Medicare & Insurance

I read in many places that Entresto (among other drugs) must be included in the formularies of Medicare Part D providers, that there is a negotiated maximum out of pocket cost for Entresto, and that there is a cap of $2100 for out of pocket expenses for Part D covered drugs in 2026. No plans that I can find in northeast Florida include Entresto in their formulariesI have no idea what Entresto is going to costIf I use some kind of drug discount plan I have no sure way of knowing how much Entresto will cost, or if that cost will be included in the $2100 limit. Where can I get answers to these questions?

After enduring years of significant cost increases with AARP /UHC PDP, I am inclined to change to an alternative carrier for a significant cost savings. Reviewing the formulary of the new carrier prior to switching reveals the need for “Prior Authorization” before filling a tier 3 prescription. While this is not unexpected having experienced initial rejection and eventual approval at AARP /UHC, I am concerned that the “Authorization” criteria is likely to vary between carriers regardless of any published consensus guidelines. Should the prescription not gain Authorization then the out-of-pocket expenses would dwarf the potential savings. I am curious whether others have experienced failed Authorization for a medication previously Authorized by a former carrier? Without access to my medical record and prescribing physician, is there any way to verify Authorization before making the carrier switch?

Are You Willing To Pay Higher Medigap Premiums for . . . . Are You Willing To Pay Higher Medigap Premiums . . . .To Get Expanded Access to Changing Your Plan sometimes during the year(like the Birthday rule )or to Offer wider coverage to those less than 65 Years oldBoth without Underwriting ?How much more ?  

I live in Ohio and will be eligible for Medicare in a few months, so I'm trying to choose a good Medigap supplement.  I will likely not be able to pass underwriting in the future, so I have to choose a policy that I will be stuck with for the next 40 years unless I move to another state that does not require underwriting.  One of my options is UnitedHealthcare.  UnitedHealthcare currently has two separate open books of business for their Medigap supplements:  1) UHIC *with* extra wellness benefits and 2) UHICA *without* any wellness benefits.  Of course, you're going to pay extra for those "extra" benefits!    UHICA stands for UnitedHealthcare Insurance Company of America, and it operates under the UnitedHealthcare umbrella. UHICA was newly introduced in 2022 to a select group of agents, and it is not available in all states.  An agent cautioned me that the UHICA offering is being removed from some states/counties, and his agency does n

CURRENTLY, disabled individuals everywhere on Medicare already get a do over at age 65 - IOW, they get to apply for a (any) Medigap plan based on GI rights based on AGE at 65.  But this law covers them BEFORE the age of 65 -  The Chris Larkin ALS Act Texas.gov HHS Senate Research Analysis of HB 2516 05/12/2025  How much will rates increase because of this special consideration - IDK ??????  But I will guess a good bit - it became effective on Sept 01, 2025 so I’m guessing that we should know the effect of it pretty soon.   The Act mandates that premiums for Plan A, B and D must match those offered to beneficiaries 65 and older, and for other Medigap plans, rates for those UNDER 65 may not exceed 200% of the rates charged to those over 65. Where it save the state money is in MEDICAID cost - it will not save those which have Medigap plans from paying higher premiums as a result of this change. How much will be the question cause that

Delta Dental PPO Protect” policy appears like a great policy to have.  I cancelled my Blue Shield PPO after 20 years and bought the above policy.  An AARP representative, Judith, spent a lot of time with me explaining the better benefits of Delta Dental over Blue Shield..and told me I could call her anytime.  The policy has a higher monthly premium of $83/mo but because of the apparent broader cover & I am willing to pay more. This special Aarp policy allows the dentist to charge a higher amount than Blue Shield and more than Delta Dental’s HMO non AARP policy for various procedures like crowns. Certainly dentists are more likely to want to take this insurance as it gives them .  At my request  my Dentist priced both plans for me.  It was significantly less for me to use the HMO policy.  This issue was not a topic of conversation with Judith.  I tried to call Judith back on the phone number she gave me.  Turns out its an AARP number. &nb

KFF Healthnews -1/15/2026 - Kaiser Permanente To Pay $556 Million in Record Medicare Advantage Fraud Settlement  Something seems to be paying off -CMS.gov - 05/21/2025 - CMS Rolls Out Aggressive Strategy to Enhance and Accelerate Medicare Advantage Audits   

Please bear with me because I have Parkinson's and write, text slowly. I have lived all over the United States and have found there IS a big Disservice affecting people on Medicare which should BE FIXED ASAP. People who live in or near BIG CITIES - HAVE MANY OPTIONS in Health Insurance plans to choose from. While those living  in Rural or Remote areas HAVE FEW- IF ANY. IF everything else IS THE SAME with recipients, They SHOULD NOT BE PENALIZED or LEFT OUT just because they LIVE in a Remote or Rural Area. Thank you. James D. Hodges

  Hello;   CNA is again raising premium prices on my LTC policy;  this after major premium increases not that long ago,  If you have a CNA LTC policy and are similarly concerned, I'd appreciate if you would communicate with me about it. Thanks;C Steve Minor  

 In my state of New Hampshire 3 Medical insurance companies with Medicare contracts have  pulled up stakes, two are completely leaving the state and two are dropping part D plan.  None of the three including one that you seem to constantly recommend or at least highlight are no offering Medicare advantage plans in my area.  It's my understanding, correct me if I'm wrong, that AARP receives some compensation for companies or products it recommends.  If I am correct and given not only what is happening now but the fact that the special rates for members through AARP evaporate rather quickly in a year or two, it feels like a conflict of interest for AARP to suggest in anyway that one private provider should be considered over another.  

AARP sent me a letter saying my Dentegra Propel plan was renewing 1 Dec 2025 into the 2nd year . That did not mean I was actually IN MY SECOND YEAR as of 1 Dec 2025, where prices decrease for dental services.  "Renewal" meant that ALL services renew on 1 Jan or the next year (1 Jan 2026), called "Calendar year". This point was NOT mentioned in the AARP letter, nor in the Cert. of Coverage that Dentegra provides the Enrollee. Due to these omissions, I did not earn the benefits promised in the 2nd year of membership in Dentegra. Requesting clarification of terms does no good thru Dentegra customer service. Dentegra sends you more LEGAL gobbelygook, via email. The NYT recommends negotiation with dentists b/c ALL dental plans are VERY costly and cover little. Dental Ins. plans are NOT like other types of medical insurance.Link: https://www.nytimes.com/2025/09/15/well/live/dental-insurance-problems.html?searchResultPosition=4

UHC Advantage Falsely Charging $22/mo for a $0 Premium UHC Advantage is Charging me $22/mo for a $0 premium.  I've called in to UHC and they say they will take care of this immediately and "its just a website glitch".  2 weeks later - bill still there on my account on the website. My previous plan, WA-0002 was $0 plan.  My new 2026 plan WA-0014 prem. is also $0.  I guess they're hoping people paythese fraudulent premium bills or are they simply incompetent and this is just a "glitch"? Anyone else having these billing issues?

I had a bad experience with Delta Dental and believe it's important to share, because it regards their customer service. I originally had the HMO version of the AARP plan, but had a bad experience with one of the dentists. I was paying on a monthly basis and after the first year, I called Delta and explained to the customer service rep that I wanted to cancel my current plan and enroll in the PPO plan. I chose at that time to pay the premium for the entire year. Months later, I discovered that Delta Dental was still withdrawing the monthly payment from my checking account for the HMO plan! I called them immediately and spoke with a rep who advised me that my HMO plan had never been cancelled. She cancelled it immediately and also advised me to file a complaint and request a refund for the funds Delta had continued withdrawing. I called later in the day to ask another question and spoke to a different rep, who also advised me to write them a letter requesting a refund for the

I am just curious why AARP does not have an affiliation to help early retirees (50 - 65) get group health insurance before we are able to get Medicare?  There seems to be plenty of information regarding Medicare and Medigap insurance, but nothing about group insurance in the pre-Medicare group. I am 58 (retired) and my wife has her own business, so no company sponsored plan is available to us.  We live in CA and go through the ACA.  Our premiums this year (2026) are currently set to go from $918/month to $2100/month.  With the large block of AARP members, I would think that some kind of group insurance could be set up. Thanks

Why is purchasing dental insurance directly from Delta Dental cheaper than buying it through AARP?  I thought AARP was supposed to help seniors not penalize them.

I called UHC to get a copy of the medical underwriting application as I want to change from G+ to G and they wouldn't give me one. They told me I could apply on line. What I discovered is you can't get a copy that way unless you fill it out (each page only has a few questions and it won't let you advance if you don't fill them out).Does anyone have a copy of the questions asked you can give me? I can't find them anywhere online (I find reference to some questions but not all of them). Also does anyone have a copy of the drug list that means automatic denial if you are taking one of them. Last year I found the list but can't find it again.  thanks.

AARP Advocacy,Push back on this -- hard. Call out your troops (us).

Social Security increase for 2026 2.8%Part B Premium deduction for 2026 increase 9% from $185 to $202Net Social Security "increase" is actually a decrease for most people

Please read the link to the well written opinion piece in The Hill.  House Bill 3467 now in committee proposes automatic enrollment for new Medicare signups into the lowest cost Medicare Advantage plan which would be irrevocable for 3 years.  There would be an optout button, as long as people were able to find it. https://thehill.com/opinion/healthcare/5617927-congress-medicare-reform-dangers/ Here is the link to the bill: https://www.congress.gov/bill/119th-congress/house-bill/3467.  You can read the full text.  Even more telling is the remarks of the AZ rep (Repub Schweiekert) a bloated verbosity. Here are the pertinent provisions.  The text speaks for itself.  CONTACT YOUR LEGISLATORS TO STRONGLY OPPOSE THIS. (From the Bill)(a) Automatic enrollment.—“(1) IN GENERAL.—Notwithstanding any other provision of this title, for plan years beginning on or after January 1, 2028, the Secretary shall provide for the automatic

I finally had enough of the poor quality of customer service with UHC.  Both their supplemental plan and drug plan need a make over in properly handling customer questions.  They are extremely frustrating and their phone representatives are not trained well to handle the basic of questions.  For example, my wife and I had to go through multiple hoops to give me authorization to conduct business with UHC regarding my wife.  Each time I had to speak on her behalf, we had to go through a long winded process before they allowed this to happen.  They also do not seem to log their calls so that there's a record of previous issues and how those issues were resolved.  I just off the phone with them trying to get my January premium refunded since I had canceled and gone with another carrier -- for a lot less money and a more reasonable customer service experience.  Their Part D side handled the cancelation without issue but the supplement side was a horrible,

About five years ago, I bought Genworth long-term care insurance based on AARP's affiliation with Genworth. Concerns about the company's viability are now great: there is a class-action lawsuit against them (2016), it was sold to a Chinese company, and one can read about dismal responses to filed claims. I tried to contact someone in AARP to see if AARP had any recommendations about what policy holders can do (as of about a year ago, New York Life became AARP's long-term care insurance associate). I've not had a response to the question: does AARP have a recommedation regarding Genworth, and, if so, what is it? Does anyone have suggestions for what to do about Genworth? Does anyone have a suggestion as to whom to contact in AARP for some advice in this matter? Thank you.

A deer ran into my car Feb 2025 and cause some damage to the left front quarter panel of my car.  I claimed the damanged on my Auto-Owners insurance and they paid to have it fixed.  I went to a chiropractor for a back adjustment for 8 months and Auto-Owners paid for that.  Auto-Owners called me and tried to get me to accept home health care which I refused.  I didn't need help bathing or getting dressed or cleaning my house.  I no longer see the Chiropractor. Now in October 2025, I receive paperwork requesting my signature so that Auto-Owners can obtain my medical records going back to January 2020 to the present and including all radiology reports including my mammograms, CT scans, Pet scan, Ultrasounds, any Nuclear Medicines,x-rays, MRIs, Interventional Rediology.  Plus they want all other health care providers records too and the paperwork says this information may no longer be protected by HIPAA. Is this a scam? Can they ask for this informat

CMS.gov 11/14/2025 - Newsroom - 2026 Medicare Parts A & B Premiums and Deductibles  November 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the 2026 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2026 Medicare Part D income-related monthly adjustment amounts. Tried to highlight it all but ead the link in case I forgot anything - PART A Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,736 in 2026In 2026, beneficiaries must pay a coinsurance amount of $434 per day for the 61st through 90th day of a hospitalization in a benefit period and $868 per day for lifetime reserve days. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $217.00 in 2026. Enrollees age 65 and older who have fewer than 40 quarters of coverage, and cer

I don’t have a ton of time at the moment to discuss this - but I wanted to get this out so that beneficiaries will understand the importance of reviewing any Medicare plan they have now for the annual enrollment period for Medicare Advantage and Part D plan switches for 2026 - occurs later this Fall. ALL Medicare plan insurers, not just United Healthcare, are looking over their Medicare marketplace exposure - yes, even Medigap or Medicare Supplemental plans - This may produce a lot of changes for 2026 and from what I am reading about most Medicare plan insurers - MAPD, Part D and even Medicare Supplemental plans - there may be lots of changes - from dropping coverage to an increase in premiums to reconstructing their formularies.   There are also changes that are being made to various programs (as required by law) - The Trump administration is continuing the negotiation for certain drugs as the Biden IRA called for - the Part D out of pocket max will increase to $ 2100 -

So frustrating, my premium is going up substantially again this year. When I signed up the information stated policy premiums where issue age based. Only increase would be due to costs, not age. I noticed last year now the same information states premiums are attained age rated. I spoke with a customer relations person and she basically said it is what it is and they really don’t care whether or not the info and how they rate my premium has changed. I don’t have a copy or screen shot of the issue age statement from them, but she said even if I did it wouldn’t matter. So disappointed and now my premium is jumping again twice what it did last year and I’m only turning 67 in January.