail. FAQs About NABIP Medicare Certification: https://ritterim.com/blog/faqs-about-nabip-medicare-certification/ How to Avoid Using Elderspeak: https://lnk.to/asgf20250530 Reach out to the team at Ritter Insurance Marketing: https://ritterim.com/meet-your-sales-team/ Reassuring Your Clients During Difficult Times: https://lnk.to/asg671 What is AHIP Certification and How Do I Get It? https://lnk.to/asg672 References: “2026 Medicare Advantage and Part D Rate Announcement.” CMS.Gov, CMS, 7 Apr. 2025, www.cms.gov/newsroom/fact-sheets/2026-medicare-advantage-and-part-d-rate-announcement. Agent Broker Compensation and Training and Testing Requirements CY2026: https://ritterim.com/documents/cms-memos/memo-agent-broker-compensation-and-training-and-testing-requirements-cy2026.pdf Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/ Not affiliated with or endorsed by Medicare or any government agency.
On January 17, the Biden-Harris Administration added 15 new drugs, including Ozempic, to the list of drugs covered by the Medicare Drug Price Negotiation Program of the Inflation Reduction Act (IRA). Now there are a total of 25 drugs that are covered by the IRA’s requirement that the Department of Health and Human Services (HHS) pays only a “fair price” for selected drugs covered by Medicare Part D. The new prices are set to take effect on January 1, 2027. What implications does this have for patients and for drug research and development? Join the discussion on the 'fair price' mandate and its impact on pharmaceutical innovation. Featuring: Lisa Ouellette, Deane F. Johnson Professor of Law at Stanford Law School Dan Troy, Managing Director at the Berkeley Research Group Brad Watts, Senior Vice President at the Global Innovation Policy Center, U.S. Chamber of Commerce [Moderator] Adam Mossoff, Professor of Law at Antonin Scalia Law School, George Mason University
Taxes - filing married or separately: check your Medicare Rates and ask you CPA. Loss Ratio: Money received vs claim payouts. Medicare Part D.
In this Episode of the Secure Your Retirement Podcast, Radon and Murs discuss the important and often confusing world of Medicare Part D with Medicare expert Shawn Southard. With the implementation of the Inflation Reduction Act Medicare provisions in 2025, significant updates have changed the way Medicare drug coverage works, especially for those nearing or already in retirement. Whether you're currently working and covered by an employer plan or about to transition to Medicare, this episode breaks down exactly what you need to know to avoid unnecessary costs and lifelong penalties.Listen in to learn about how Medicare Part D changes affect your coverage decisions, how employer coverage and Medicare interact, and why understanding creditable drug coverage is now more crucial than ever. Shawn also discusses HSA and Medicare rules, key timelines for enrollment, and strategies to avoid the dreaded Medicare late enrollment penalty. This is a must-listen for anyone planning to retire comfortably while staying informed and protected when it comes to their Medicare Part D options.In this episode, find out:· What exactly Medicare Part D covers and how it works.· How the Inflation Reduction Act Medicare provisions lower out-of-pocket drug costs.· What "creditable" drug coverage means and how to know if your employer plan qualifies.· When and how to enroll in Part D to avoid Medicare penalties.· How HSA and Medicare rules impact your decision to delay enrollment.Tweetable Quotes:“With Medicare Part D changes, what used to be a no-brainer may now require a complete reevaluation.” – Murs Tariq“Missing a 63-day window could mean a lifetime of penalties—knowing your coverage status is critical.” – Radon StancilResources: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.
A Lancet study warns of consequences for HIV prevention if PEPFAR loses funding, potentially millions of new pediatric HIV cases and increased AIDS-related deaths. Medicare Part D is highlighted, with research linking subsidy loss to higher mortality rates. A report from BMJ notes a 3.1% decline in U.S. drug overdose deaths, signaling a possible peak in the fentanyl crisis.
The Department of Health and Human Services is facing another legal challenge over its decision to cut funding for public health initiatives. More nurses say they plan to leave the field due to stress and burnout. And, a new study finds that Medicare Part D coverage of popular weight loss drugs could raise costs by billions of dollars. Those stories and more coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.
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