Navigate Health Insurance Services

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Navigate Health Insurance Services I started in the Medicare industry as an internal sales agent at a major Medicare insurance company, where I learned the ins-and-outs of Medicare.

Licensed independent insurance agent based in Colorado, helping clients with Medicare, health insurance, dental, vision, life insurance, and care planning coverage. In 2016, I left my insurance job to teach at a high school in an inner-city neighborhood. I enjoyed teaching young adults very much, but after two years of teaching I decided the bureaucracy of teaching wasn’t for me, and I returned to the Medicare industry as an independent insurance agent. I’m still an educator, but now I educate adults ages 65 or better and help navigate the complex world of Medicare and local healthcare systems.

What is a Service Area Reduction in Medicare?A Medicare Advantage plan has an approved geographic service area. A Servic...
09/30/2026

What is a Service Area Reduction in Medicare?

A Medicare Advantage plan has an approved geographic service area. A Service Area Reduction, or SAR, happens when the plan continues into the next year but removes part of the area it currently serves.

In practical terms:

- The plan may still be available in other locations.
- If your address is in the removed area, your current plan generally cannot continue for you next year.
- Your plan must send you a notice explaining the effective date and alternatives for obtaining Medicare coverage.
- Affected members may qualify for a Special Enrollment Period, but Annual Enrollment is already approaching.

This is different from an ordinary change to a premium, deductible, copay, provider network, or drug list. It is also different from a plan ending everywhere.

The important step is simple: open and keep every plan notice you receive. Look for wording such as "non-renewal" or "service area reduction." Do not assume another Medicare Advantage or prescription drug plan will automatically be selected for you.

Medicare Annual Enrollment runs October 15 through December 7. If you receive a notice or want help confirming whether your current coverage will remain available in 2027, schedule an appointment with me. I can help you review the plans available at your address, along with your doctors, prescriptions, and expected healthcare needs.

Schedule an appointment:
https://calendly.com/navigate-insurance

CMS enrollment guidance:
https://www.cms.gov/files/document/cy-2027-c-d-enrollment-disenrollment-guidance.pdf

Medicare Special Enrollment Period information:
https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods

Not affiliated with or endorsed by Medicare or any government agency.

Medicare is making it easier to see how Medicare Advantage plans handle requests for care.Before a plan covers certain m...
09/10/2026

Medicare is making it easier to see how Medicare Advantage plans handle requests for care.

Before a plan covers certain medical services, it may require your healthcare provider to get approval. This is called prior authorization.

A KFF analysis published in January 2026 examined CMS Medicare Advantage data for 2024. Insurers decided 52.8 million prior authorization requests:

- 92.3% were approved in full
- 7.7% were not fully approved
- Only 11.5% of denials were appealed
- When someone asked the plan to look again, it changed its original answer 80.7% of the time

Put more simply: after someone asked the plan to look again, the plan approved all or part of the requested care in more than 8 out of 10 appeals.

These are overall Medicare Advantage figures. They cannot predict the outcome of one person's request, and a changed decision does not necessarily mean the original decision was improper. Sometimes additional medical records are provided during the appeal.

Still, the numbers show why better reporting is important.

Beginning in 2026, Medicare Advantage organizations must publicly report more information about services requiring prior authorization, approval and denial rates, appeals, and response times. This is a positive development. It gives beneficiaries, providers, and advisors more information about how coverage works when care is needed.

When I review 2027 coverage with a client, I consider provider networks, prescriptions, plan approval rules, and available performance information together. To schedule an appointment with me:

https://calendly.com/navigate-insurance

KFF analysis:
https://www.kff.org/medicare/medicare-advantage-insurers-made-nearly-53-million-prior-authorization-determinations-in-2024/

CMS reporting requirements:
https://www.cms.gov/prior-authorization-metrics-reporting-overview-template

Not affiliated with or endorsed by Medicare or any government agency.

Will your current Medicare coverage still fit in 2027?The Medicare Annual Enrollment Period runs October 15 through Dece...
09/03/2026

Will your current Medicare coverage still fit in 2027?

The Medicare Annual Enrollment Period runs October 15 through December 7. Plan costs, prescription coverage, pharmacies, and provider networks can change from one year to the next, even when you are satisfied with your current plan.

Before reviewing your options, gather:

• Your Annual Notice of Change when it arrives
• A list of your doctors, specialists, and preferred hospitals
• Prescription names and dosages
• Preferred pharmacies
• Any changes in your health needs or budget

I can help you compare the details and understand how available options fit your doctors, prescriptions, and priorities. To schedule a Medicare review, contact Navigate Health Insurance Services or visit:

https://www.navigatehealthinsurance.com/

Provider and pharmacy participation can change. Confirm current participation directly with both the plan and the provider or pharmacy.

Not affiliated with or endorsed by Medicare or any government agency.

Medicare physician payments may change in 2027. Why could that matter to you?CMS has proposed lowering Medicare's physic...
08/26/2026

Medicare physician payments may change in 2027. Why could that matter to you?

CMS has proposed lowering Medicare's physician payment conversion factors from their temporary 2026 levels. The proposal is not final, and it does not mean your doctor will stop accepting Medicare.

However, medical practices are also facing higher operating costs. Over time, that pressure may influence whether a practice accepts new Medicare patients or participates in particular Medicare Advantage plan networks.

That makes this fall's Medicare Annual Enrollment Period especially important.

From October 15 through December 7, you can review your coverage for 2027. Plans release updated benefits, costs, and provider information before this period. Even if you are satisfied with your current coverage, it is worth checking whether the doctors and facilities that matter to you are still participating.

If keeping your doctors is important, I can help you compare plan networks and identify questions to ask each provider before you enroll. Contact Navigate Health Insurance Services for a Medicare review.

CMS physician-payment proposal:
https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule

Medicare Annual Enrollment information:
https://www.medicare.gov/health-drug-plans/open-enrollment

Provider networks can change during the year. Always confirm current participation directly with both the plan and the provider.

Not affiliated with or endorsed by Medicare or any government agency.

Medicare is paying more attention to what happens after certain major surgeries, not just the procedure itself.Through p...
08/22/2026

Medicare is paying more attention to what happens after certain major surgeries, not just the procedure itself.

Through programs such as TEAM, and the upcoming CJR-X model for joint replacements, participating hospitals are being held more accountable for both the quality and total cost of care during recovery. That can include follow-up visits, rehabilitation, care transitions, and avoiding preventable complications or readmissions.

Why does this matter for beneficiaries?

• Better communication between the hospital, doctors, therapists, and other providers
• A clearer recovery plan after discharge
• More attention to unnecessary or duplicate services
• The potential to reduce avoidable health problems and costs

These programs mainly operate behind the scenes for people with Original Medicare. They do not guarantee a lower individual bill.

If you are planning a major surgery, ask who is coordinating your recovery, what follow-up care is expected, and whom to call if something changes after you return home.

Official CMS references:

TEAM: https://www.cms.gov/priorities/innovation/innovation-models/team-model

CJR-X: https://www.cms.gov/priorities/innovation/innovation-models/cjr-x

Questions about how your Medicare coverage fits into a planned surgery? Schedule an appointment at navigatehealthinsurance.com.

Not affiliated with or endorsed by Medicare or any government agency.

Medicare update: Part D costs may look different in 2027.CMS recently announced that the temporary Part D Premium Stabil...
08/13/2026

Medicare update: Part D costs may look different in 2027.

CMS recently announced that the temporary Part D Premium Stabilization Demonstration will end after 2026. Plain-language version: this program helped smooth some premium changes for standalone Part D prescription drug plans after recent Part D benefit changes.

This does not mean Part D is ending, and it does not mean everyone should switch plans today. Plan-specific premiums, formularies, pharmacy networks, and drug costs are not final yet.

What it does mean: this fall's Part D review may matter more than usual.

Before Medicare Open Enrollment, it helps to have an updated medication list, preferred pharmacies, current plan information, and any plan notices you receive.

Medicare Open Enrollment runs October 15 to December 7.

I help people review Part D coverage and compare options when plan details are available.

Not affiliated with or endorsed by Medicare or any government agency.

Medicare question of the week: What is the new Medicare GLP-1 Bridge?Medicare recently launched a temporary program call...
08/05/2026

Medicare question of the week: What is the new Medicare GLP-1 Bridge?

Medicare recently launched a temporary program called Medicare GLP-1 Bridge. It may help certain people with Medicare drug coverage access specific GLP-1 weight-loss medications, but it is not automatic coverage for everyone.

A few important details:

The program has eligibility rules.
Only certain drugs and forms are included.
Your doctor is the right place to start medically.
Prior authorization may be required.
The $50 copay works differently from regular Part D cost-sharing.

If you are hearing headlines about this program, the main takeaway is simple: check the details before assuming it applies to your situation.

Not affiliated with or endorsed by Medicare or any government agency.

Medicare question of the week: What should you bring to a Medicare review?If you are getting ready to compare Medicare o...
07/24/2026

Medicare question of the week: What should you bring to a Medicare review?

If you are getting ready to compare Medicare options, it helps to have a few things in front of you: your current coverage, your doctor list, prescriptions, preferred pharmacies, and any notices about plan changes.

Those details make the conversation more useful and help keep the focus on your actual needs.

If you are not sure where to start, that is normal. Schedule an appointment and I can help walk through it step by step.

Not affiliated with or endorsed by Medicare or any government agency.

Medicare question of the week:Are your doctors in network?If you are considering a Medicare Advantage plan, one of the f...
07/15/2026

Medicare question of the week:

Are your doctors in network?

If you are considering a Medicare Advantage plan, one of the first things to check is whether your doctors, hospitals, and specialists are in network.

A plan can look appealing on paper, but the details matter. Doctors, prescriptions, pharmacies, expected costs, and local network fit all play a role in whether a plan makes sense for your situation.

If you are comparing Medicare options, I can help you review the details before you enroll.

Not affiliated with or endorsed by Medicare or any government agency.

Medicare question of the week:I take prescriptions. Does the pharmacy I use matter for Part D?Often, yes. Part D plan fi...
07/02/2026

Medicare question of the week:

I take prescriptions. Does the pharmacy I use matter for Part D?

Often, yes. Part D plan fit can depend on the specific medications you take, your dosages, plan formularies, and which pharmacies are preferred in the plan.

That is why it helps to review your prescription list before comparing plans. A plan that looks fine at first can fit differently once medications and pharmacies are checked.

If you are reviewing Medicare options, I can help you compare Part D coverage and enroll when you are ready.

Not affiliated with or endorsed by Medicare or any government agency.

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