Centene is the most likely to overturn a prior authorization denial decision when appealed, while Humana is the least likely, according to a KFF analysis. Medicare Advantage insurers denied 7.4% of prior authorization requests in 2022, up from 5.8% in 2021. Among those denials, 9.9% were appealed. Among those appeals, 83.2% of denals were overturned.

Medicare Advantage insurers ranked by prior auth denial overturn rates

Medicare Advantage (MA) enrollment has grown to 32.8 million in 2024, representing 54% of total Medicare spending, with significant variation in enrollment across states and counties. This year, 32.8 million people enrolled in a Medicare Advantage (MA) plan, accounting for $462 billion (54%) of total Medicare spending, according to an...

Medicare Advantage Hits 32.8M Enrollees, 54% of Spending

The KFF analysis reported on the number of prior authorizations by plans, but found the data do not contain enough information to assess prior authorization by type of service, type of plan or reasons for denials. In 2022, more than 46 million prior authorization requests were submitted to Medicare Advantage...

Prior Authorization Denials in Medicare Advantage Plans Increasing

Kiplinger

Medicare open enrollment runs from October 15 to December 7 each year. During this period, you can switch from original Medicare to a Medicare Advantage plan, or vice versa. You can also choose a new Advantage plan or new Medicare Part D prescription drug coverage. Knowing more about changes to Medicare taking effect in 2025 will help you select the best plan when the time comes.

Three Medicare Changes on the Horizon for 2025

Switching your Medicare Part D plan may help maximize your prescription drug coverage and help save money. Medicare Part D plans may change some coverage benefits from year-to-year, and verifying any plan changes before Medicare’s annual open enrollment gives you the opportunity to switch to a plan that may fit your needs better.

8 Reasons to Switch Medicare Part D Plans

NBC News

The Biden administration said Thursday that it had reached an agreement with drugmakers to lower prices on the 10 costliest prescription drugs under Medicare. It's part of the federal government's first-ever drug pricing negotiations, a cost reduction it claims could help ease the financial burden on the estimated 1 in 7 older adults in the U.S. struggling to pay for their medications.

Medicare announces lower prices on 10 common, high-cost drugs

Fortune

People very limited financial resources may qualify for Medicaid to help pay for health costs not covered by Medicare. Health care expenses often increase as people age, due to more health challenges and care needs. According to the Centers for Medicare & Medicaid Services, U.S. adults ages 65 and over...

Who is eligible for both Medicare and Medicaid?

HealthPartners, a prominent healthcare provider, has announced plans to withdraw from the Medicare Advantage plan offered by UnitedHealthcare starting in 2025. This decision will affect approximately 30,000 patients and marks a considerable shift in the relationship between the two healthcare giants. A potential coverage gap is anticipated for the affected...

HealthPartners to exit UnitedHealthcare’s Medicare plan in 2025

The Social Security Administration utilizes four variables when calculating your monthly retired-worker benefit. There are well-defined advantages to initially collecting Social Security benefits at ages 62, 66, and 70. A thorough study of 20,000 retired-worker claims finds that one claiming age is superior to all others in terms of maximizing...

Here's the Average Social Security Benefit at Ages 62, 66, and 70

Medicare Advantage insurers face mounting evidence that their in-home health risk assessment programs inaccurately judge patients’ health status, leading to greater cost burdens on plan members and Medicare itself. UnitedHealth Group, the largest MA insurer in the US, defended its HouseCalls health assessment program in a statement last week.

UnitedHealth Group refutes claims that HouseCalls program produces inflated risk scores

The Motley Fool

Social Security's cost-of-living adjustment (COLA) is on the verge of doing something that hasn't happened in roughly three decades -- but it likely won't help retirees.

Social Security's 2025 Cost-of-Living Adjustment (COLA) Forecast Has Changed -- but a History-Making "Raise" Is Still Probable

Social Security benefits are set to increase in 2025, with updated figures on the exact amount scheduled for release this fall. Here’s what you need to know about the upcoming adjustment. Projected Increase for 2025. The official numbers for the 2025 Social Security cost-of-living adjustment (COLA) will be announced...

BIG ANNOUNCEMENT: Social Security Cola Increase 2025 (What We Know)

Keep this information handy. It could be a financial lifesaver.

Knowing These 3 Things About Medicare Could Save You a Ton of Money in Retirement

Mediaite

After issuing an ultimatum to Kamala Harris over a Fox News debate, Trump is reportedly open to returning to ABC or proposing a new debate with NBC News.
The post JUST IN: Trump Has ‘Apparently Changed His Mind’ on Fox News Debate Ultimatum, Per Washington Post’s Josh Dawsey first appeared on Mediaite.

JUST IN: Trump Has ‘Apparently Changed His Mind’ on Fox News Debate Ultimatum, Per Washington Post’s Josh Dawsey

SmartAsset

Medicare isn't free. This catches many retirees by surprise. Medicare has a reputation for simplicity. You turn 65 and get access to free universal health insurance. This is true to a certain degree, and that's one of the reasons the program is overwhelmingly popular among recipients. However, in practice, Medicare has many carve-outs and exceptions. […] The post Medicare Premiums: What You Should Expect to Pay in 2024 appeared first on SmartReads by SmartAsset.

Medicare Premiums: What You Should Expect to Pay in 2024

The Social Security Administration at the start of each year adjusts how much it will pay out to beneficiaries due to inflation and increased cost-of-living expenses. With around 68 million people currently receiving Social Security benefits, this adjustment in the amount of money beneficiaries get receives a lot of attention.

Social Security COLA Predicted to Dip in 2025: Here's What to Know

FinanceBuzz

Here are 13 freebies included with Original Medicare plans that can help you keep more cash in your pocket and eliminate some of your money stress.

Don't Miss These 13 Totally Free Things You Get With Medicare

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Jesse Slome

Millions of seniors will wake up January 1st only to realize their Medicare plan coverage has changed and that it's too late to act. Fortunately Medicare provides an annual opportunity for seniors to review coverage for the coming year. If a better plan would offer improved coverage or yield savings, switching is possible.

Seniors Need To Prepare Now For Medicare's Annual Enrollment Period

The Social Security Administration (SSA) is making changes to its payment schedule for August and September. This will affect millions of Americans who rely on Social Security benefits, particularly those receiving Supplemental Security Income (SSI). Typically, SSI benefits are paid on the first of each month. However, when the first...

Early SSI payments scheduled for August

If you get Social Security checks, keep an eye on the calendar: Certain beneficiaries will receive two payments in August. The scheduling change affects Supplemental Security Income, or SSI, which is a Social Security program that provides financial help to low- and no-income Americans who don't have many resources and are blind, disabled, or age 65 and up. According to the latest data from the Social Security Administration, about 7.4 million people receive SSI every month.

Millions of Social Security Recipients Will Get 2 Payments This Month

NewsBreak

Medicare Advantage: Prior approval rates high and rising

Almost all the older Americans who have Medicare Advantage insurance (99%) are subject to prior authorization for some things, most often higher-cost services like inpatient hospital...

Medicare Advantage: Prior approval rates high and rising

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