Crumes Insurance

08/16/2026

08/06/2026

If passed, Medicare Advantage plans will be required to have an actual physician review cases, rather than relying on AI to determine approvals and denials.

https://www.mcknights.com/news/guardrails-would-stop-ai-driven-medicare-advantage-denials/?fbclid=IwdGRleAThhMZwZG9mAWZkaWQWUL-GTjX02gmM3XjRvLkLBp4cQ4id8mV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR782q4rfmXS8CSiEv12QLPvLgSwWfuHd4YsaesSMftJHFRQXDmtuoSZfopw0A_aem_rlGI1kZDiN14ompUylaJ2w

Medicare Advantage plans could no longer rely solely on automated tools to make coverage decisions under a new House bill that requires a physician to review and approve any artificial intelligence-generated prior authorization requests or denials.

08/04/2026

Medicare will only contact you if you contact Medicare first. Guard your Medicare card and Medicare Number: If someone you don’t know asks for your Medicare Number or personal information, it’s a scam! Report possible fraud to 1-800-MEDICARE. https://go.medicare.gov/4w84nvD

07/30/2026

If you have seen headlines saying Medicare Part D costs are going up because federal subsidies are ending, here’s what you need to know.

The subsidies that are ending were NOT payments to Medicare beneficiaries. They were TEMPORARY payments to insurance companies designed to help offset the cost of major changes made by the Inflation Reduction Act.

Beginning in 2025, the law eliminated the Part D coverage gap (“donut hole”) and capped annual out-of-pocket prescription drug costs. Those changes shifted more financial responsibility to Part D plans/carriers, so CMS created a temporary demonstration program to help stabilize premiums while the market adjusted.

That demonstration program is ending after 2026.

What does that mean for you?

It means some Part D premiums could increase in 2027. It does NOT automatically mean your prescription drug costs will increase because the subsidies are ending. It also does NOT affect Medicare’s Extra Help program or eliminate the annual out-of-pocket protection that beneficiaries now have.

The reality is we don’t yet know what 2027 Part D premiums will look like. Carriers are still filing plans, and CMS is reviewing them. We’ll have a much clearer picture once 2027 plans are released this fall.

Until then, be cautious of headlines that suggest everyone will see higher drug costs. The situation is more nuanced than that.

As always, review your coverage during Annual Enrollment. Every year is different, and 2027 will be no exception.

07/06/2026

After a two-month grace period — which Wellcare extended to three — Medicare drug plans can drop customers who don't pay their premiums, no matter how small the amount. Some members who lost their coverage in Nevada, for example, owed as little as $8.10 for three months, according to a KFF Health News analysis of Medicare drug plan data.

Wellcare terminated coverage for about 140,000 Value Script beneficiaries in April, according to a person with knowledge of the matter who was not authorized to speak publicly about it and feared reprisals at work for doing so. About 40,000 of the people who were dropped may be able to enroll in new coverage immediately because they have low incomes and receive financial assistance through a program Medicare calls "Extra Help."

Multiple state officials said they had heard the same disenrollment figures, including Nevada's insurance commissioner, Ned Gaines, who chairs the National Association of Insurance Commissioners' senior issues task force; Rebecca Gouty, director of the State Health Insurance Assistance Program in West Virginia; and Tim Smolen, director of Washington state's Statewide Health Insurance Benefits Advisors.

https://www.npr.org/2026/07/06/nx-s1-5879413/medicare-drug-plan-coverage-premiums-wellcare?fbclid=IwdGRleAS412lwZG9mAWZkaWQWUKDKvBrM7SrmU_VaE-FtIn_OqJS9eGV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR7IYWVV6KzIOvpFNBPM7yFcA57LnYLkx1rcg6tmbR3l-gupTd-jRdlq2jJM_A_aem_Py9QE5nfgwvAdZRntj5vmw

Thousands of people lost coverage over as little as $8 in delinquent payments. They didn't know their zero-dollar premiums had gone up and they owed money. Most now can't get coverage until 2027.

07/04/2026

Happy Fourth of July!

Crumes Insurance

07/04/2026

America will celebrate the most important milestone in our country's history—250 years of American Independence - July 4th, 2026

07/02/2026

Happy Fourth of July

We will be off in observance of the Fourth of July

Friday, July 3rd
through
Monday, July 6th

Returning to business as usual Tuesday July 7th

Hope everyone has a safe and fun holiday weekend!!!

07/02/2026

Information from Medicare website regarding GLP-1s.

We get a lot of questions about this so I wanted to share this to help anyone that has questions about the GLP-1 Bridge program that CMS rolled out 7-1-2026.

Weight loss drugs Medicare will provide access to certain GLP-1 drugs if you’re eligible and have Medicare drug coverage (Part D) $50 monthly copayment Description Coverage details Who's eligible Provider requirements Costs Description GLP-1 drugs can help you manage your weight and improve your h...