All articles tagged with #medicare
In a large UK trial of 142,000 adults over three years, Grail's Galleri multi-cancer blood test did not reduce late-stage cancers (stages 3–4), though researchers noted a secondary signal of fewer Stage 4 cancers; the test remains FDA-unapproved, is sold with limited insurer coverage, and Medicare coverage remains under legislative review.
A BuzzFeed feature curating elder perspectives from a Reddit thread about aging in America, highlighting underreported issues such as workplace ageism, Medicare and medical planning hassles, retirement insecurity, health and mobility challenges (vision, hearing, balance), and the emotional toll of isolation and stigma—calling for greater awareness and support for older adults.
Eli Lilly CEO Dave Ricks says Medicare coverage of obesity treatments later this year could be a major catalyst for the launch of orforglipron, with a full rollout planned in Q2 and price reductions expected in the second half under Trump-era deals; the move could expand access to 20–30 million beneficiaries and follows strong early demand for competitor Wegovy, a GLP-1 obesity pill.
A looming partial government shutdown could affect roughly half of federal workers—about 500k unpaid and 480k furloughed—while SNAP remains funded; Social Security and Medicare payments would continue but benefit verification and card issuance could pause, and travel may face delays as TSA operates without pay. Funding gaps would hit major agencies like Defense, Education, HHS, and Homeland Security, while others (Agriculture, Justice, Energy, Interior, Veterans Affairs) stay funded. Lawmakers are negotiating Homeland Security reforms to avert the shutdown, with a midnight Friday deadline.
Medicare announced the next round of price negotiations under the Inflation Reduction Act, targeting Botox plus 14 other expensive drugs (including Trulicity) used for cancer, diabetes, Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. The negotiated prices, affecting about $27 billion in Medicare Part B and Part D spending, will take effect in 2028. Drugmakers can opt out, but historically none have; Part B covers clinic-administered drugs and Part D covers prescriptions.
The Trump administration proposed Medicare insurer payment rates that were lower than analysts expected, triggering a sharp selloff in stocks of UnitedHealth Group, Humana, and CVS Health as investors priced in tighter reimbursements.
The CMS proposed only a 0.09% average 2027 increase for Medicare Advantage rates, far below analysts’ expectations, sending shares of UnitedHealth, Humana, CVS Health and peers down sharply (as much as about 20% for UNH) on concerns about margins and future revenue. The notice also highlighted a plan to exclude diagnosis information from certain risk-score calculations, which could further affect payments. Analysts noted the flat-rate stance would blunt the sector’s margin turnaround despite past rate hikes, contributing to a broad market pullback in health-insurer stocks.
The White House announced that 15 prescription drugs will be included in Medicare's price-negotiation program, a major move aimed at lowering U.S. prescription costs, disclosed during a rural health care event with the President and key health officials in attendance.
CMS announced the third cycle of its Medicare Drug Price Negotiation program, selecting 15 high-cost drugs—including Part B therapies for the first time—plus one renegotiation (Tradjenta); negotiations will occur in 2026 with negotiated prices taking effect January 1, 2028. The agency also released a list of 50 top negotiation-eligible drugs. The 15 drugs were used by about 1.8 million beneficiaries in 2024–2025, accounting for roughly $27 billion in Part B/D spending (about 6% of total); CMS notes potential savings—about $8.5 billion—if those prices had been in effect in 2024, and providers have until February 28, 2026 to participate.
Medicare will end broad telehealth coverage on Jan. 31, 2026, generally requiring beneficiaries to be in a medical facility in a rural area for telehealth visits, with exceptions for ESRD home dialysis, acute-stroke evaluations, and certain home-based behavioral health services. Through Jan. 30, 2026, telehealth remains nationwide; after the deadline, many seniors may need in-person visits or rely on a Medicare Advantage plan that continues coverage in some cases.
A new Medicare claims analysis found that about 25% of people with dementia are prescribed risky, brain-altering medications such as antidepressants and antipsychotics, despite longstanding clinical guidelines cautioning against this practice.
The article discusses skepticism around Trump's proposed plan to pressure insurers into lowering prices, with critics arguing it oversimplifies a complex healthcare issue and may not lead to significant relief for families, while some politicians remain cautiously optimistic.
Drugmakers plan to raise prices on at least 350 medicines in the U.S., including vaccines and cancer treatments, despite pressure from the Trump administration to lower costs, with some drugs also seeing significant price cuts. The increases are part of ongoing strategies to maximize profits amid regulatory and political scrutiny, while some companies adjust prices to keep pace with inflation and support innovation.
Drugmakers plan to raise prices on at least 350 medicines in the US for 2026, including vaccines and cancer treatments, despite pressure from the Trump administration to lower costs. While some drugs will see price cuts, overall prices are increasing, with companies like Pfizer and GSK citing the need to support innovation and cover costs. These hikes occur even as the US continues to pay significantly more for prescription drugs compared to other developed nations.
TRICARE For Life moves with beneficiaries whether they move within the U.S. or overseas, requiring updates to addresses in DEERS, Social Security, and TRICARE systems. It provides Medicare-wraparound coverage, with specific procedures for care and prescriptions in new locations, including overseas. Beneficiaries should explore provider options, update their information, and understand coverage details, especially when moving abroad or within the U.S. territories.