South Dakota Senior Insurance Blog

HSA and Medicare: How to Avoid a Costly Contribution Mistake

Wed, 23 Sep 2026 06:00:02 GMT

How Medicare Enrollment Can Create Consequences for Your HSA Contributions

Many Americans spend years building savings in a Health Savings Account (HSA), one of the most tax-advantaged ways to save for health care expenses. HSA funds can be used for many qualified medical expenses, including deductibles, copays, coinsurance, prescription medications and certain medical equipment… even when you are on Medicare. That is why HSAs can be such an important part of your retirement planning.

But when Medicare enters the picture, the rules can lead to unexpected tax consequences.

Where Medicare Can Create a Problem with HSAs

Some people continue working after age 65 and remain covered by an employer-sponsored HSA-eligible high-deductible health plan (HDHP). That's allowed. Simply turning 65 or becoming eligible for Medicare doesn't automatically prevent you from contributing to an HSA. The issue begins when you are actually enrolled in Medicare. Once you're enrolled in Medicare Part A and/or B, you generally can no longer contribute to an HSA.

The confusion is that Medicare enrollment doesn't always happen when people expect it to.

One way this can happen is through Social Security benefits. If you're already receiving Social Security benefits when you become eligible for Medicare, you're generally automatically enrolled in Medicare Part A and Part B. While Part B can generally be declined, premium-free Part A usually takes effect automatically. Once Part A coverage begins, you're no longer eligible to contribute to an HSA, even if you're still working and covered by your employer's HSA-eligible health plan.

That means someone could continue making HSA contributions through payroll, or continue receiving employer contributions, without realizing that Medicare coverage has kicked in and made them ineligible to make those contributions.

A second issue can arise when someone delays Medicare while continuing to work and contribute to an HSA. When that person later applies for premium-free Medicare Part A after age 65, their Part A coverage can generally be retroactive for up to six months, but not earlier than the month they first became eligible for Medicare.

This creates a potential HSA problem because a person can't make HSA contributions for months in which they're covered by Medicare. If Part A is applied retroactively, HSA contributions made for those retroactively covered months may become excess contributions, even though the person wasn't aware at the time that Medicare coverage would later reach back to those months.

For example, someone who works past 65, keeps an HSA-eligible employer plan and delays Medicare might continue contributing to an HSA. If they later enroll in Medicare and receive six months of retroactive Part A coverage, some of those recent HSA contributions may no longer be allowable.

That's why it's important for people who work past 65 to coordinate the timing of Medicare enrollment, Social Security benefits, and HSA contributions.

The Potential Tax Consequences

The IRS generally imposes a 6% excise tax on these “excess” HSA contributions that aren't corrected as permitted under IRS rules. The tax can apply for each tax year the excess remains in the account.

In some cases, an individual may be able to avoid the 6% excise tax by withdrawing the excess contribution, along with any earnings attributable to it, by the applicable tax-return deadline and properly reporting the correction.

Because the tax treatment depends on the circumstances and timing, anyone who discovers a possible excess contribution should consider contacting the HSA custodian and a qualified tax professional.

How to Avoid HSA Contribution Problems

If you're approaching Medicare eligibility, planning to enroll in Medicare, or applying for Social Security benefits after age 65, review your HSA contribution strategy ahead of time. The correct time to stop contributing isn't the same for everyone.

For example, if you enroll in Medicare during your Initial Enrollment Period, you generally need to make your last HSA contribution for the month before your Medicare Part A coverage begins. Special rules can apply if your birthday is on the first day of a month.

If you delay Medicare and later enroll in premium-free Part A, Medicare recommends accounting for the possibility that Part A coverage will be retroactive. If you enroll six or more months after turning 65, that generally means stopping HSA contributions six months before the month you apply for Medicare or Social Security benefits.

Because enrollment dates and individual circumstances can vary, confirm the effective date of your Medicare coverage before determining your final HSA contribution.

Your HSA Can Still Be Valuable After Medicare

Enrolling in Medicare means you can no longer make HSA contributions, but it doesn't mean you can't use the money already in your account. You can continue pulling from your HSA after enrolling in Medicare, and withdrawals for qualified medical expenses can generally remain tax-free. HSA funds can therefore continue to be a valuable resource for health care expenses throughout retirement.

The key is planning ahead. Understanding when Medicare coverage begins, and when HSA contributions must stop, can help you preserve the tax advantages you've worked to build.

Medicare Scam Calls and Fake Agents Are Getting Harder to Spot

Wed, 16 Sep 2026 06:00:11 GMT

Who's Really on the Other End of That Medicare Call?

The phone rings. The voice on the other end says your name, your age, and your address. It sounds official. It m ay even sound friendly. And within a minute, you are being asked to confirm your Medicare number. What do you do?

Complaints about Medicare-related scam calls have climbed sharply over the past year. Reports to the Better Business Bureau indicate that these kinds of calls remain a major concern for people Medicare. Some have even described getting dozens of these calls in a single day. Enrollment season tends to make it worse, because legitimate outreach picks up at the same time criminals do.

Here is how these calls tend to sound, and how to protect yourself.

The Three Pitches You Are Most Likely to Hear

Many Medicare scam calls follow similar scripts. Once you recognize a few key patterns, the calls lose a lot of their power.

"You qualify for extra benefits"

A recorded voice says it is reaching out to make sure you receive unclaimed Medicare benefits. The recording asks whether you have Part A and Part B, then transfers you to a live person. The real goal is either to get your personal information or to switch you to a plan you did not ask for.

"Your card is expiring"

The caller warns that your Medicare card is about to expire, or that your coverage could be interrupted unless you verify a few details. Fear and urgency are the strategy here. If you hand over your Medicare number or Social Security number, criminals can use it to steal your identity or bill you for services you never received.

"Something free is on the way"

Free braces. Free hearing aids. Free gift cards or a free smartphone. The offered gift is bait. One woman in Texas received a large box of orthopedic braces she never ordered, and later learned Medicare had been billed more than $700 for them. Her secondary insurer was charged as well, and additional claims were filed for supplies she never requested.

Fraudulent claims can also leave inaccurate information in your medical records, including diagnoses for conditions you do not have.

Fake Agents Are Part of the Problem

Not every scammer sounds like a robot. Some present themselves as licensed insurance agents. They may reference a well-known carrier, quote a plan name, or offer to walk you through your options right now over the phone.

A few things a real agent will not do:

Pressure you to decide something during a first call
Refuse to give you a full name, license number, or office phone number
Ask you to pay by gift card, wire transfer, or a payment app
Tell you that you must act today or lose your coverage
Show up at your door uninvited to sell you a plan

Verifying an agent is simpler than most people expect. Ask for their name and license number, then hang up and call the agency's main office number yourself. You can also check the license with your state Department of Insurance. Anyone who is legitimate will not mind you doing this; they know you need to be careful.

Habits That Keep You Safe

Treat unexpected Medicare calls with skepticism, even friendly ones
Never give your Medicare number, Social Security number, or bank details to someone who called you
Remember that Medicare generally reaches out by mail first and does not call to ask for your Medicare number or banking information
Hang up on anyone who pressures you or claims your coverage is at risk
Read your Medicare Summary Notices and Explanation of Benefits statements and look for charges you do not recognize
Report anything unfamiliar right away

Hanging up may feel rude, but it is the single most effective thing you can do.

If You Think You Already Shared Something You Shouldn't Have

Act quickly, but do not panic. Write down what you shared and when. Review your recent statements. Then report it. You can contact the Senior Medicare Patrol program in your state, call 1-800-MEDICARE, or file a report with the Federal Trade Commission at ReportFraud.ftc.gov.

The Easiest Defense Is a Person You Already Know

Scam calls work because they catch people on their own and unsure. Having a licensed agent you already trust means you have someone in your corner. You have a number you can call to ask whether an offer is real before you respond to it. If you have questions about a call you received, or you want a second set of eyes on your current coverage, reach out to our office. We are here to help you!

What Medicare Really Covers for GLP-1 Drugs in 2026

Wed, 09 Sep 2026 06:00:23 GMT

A Plain-English Guide to the New $50 Copay Program and How to Get Started

For years, Medicare generally has not covered medications when they are prescribed solely f or weight loss. Federal law currently excludes drugs used for weight loss from the standard Part D benefit. However, a new, limited exception to the rule became available on July 1, 2026.

Through a temporary program called the Medicare GLP-1 Bridge program, certain people with Medicare drug coverage may now be able to get select GLP-1 medications intended for weight management for a $50 copay per one-month supply. The Bridge program does not eliminate the underlying Part D exclusion for weight-loss drugs. Instead, it provides a separate, temporary pathway for eligible Medicare beneficiaries.

Read on to learn what the program covers, who could qualify, and how the process works.

Medicare Part D’s Existing GLP-1 Coverage

Before looking at the new Bridge program, it helps to understand GLP-1 coverage up to this point.

Medicare Part D can cover certain GLP-1 medications when they are prescribed for a medically accepted condition other than weight loss. Depending on the particular drug, those conditions may include:

Type 2 diabetes
Certain cardiovascular risks
Moderate-to-severe obstructive sleep apnea
Certain cases of metabolic dysfunction-associated steatohepatitis (MASH), a serious form of fatty liver disease

If your doctor prescribes a GLP-1 for one of these approved conditions, or something other than weight loss, your Medicare Part D plan may cover it. Which specific drugs are covered and what requirements apply depend on your particular plan.

The New Medicare GLP-1 Bridge Program

The Medicare GLP-1 Bridge program is a temporary program scheduled to run from July 1, 2026, through December 31, 2027. It gives eligible people with Medicare drug coverage access to certain GLP-1 medications for the purpose of weight management for a flat $50 copay per one-month supply. The program is available nationwide, including in U.S. territories.

One important note is that the Bridge program operates outside the regular Part D benefit. Medicare pays participating pharmacies through a central processor rather than having your Part D plan pay for the medication. This means your Part D plan does not have to opt into the Bridge program for you to participate.

Which Drugs Are Covered as of August 2026?

As of August 2026, the Medicare GLP-1 Bridge includes these medications when prescribed to reduce excess body weight and maintain weight reduction:

Foundayo — tablet
Wegovy — injection or tablet
Zepbound — KwikPen only (not single-dose vials or pens)

Because the Bridge program is evolving, Medicare may update covered products over the duration of the program.

What About Ozempic and Mounjaro?

The names of these medications are familiar to many people, so you may wonder if they're covered. The answer is no: Ozempic and Mounjaro are not covered through the Medicare GLP-1 Bridge program. Instead, they remain subject to regular Medicare Part D coverage rules and are most often prescribed to treat type 2 diabetes. Wegovy and Zepbound, on the other hand, are versions approved specifically for chronic weight management.

So, if you take a GLP-1 medication for a condition that can be covered under Part D, continue working with your health care provider and Medicare drug plan or Medicare Advantage plan regarding coverage. If, however, you are seeking a pathway to weight management, then the Bridge program may be worth pursuing. The first step is to find out if you're eligible.

Who Qualifies for the GLP-1 Bridge?

To participate, you must be 18 or older, have Medicare drug coverage, and meet one of Medicare's clinical eligibility standards when starting treatment.

You may qualify if you have:

A body mass index (BMI) of 35 or higher
A BMI of 30 or higher plus heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher
A BMI of 27 or higher plus prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease

You may also qualify for coverage of a GLP-1 drug if you started taking a GLP-1 drug prior to the start of the Bridge program and you met the eligibility conditions when you started taking the drug, even though you may not qualify now. For example, if you started taking a GLP-1 drug in January 2025 and at that time your BMI was 35, you may qualify for the Bridge program even if your current BMI is 25.

Medicare has additional clinical definitions and requirements for these conditions. Your health care provider will determine whether you meet the program's criteria.

You generally aren't eligible for the Bridge program if you already get GLP-1 drugs through your Part D coverage or if you have certain conditions for which GLP-1 treatment may be covered through regular Part D rules, including:

Type 2 diabetes
Moderate-to-severe obstructive sleep apnea
Certain fatty liver disease

Having one of these conditions may make you ineligible for the Bridge program even if your particular Medicare drug plan doesn't currently cover the medication. In that situation, regular Part D coverage and exception rules may apply.

You must also have qualifying Medicare drug coverage. That can include:

A standalone Medicare Part D plan
A Medicare Advantage plan with drug coverage
A Special Needs Plan with drug coverage
Certain employer or union Medicare drug plans
The LI NET program

How Do You Get Started?

The process starts with your health care provider rather than your Medicare drug plan.

Talk with your health care provider. Ask whether one of the covered medications is medically appropriate for you and whether you meet Medicare's BMI and health-condition requirements.
If they agree, your provider will send a prescription to your pharmacy. The medication must be prescribed as part of a treatment plan that includes diet and physical activity.
The first fill may take extra time. The pharmacy's initial claim may trigger a prior-authorization request to your provider. Once the required prior authorization is submitted, CMS says an approval or denial will generally be communicated within 72 hours.
Watch for a letter from Medicare. If your prior authorization is approved, Medicare will send you a letter confirming coverage through the Bridge program.
Be prepared to provide your Medicare information at the pharmacy. Your pharmacy may need your Medicare Number or, in some circumstances, the last four digits of your Social Security Number to process the claim.

Once approved, the prior authorization generally remains valid through December 31, 2027, including for refills and dose changes. A new authorization may be required if you change to a different GLP-1 medication covered by the Bridge.

How Does the $50 Copay Work?

The $50 copay works differently from what you normally pay for medications covered by your Part D plan because Bridge program medications are paid for outside your regular Part D benefit.

For medications you receive through the Bridge program:

You pay a flat $50 copay for a one-month supply
The $50 does not count toward your Part D deductible or annual out-of-pocket limit
It will not appear on your Part D Explanation of Benefits or your Medicare Summary Notice
Extra Help does not reduce the $50 copay
The Medicare Prescription Payment Plan cannot be used to spread the $50 cost across monthly payments

Those differences are especially important to understand if you receive Extra Help or are tracking your prescription drug spending toward your Part D out-of-pocket limit.

Your Next Step

If you think you might qualify for the Medicare GLP-1 Bridge, start by talking with your health care provider. Your provider can help determine whether one of the covered medications is appropriate for you and whether you meet Medicare's eligibility requirements.

The GLP-1 Bridge is currently scheduled to end December 31, 2027, so it's also worth discussing how your treatment and coverage options could change after the program period ends.

If you have questions about your current Medicare drug coverage, we're happy to help you understand how your plan works and where the GLP-1 Bridge program may fit in.

This article is accurate as of August 2026. The GLP-1 Bridge program keeps evolving, so it is good to keep an eye out for ongoing updates.

It's Time to Prepare for Medicare Annual Enrollment

Wed, 02 Sep 2026 06:00:00 GMT

Plan Ahead for the Best Results

As we head into fall, it's time to think about an important Medicare milestone: the Annual Enrollment Period. If you're on Medicare, this is your chance to review your coverage and make changes if your needs have shifted, or if there will be changes to your current plan that you don’t like.

Key Dates for Annual Enrollment in 2026

October 1, 2026: Plan details for 2027 go live. You can start comparing Medicare Advantage (Part C) and prescription drug (Part D) options in your area, though you can't make changes yet.

October 15 – December 7, 2026: Enrollment is officially open. This is when you can:

Join a Medicare Advantage or Part D plan
Switch to a different plan
Drop coverage or switch back to Original Medicare

January 1, 2027: Any changes you made take effect. Make sure you review your new plan documents so you understand your coverage and costs.

What About Medigap?

If you have a Medicare Supplement (Medigap) plan, it works differently. The rules for joining or switching a Medigap plan are more complicated than those for Medicare Advantage and Part D plans. Reach out to us to discuss your options.

How to Get Ready Now

Between now and October, set aside some time to prepare.

Gather recent medical bills and receipts
Make or update your complete list of current medications and doses
List the doctors and hospitals you have used most over the past year
Check your current plan's summary of coverage
Watch for your Annual Notice of Changes (ANOC) from your health insurance company (usually arrives in late September)—this tells you what's changing in your coverage, costs, provider and pharmacy network, and benefits for 2027
Schedule a review session with our team starting October 1—slots fill up fast

The more organized you are, the easier it will be to make confident choices.

Let's Plan Ahead

Whether you want to stick with what you have or explore new options, we can help you understand your current plan, see what else is available, and make sure your doctors and prescriptions and other benefits are covered. Schedule now to meet with us starting October 1st.

If you have questions now about the process and what to expect, reach out anytime. We're here to help make the process as straightforward and successful as possible.

Hybrid Life Insurance: Plan for Long-Term Care Without Throwing Away Premiums

Wed, 26 Aug 2026 06:00:06 GMT

A Life Insurance Policy That Can Also Help Pay for Long-Term Care

Many people put off buying long-term care insurance because of one nagging worry: what if I pay premiums for years and never need care? With a traditional, stand-alone long-term care policy, that concern is valid. If you never file a claim, those premium dollars are generally gone, a structure often described as “use it or lose it.” Hybrid life insurance, sometimes called linked-benefit life insurance, was designed with that exact worry in mind. These policies combine a life insurance death benefit with long-term care coverage in a single contract, so your family is protected either way, whether you eventually need long-term care or not.

What Is Hybrid or Linked-Benefit Life Insurance

At its core, a hybrid policy is a life insurance policy, usually a form of permanent life insurance, that includes a long-term care benefit built in. If you eventually need help with daily living activities, such as bathing, dressing, or mobility, due to a chronic illness or cognitive decline, you may be able to access a portion of your policy's benefit early to help pay for that care, whether it's provided at home, in an assisted living community, or in a nursing facility. If you never need long-term care, the policy still pays a death benefit to your beneficiaries when you pass away. That dual-purpose design is the main appeal: the money isn't earmarked for one single outcome.

How It Differs From a Standalone Long-Term Care Policy

Traditional long-term care insurance is designed purely to cover care costs. You pay premiums, and if you need qualifying care, the policy pays benefits toward it. But if you go your whole life without needing that kind of care, there's typically no payout and no return of premium. Standalone LTC premiums have also been known to increase over time as insurers adjust pricing. Hybrid policies take a different approach. Because the long-term care benefit is linked to a life insurance policy, an unused LTC benefit doesn't simply disappear. Instead, your beneficiaries generally still receive a death benefit, meaning the value you've paid for isn't lost even if long-term care is never needed.

Two Common Structures

Linked-Benefit Policies

These often set your long-term care benefit pool at two to three times the total premium paid at issuance. Many plans offer optional inflation protection, helping your coverage keep pace with rising costs.

Acceleration Riders

With this design, you attach a long-term care rider to a permanent life insurance policy. If you use the care benefit, it reduces your death benefit dollar-for-dollar.

How Premiums Typically Work

Many policyholders appreciate that hybrid premiums are often structured as level and guaranteed. Depending on how the policy is designed, you might pay a single lump sum up front, spread premiums over a set number of years, or pay over the course of your lifetime. Because pricing and structure vary widely by policy and by insurer, it's worth reviewing exactly how premiums are scheduled, and what happens to your coverage if you were ever unable to continue paying, before you commit.

Tax Considerations to Keep in Mind

Generally speaking, long-term care benefits paid out from a policy that qualifies under Internal Revenue Code Section 7702(b) are treated as excludable from income for federal tax purposes, subject to current IRS per-diem limits that can change from year to year. Death benefits paid to beneficiaries are also typically free of federal income tax in most circumstances. That said, tax treatment can depend on how a policy is structured and your individual situation, so these general statements shouldn't be treated as tax advice. A qualified tax advisor can help you understand how a hybrid policy would apply to your own tax picture.

Who Might Consider This Kind of Policy

Hybrid life insurance tends to appeal to people who want some protection against the cost of long-term care but don't like the idea of premiums that provide no value if care is never needed. It can also be attractive to those who prefer the predictability of level, guaranteed premiums over policies whose costs might rise later. Because these policies often require a larger upfront premium or a structured payment plan, and because underwriting requirements still apply in most cases, they tend to be considered by people who already have some savings set aside and are looking for an efficient way to help protect those assets from the cost of extended care.

Talk to a Licensed Agent About Your Options

Hybrid life insurance with long-term care benefits isn't a one-size-fits-all product. Designs, benefit pools, riders, and pricing can vary significantly from one policy to the next, and what makes sense for one household's health, age, and budget may not make sense for another. A licensed life insurance agent can walk you through the available structures, explain how the death benefit and long-term care benefit interact in a specific policy, and help you decide whether this approach fits your broader financial and family planning goals.

Questions you can ask one of our agents: What is the maximum benefit pool? Is there an inflation protection rider?

This article is for general informational purposes only and is not insurance, legal, financial, or tax advice. Policy features, benefit amounts, premiums, and tax treatment vary by insurer and by individual policy, and no specific savings, coverage, or tax outcome is guaranteed. Review any policy's terms carefully and consult a licensed insurance agent and a qualified tax advisor about how a hybrid life insurance policy might fit your particular situation.

Why Getting Older Might Make You Happier, and How to Borrow the Secret Now

Wed, 19 Aug 2026 06:00:02 GMT

The Happiness Story Isn’t What You Grew Up Hearing

For decades, researchers described happiness across a lifetime as a U-shape: high in youth, dipping through the so-called midlife crisis, then climbing back up in your later years. Newer research is complicating that tidy picture, but one finding keeps holding up: older adults consistently report strong emotional well-being, often stronger than people in their 30s, 40s, and 50s. The interesting part isn’t the shape of the curve. It’s why it happens.

It’s Not About Having Fewer Problems

Older adults aren’t happier because life gets easier. Health concerns, loss, and physical limitations tend to increase with age, not decrease. Researchers who study this, including psychologist Laura Carstensen’s work on socioemotional selectivity, point to something different: as people become more aware that time is limited, they naturally shift their attention and energy toward what matters most. Priorities narrow. Petty conflicts matter less. Meaningful relationships and present-moment experiences move to the front of the line.

Older Adults Get Better at Managing Their Emotions

Multiple studies point to something researchers call the positivity effect. Compared with younger adults, older adults tend to pay less attention to negative information, recover faster from stress, and hold onto positive memories more readily. This isn’t denial. It’s a learned skill, built from decades of practice regulating emotions and choosing what to focus on.

Relationships Get Deeper, Not Just Fewer

Research on aging consistently links close relationships with spouses, adult children, and friends to higher happiness in later life. But it’s not about the number of relationships. Older adults tend to trim their social circles and invest more deeply in the handful of relationships that genuinely matter to them. That shift toward quality over quantity shows up again and again as a strong predictor of well-being.

Three Lessons You Can Borrow at Any Age

Trim your circle on purpose. You don’t need more friends. You need a few relationships you actually invest in.

Practice noticing the good. Older adults don’t ignore hard things, they’ve just built the habit of also registering what’s going right. That habit can start at any age.

Ask what actually matters before your calendar fills up. You don’t need to wait until later in life to prioritize the people and activities that matter most to you.

Older Adults Also Tend to Compare Themselves Less

Younger adults often measure their lives against a moving target: a coworker’s promotion, a friend’s new house, a stranger’s highlight reel online. Researchers have found that this kind of social comparison tends to fade with age. Older adults are more likely to judge their lives against their own values and history rather than against other people. That shift alone removes a major source of everyday dissatisfaction, and it’s a habit you can start practicing well before you retire.

A Word of Caution About the Research

It’s worth being honest that this is an active area of study, and researchers don’t all agree on the details. Some recent analyses challenge the classic U-shaped curve entirely, arguing that once you control for survey biases, happiness looks more like a slow decline with a small uptick around the early 60s, followed by a steeper drop in very old age tied to health decline. Other work still finds strong support for a late-life rebound. What almost none of the research disputes is the core idea: older adults, as a group, tend to report meaningfully higher emotional well-being and life satisfaction than middle-aged adults, even while facing more physical limitations. The mechanism, not the existence of the pattern, is what’s still being debated.

It’s Never Too Early to Start

The research is still evolving, and no single study has the final word on exactly how happiness moves across a life. But the underlying lesson holds regardless of the exact curve: emotional well-being isn’t just a matter of circumstance. It’s shaped by where you put your attention and who you choose to spend your time with. Those are habits worth building now, whatever age you’re starting from, and they tend to compound the same way good financial habits do.

Your ANOC Is Coming: Don't Throw This Medicare Letter Away!

Wed, 12 Aug 2026 06:00:09 GMT

What Your Annual Notice of Change Really Means for You

Every fall, if you're enrolled in a Medicare Advantage plan or a stand-alone Part D prescription drug plan, you'll receive an important piece of mail: the Annual Notice of Change, or ANOC. Many people glance at the envelope, assume it's routine paperwork, and tuck it away in a drawer, but this is a letter worth reviewing.

Your ANOC is your plan's official preview of what will change starting January 1 of the coming year. By law, plans must deliver it to you no later than September 30 each year, which gives you time to review it before Medicare's Annual Enrollment Period begins on October 15. Inside, you'll typically find details about premiums, drug coverage, copayments and coinsurance, provider networks, and any coverage changes starting January 1.

Why This Letter Deserves Your Attention

Many people assume that if you've been happy with your plan all year, then you don’t need to do anything and nothing will change. But Medicare Advantage and Part D plans are permitted to adjust their costs and coverage from one year to the next. The monthly premium might go up or down, a medication you've taken for years may move to a different cost tier or no longer be covered at all, or prior approval may now be required. A doctor or specialist you see regularly may no longer be part of the plan's network.

These changes do not require your permission and can significantly impact your coverage. Reviewing your ANOC carefully gives you a critical head start, allowing you to identify specific concerns or areas to address, such as network or formulary changes, before annual enrollment arrives. This ensures that when it comes time to sit down with us after October 1 for your Medicare review, you and your agent can focus on evaluating the aspects of your plan that you already know need your attention.

What Can Actually Change

The ANOC covers more ground than most people expect. Along with monthly premiums and annual deductibles, it can outline new copayment or coinsurance amounts for doctor visits, specialist care, and hospital stays. It will also show whether your medications have moved to a different cost tier, been removed from the formulary altogether, or gained a new requirement like prior authorization or step therapy. Provider and pharmacy networks can change, too, meaning a doctor or pharmacy you rely on today might not be included next year. Even the maximum amount you'd pay out of pocket in a year, and benefits like dental, vision, or hearing can be adjusted, expanded, or reduced. The plan may even add new, additional supplemental benefits in the coming year.

A Quick Example

Consider a longtime Medicare Advantage enrollee named Margaret, who was satisfied with her plan, didn’t open her ANOC, and let her enrollment automatically renew during annual enrollment. It wasn’t until January that she realized her monthly premium had gone up slightly, and more importantly, a maintenance medication she'd taken for years had moved to a higher cost tier. She also discovered that one of her regular specialists was no longer in the plan's network. Had she caught these changes in October, she would have had time to compare plans and talk with a licensed agent before the Annual Enrollment Period closed. But now she was locked into her plan for the rest of the year.

What to Do When Your ANOC Arrives

The envelope will likely be marked with something like "Important Plan Information” or may be labeled “Annual Notice of Change.” Open it and read through the entire letter. Many ANOCs include a side-by-side comparison of this year's plan details versus next year's. Pay close attention to four things in particular: your premium, your specific medications, the providers you see most often, and the benefits you use most or expect to use in the coming year. If anything has changed in a way that concerns you, that's your cue to explore other options. Starting on October 1, you can work with one of our licensed insurance agents to compare plans and prepare for Annual Enrollment from October 15 - December 7.

Common Mistakes to Avoid

The most common mistake is simply not opening the envelope, and assuming that because nothing has gone wrong this year, nothing will change next year. Another is reading only the first page and missing details buried further in, such as formulary or network changes. Some people miss the window and open it too late to take action during the Annual Enrollment Period, which runs October 15 through December 7. Others focus solely on the premium and overlook drug coverage or network changes, which can end up costing far more over the course of a year.

Free, Unbiased Help Is Available

You don't have to sort through your ANOC alone. Starting on October 1, we can walk you through the changes and help you weigh plans that may better fit your needs in 2027. If you'd like more immediate assistance, your State Health Insurance Assistance Program, known as SHIP, offers free resources to help you understand your notice. Either way, any changes you decide to make during the Annual Enrollment Period will take effect on January 1.

Conclusion

Your ANOC may look like just another piece of mail, but it's one of the most useful documents Medicare sends you all year. Reading it carefully, checking your premium, your medications, and your providers, and comparing your options can help you make sure you’ve got a plan that truly fits your needs. Don't throw it away, and don't let it sit unopened. A little attention each fall can go a long way toward protecting your healthcare and your budget in the year ahead.

Why Working With a Licensed Insurance Agent Still Matters

Sat, 08 Aug 2026 06:00:01 GMT

The Value of a Trusted Advisor in an AI-Centered World

Today, the word "agent" has taken on a new meaning. In an era of instant gratification, getting an insurance quote online or using an AI agent to collect quotes for you has never been easier. With a few simple commands or clicks, you can secure a price in minutes, and in many cases, enroll in a health insurance plan. However, while speed and convenience are undeniable benefits, there is a critical distinction between buying the cheapest or most visible policy and buying the right policy for you. That difference is where a licensed independent insurance agent adds real value. And we mean a human agent. Instant quotes can give you quick and useful information; what they can't do is tell you whether it's actually the right fit for your family, your health, your lifestyle, or your budget.

A Personalized Look at Your Needs

Whether you're shopping for health insurance, property insurance, or something else, a good insurance agent doesn't start with a product; they start with a conversation. What are your healthcare needs? Do you have children? Are you nearing retirement? Those answers shape a recommendation built around your actual circumstances, rather than a generic set of coverage limits generated by an online form. This personalized needs assessment often reveals gaps you might not have considered.

Access to Compare Multiple Carriers Objectively

Many independent agents maintain relationships with a range of carriers. That means they're not tied to selling one company's policies, but they can pull quotes and coverage details from multiple sources and lay them side by side for you. You get a broader view of what's available, along with an explanation of how the coverage, not just the cost, differs from one option to the next. That kind of objective comparison is difficult to get by shopping company by company on your own.

Help Understanding the Fine Print

Insurance policies are dense with terminology: exclusions, endorsements, riders, and sublimits, to name just a few. An agent can walk you through what your policy actually covers, what it doesn't, and why certain terms exist, in plain language you can understand. It is far better to understand an exclusion or a term of coverage before you need to rely on your policy, rather than discovering a limitation while in the midst of a crisis.

An Advocate When You Need to File a Claim

Filing a claim can be stressful, especially if a major event or emergency has occurred. An agent who knows your policy and your history can help you understand what documentation you'll need, what to expect from the process, and who to contact with questions along the way. Having someone in your corner who can help you navigate that process, rather than facing an unfamiliar claims system entirely on your own, is one of the most valued parts of working with an agent.

Ongoing Reviews as Life Changes

Your insurance needs at twenty-five look very different from your needs at forty-five or sixty-five. Getting married, having children, buying a home, starting a business, or heading into retirement can all shift what kind of coverage makes sense. A good agent doesn't just sell a policy and disappear; they check in over time, often around renewals or major life events, to see whether your coverage still fits. That kind of ongoing relationship helps make sure your policies keep pace with your life, rather than staying frozen at whatever made sense years earlier.

A Local, Accountable Relationship

There's also something to be said for having a real person to call, someone local who knows your name, your history, and your household, rather than an anonymous chat window. That kind of relationship builds accountability. An agent who lives in your community and has an ongoing relationship with you has a stake in your long-term satisfaction, not just in closing a single sale. And best of all, in the majority of cases, agents are compensated through a commission paid by the insurance carrier, built into the overall cost of the policy, rather than through a separate fee charged to you. So you get the added advantage without any added cost.

The Bottom Line

A licensed agent can't promise the lowest possible price or a guaranteed outcome every time, and it's worth being cautious of anyone who claims otherwise. What an agent can do is take the time to understand your needs, compare your options, explain the details in plain language, and stand beside you when it matters most, at claim time and as your life changes. Reach out to our team today to get unbiased and experience guidance for your insurance needs.

Are You Getting Enough Nutrients on GLP-1 Medication?

Wed, 22 Jul 2026 06:00:10 GMT

What the Latest Research Says About GLP-1s, Nutrition Gaps, and Getting Enough of What Matters

If you're using a popular GLP-1 medication like Ozempic, Zepbound or W egovy for weight loss, it's important to be mindful of your nutrition, because you're probably eating significantly less than you used to. A recent review found that total caloric intake dropped by 16% to 39% in patients taking a GLP-1.

These medications help you feel full faster, so you eat less, which can lead to significant weight loss. But that same reduced appetite has a downside: it can mean you aren't taking in enough of the essential nutrients your body needs to stay healthy.

Some people taking GLP-1 medications say they don't feel hungry, skip eating for most of the day, or have just one large meal in the evening. And plenty of people on these drugs never change the kind of food they eat — they simply eat smaller amounts of the same less-healthy choices. The result is fewer calories and less variety, which is a recipe for missing key nutrients.

What the Latest Research Shows

This isn't just anecdotal. A narrative review published in Clinical Obesity in early 2026 pooled six studies covering more than 480,000 adults with diabetes, obesity, or both who were taking GLP-1 drugs. The researchers concluded that nutritional deficiencies should be considered "a common consequence" of GLP-1 therapy, and that doctors should monitor patients accordingly.

A few highlights from that research:

Vitamin D deficiency was the most common problem, affecting about 13.6% of participants after 12 months of treatment in the largest study.
Iron deficiency (around 3.2%) and B vitamin deficiency (around 2.6%) also showed up, along with anemia tied to poor nutrition (about 4%).
Deficiencies tended to worsen the longer people stayed on treatment — more were diagnosed at 12 months than at 6 months.
In a smaller study that tracked detailed food diaries, the gaps were striking: many participants fell short on calcium, nearly two-thirds didn't get enough iron, and almost none met the recommendation for vitamin D.

It's worth noting these findings come largely from observational data, so they show a strong association rather than ironclad proof of cause and effect. Still, the pattern is consistent enough that nutrition deserves real attention while you're on these medications.

What Happens When You Don't Get Enough

Falling short on nutrients can show up in ways that are easy to write off as "just part of losing weight," but shouldn't be ignored:

Fatigue and dizziness — often linked to low iron, low calorie intake, or not drinking enough fluids.
Muscle loss — too little protein can lead to a progressive loss of muscle mass and strength. This is a real concern on GLP-1s, since rapid weight loss can include muscle, not just fat.
Digestive issues like constipation — frequently a sign of too little fiber and water.
Hair and skin problems — a common downstream effect of overall undernutrition.

What to Eat and Drink for Balanced Nutrition

Even when your appetite is low, the right food choices go a long way toward preventing these problems. The key is quality over quantity: with fewer bites to work with, each one should count. Aim to build meals around protein, healthy fats, whole grains, and plenty of fruits and vegetables.

Protein

Lean meats (chicken, turkey)
Fish and seafood
Eggs
Plant-based proteins like beans, lentils, tofu and soy products
Low-fat dairy (yogurt, milk, cheese)

Fiber

Whole grains (oats, quinoa, brown rice)
Vegetables (broccoli, carrots, spinach, kale)
Fruits (apples, oranges, berries)
Nuts, seeds and legumes

Healthy fats

Avocados
Nuts and seeds
Olive oil and other plant-based oils
Fatty fish (salmon, tuna, mackerel)

Hydration

Water (aim for 8–10 glasses a day)
Low-calorie drinks (herbal tea, unsweetened beverages)
Nutrient-dense drinks like low-fat milk or soy milk
Limit sugary sodas, excess caffeine, and alcohol

Additional Tips for Staying Healthy

Listen to your body. Fatigue, muscle loss, or constipation can all be signs that you're not getting enough nutrients or fluids.
Don't skip meals entirely. Going without food all day can lead to malnutrition over time, even if you're not hungry.
Consider meal replacement shakes or bars if your appetite is very low — they can help you hit your protein and vitamin targets when whole meals feel like too much.
Add a daily multivitamin and supplements if your doctor recommends it. Given how often vitamin D, iron, and B vitamins come up in the research, this is a reasonable conversation to have.
Keep moving. Light to moderate exercise — especially walking and resistance training — helps preserve muscle and enhances the benefits of the medication.
Ask about bloodwork. If you've been on a GLP-1 for several months, periodic lab checks can catch a developing deficiency before it causes symptoms.

GLP-1 medications can be a powerful tool for weight loss and metabolic health. Getting the nutrition piece right is what helps you feel strong and energized along the way — not just lighter on the scale.

Medicare and Skin Cancer Prevention: What Screenings Are Covered?

Wed, 15 Jul 2026 06:00:06 GMT

Understanding Coverage for Skin Exams and Care

Skin cancer is the most common type of cancer in the United States, and the risk increases with age. Years of accumula ted sun exposure can raise the likelihood of developing skin cancer, making prevention and early detection especially important for Medicare beneficiaries.

Many people are surprised to learn that Medicare's coverage for skin cancer screenings is different from its coverage for other preventive services like mammograms, colonoscopies, and lung cancer screenings. Understanding what Medicare does—and does not—cover can help you make informed decisions about your skin health.

Does Medicare Cover Routine Skin Cancer Screenings?

In general, Medicare does not cover routine skin cancer screenings for people who do not have symptoms or signs of skin cancer. Unlike certain preventive screenings that are specifically listed as covered Medicare benefits, routine full-body skin exams for screening purposes are not included among Medicare's preventive services.

This means that if you schedule a dermatologist appointment solely for an annual skin cancer screening and have no symptoms or concerns, Medicare may not pay for the visit.

When Does Medicare Cover Skin Exams?

While Medicare does not generally cover preventive skin cancer screenings, it does cover medically necessary evaluations when there is a concern about a specific skin condition or abnormality.

Medicare Part B typically covers visits to a doctor or dermatologist when you notice symptoms such as:

A new mole or skin growth
A mole that changes in size, shape, or color
A sore that does not heal
A spot that bleeds, crusts, or itches
Any unusual skin change that raises concern

In these situations, the appointment is considered diagnostic rather than preventive, making it eligible for Medicare coverage.

What Tests and Treatments Are Covered?

If your doctor identifies a suspicious lesion, Medicare generally covers medically necessary testing and treatment.

Covered services may include:

Dermatology consultations
Skin biopsies
Laboratory analysis of tissue samples
Surgical removal of cancerous lesions
Treatment of precancerous lesions such as actinic keratoses
Radiation therapy when medically necessary
Certain chemotherapy medications and treatments

Under Original Medicare, Part B typically covers 80% of the Medicare-approved amount after your deductible is met, leaving you responsible for the remaining 20% unless you have supplemental coverage.

The Importance of Skin Cancer Awareness

Although Medicare may not cover routine screenings, that does not mean skin checks are unimportant. The American Academy of Dermatology and many cancer experts emphasize that early detection is one of the best ways to improve treatment outcomes.

The three most common forms of skin cancer are:

Basal Cell Carcinoma

The most common type of skin cancer. It often appears as a pearly bump, a pink growth, or a sore that doesn't heal.

Squamous Cell Carcinoma

Often develops on sun-exposed areas such as the face, ears, neck, and hands. It may appear as a scaly patch, wart-like growth, or persistent sore.

Melanoma

Less common but more dangerous because it can spread quickly. Melanoma often develops in or around a mole and may show changes in color, shape, or size.

How to Perform a Skin Self-Check

Since Medicare beneficiaries may not receive routine screening coverage, regular self-examinations can play an important role in early detection.

Experts recommend looking for the ABCDE warning signs of melanoma:

A – Asymmetry: One half of the spot does not match the other.
B – Border: Edges are irregular, ragged, or blurred.
C – Color: Multiple colors or uneven coloring.
D – Diameter: Larger than about 6 millimeters (roughly the size of a pencil eraser).
E – Evolving: Changes in size, shape, color, or symptoms.

Don't forget to check often-overlooked areas such as the scalp, ears, back, feet, and between the toes.

Tips for Preventing Skin Cancer

Prevention remains the best defense against skin cancer. Consider these simple habits:

Wear broad-spectrum sunscreen with SPF 30 or higher.
Reapply sunscreen every two hours when outdoors.
Wear protective clothing, hats, and sunglasses.
Seek shade during peak sunlight hours, typically between 10 a.m. and 4 p.m.
Avoid tanning beds.
Monitor your skin regularly and report concerning changes to your doctor promptly.

Recap

Medicare generally does not cover routine skin cancer screenings for individuals without symptoms. However, Medicare does cover medically necessary evaluations, diagnostic testing, biopsies, and treatment when a suspicious skin change is present.

The key is to stay vigilant. Regular self-checks, sun protection, and prompt attention to unusual skin changes can help detect skin cancer early, when treatment is often most effective.

New Study Links Processed Foods and Weight Gain

Wed, 08 Jul 2026 06:00:11 GMT

Findings From a Landmark Study Confirm Dietary Impact

Many Americans rely on packaged and convenience foods to save time, but research suggests that diets high in ul tra-processed foods make it easier to consume excess calories and gain weight.

A widely discussed study conducted by researchers at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) examined how processed foods affect eating habits and body weight. The findings provided some of the strongest evidence to date that the type of food we eat can influence how much we eat, even when calories and nutrients appear similar on paper.

Inside the Study

The study followed 20 adults who lived in a research facility for four weeks. Participants spent two weeks eating a diet rich in ultra-processed foods and two weeks eating a diet centered on minimally processed foods.

Importantly, both meal plans were designed to provide similar amounts of calories, fat, carbohydrates, sugar, sodium, and fiber. Participants were free to eat as much or as little as they wanted during each phase.

Examples of ultra-processed foods included packaged breads, sweetened cereals, flavored yogurts, and ready-made meals. The minimally processed diet emphasized foods such as fruits, vegetables, whole grains, eggs, nuts, and freshly prepared meals.

What the Researchers Found

The results were striking.

When participants followed the ultra-processed diet, they consumed about 500 additional calories per day on average. Over the two-week period, they gained roughly two pounds.

During the minimally processed diet phase, participants tended naturally to eat fewer calories, and they lost a similar amount of weight.

Researchers also observed changes in hormones that help regulate hunger and fullness. Participants eating the minimally processed diet experienced increases in hormones associated with feeling satisfied and decreases in hormones linked to hunger.

Why Might Processed Foods Lead to Overeating?

The study was not designed to identify a single cause, but researchers noted several possible explanations.

One factor was eating speed. Participants tended to eat processed foods more quickly than minimally processed foods. Foods that require more chewing may help slow down eating, giving the body more time to recognize fullness signals.

Texture, flavor combinations, and convenience may also play a role. Many ultra-processed foods are engineered to be highly appealing and easy to consume, making it easier to eat large portions before feeling satisfied.

What Counts as Ultra-Processed Food?

Not all processed foods are unhealthy. Frozen vegetables, canned beans, plain yogurt, and whole-grain bread are technically processed but can still be nutritious choices.

Ultra-processed foods are generally products that contain multiple ingredients, additives, flavorings, or preservatives and are far removed from their original form.

Examples include:

Sugary breakfast cereals
Packaged snack foods
Candy and desserts
Sweetened beverages
Many frozen dinners
Processed meats such as hot dogs and some sausages
Packaged baked goods

Practical Ways to Eat Less Processed Food

You do not need to eliminate processed foods entirely to improve your diet. Small changes can make a meaningful difference.

Consider these strategies:

Fill half your plate with fruits and vegetables.
Choose whole grains more often, such as oatmeal, brown rice, or quinoa.
Include lean protein sources like fish, poultry, eggs, beans, or nuts.
Prepare simple meals at home when possible.
Keep nutritious snacks on hand, such as fruit, yogurt, nuts, or vegetables.
Slow down during meals and pay attention to hunger and fullness cues.

Takeaways

This study suggests that diets high in ultra-processed foods may encourage people to eat more calories and gain weight, even when meals contain similar amounts of nutrients. While no single food determines your health, emphasizing whole and minimally processed foods may help support healthy weight management and overall well-being.

The goal is not perfection. Making gradual shifts toward more whole foods and fewer heavily-processed options can be a sustainable way to improve your eating habits over time.

How to Have a Safe Fourth of July Celebration

Mon, 29 Jun 2026 14:40:03 GMT

Simple Safety Tips to Help Protect Your Family, Friends, and Property During Your Fourth of July Festivities

Fourth of July is one of America's favorite holidays and it's a time to enjoy Independence Day with your family and friends.

Unfortunately, every year more than 11,000 people are sent to the emergency room for fireworks-related injuries, and in a typical year about eight to 10 people are killed by fireworks.

On top of that, fourth of July fireworks start an average of 18,500 fires every year, including 1,300 structure fires, 300 vehicle fires, and 16,900 outside fires, according to the National Fire Protection Association.

But you can take steps to protect your family and your property so that you don't have to be one of those statistics. It all comes down to common sense and respecting the power of the fireworks.

Mind the Sparklers

Usually these are known as "kiddie" fireworks, but you may be surprised to know that they cause one-quarter of the house fires and emergency room fireworks injuries on Fourth of July.

Sparklers are best handled by people aged 12 and older. Children younger than 12 require extreme supervision.
Everyone handling sparklers should wear closed-toe shoes, and not flip-flops or sandals, to protect their feet from sparks.
Keep a bucket of water to place sparklers in after they finish sparkling; they are still hot and dangerous.

Adult Supervision

Always have an adult vigilantly supervise fireworks activities and never allow children to play with or ignite fireworks.

Keep a Safe Distance from Your Home

If you are going to use fireworks at home, be sure you're lighting them in a safe area. A “safe area” means away from homes, buildings, trees, and bushes.

If your gutters have accumulated leaves, pine needles, or other flammable material, clean them before using fireworks near your home. If you're leaving town for the holiday, ask a neighbor to keep an eye on your house.

Be Prepared for the Worst

If you set off fireworks, keep a bucket of water handy in case of malfunction or fire. A fire extinguisher should be kept nearby in case of an emergency, especially if you are lighting fireworks on your street.

Follow Instructions

Always follow instructions for lighting fireworks. If fireworks malfunction, don't relight them! Douse and soak them with water, then throw them away. Also, never ignite fireworks in a container, especially one that is glass or metal.

Stay Away from Others

Don't aim fireworks at other people. They can cause severe injury.

By taking a few simple precautions and using common sense, you can enjoy a fun, memorable, and safe Fourth of July while helping protect your loved ones, your neighbors, and your property.

How Long-Term Care Coverage Protects Your Whole Family

Wed, 24 Jun 2026 16:00:13 GMT

What Happens to Your Family if You Don't Have Coverage?

Most of us don't spend much time thinking about what would happen if a serious illness or injury left us needing help with everyday tasks. But it's one of the most important financial questions a family can face, and the time to think about it is before long-term care is needed. In other words, the time to think about it is now.

Consider this… Assisted living facilities and nursing home care can cost upwards of $6,000 a month. Even in-home nursing care averages around $2,000 per month. If you needed that level of care for longer than a few months, where would that money come from?

For most families, the answer is painful. It comes from retirement savings. It comes from the inheritance you spent decades building. And sometimes, it comes from your children.

The Hidden Cost Nobody Plans For

Here's what surprises many people: health insurance, Medicare, and most other traditional coverage are simply not designed to pay for long-term personal care. That includes help with bathing, dressing, getting around the house, and managing daily life. Medicare may cover short-term skilled care under very specific conditions, but it does not cover ongoing personal or custodial care. Medicaid may help in some situations, but qualifying typically requires spending down most of your assets first.

That means, without a plan, the financial burden lands directly on you and your family.

And it's not only a financial burden. When a loved one needs care and no plan is in place, family members often step in to fill the gap themselves. A spouse puts their own health on the back burner. An adult child cuts back work hours or dips into their own savings. Relationships that were built on love and good memories can become strained under the weight of physical, emotional, and financial stress that nobody was prepared for.

The Ripple Effect on Your Legacy

You've likely worked hard to build something for the people you love, like a retirement that provides security, or savings you hoped to pass on to your children.

A long-term care event, without proper coverage, can erode all of that quickly. It's not uncommon for families to see years of savings depleted within a relatively short period of time when care costs are paid entirely out of pocket. What was meant to be a legacy quietly disappears simply because long-term care wasn't part of the conversation.

The earlier you address this, the better positioned you are. Purchasing a policy while you're younger and healthier typically means lower premiums over the life of the policy. Waiting can mean higher costs or, in some cases, limited options.

What Long-Term Care Insurance Can Do

A long-term care insurance policy can help cover a range of services, including in-home care, adult day programs, assisted living, memory care, skilled nursing facilities, hospice services, and respite care for family caregivers. Many comprehensive policies also cover in-home therapies, help with daily activities like meal preparation and housekeeping, and even home modifications such as wheelchair ramps.

For people who want to stay in their own home, the right coverage can make that possible. For families who want to be involved in a loved one's care without being financially or physically overwhelmed by it, coverage creates breathing room.

Every policy is different, and the right plan depends on your needs, your health, and your goals. That's a conversation worth having sooner rather than later.

It's More Than Insurance. It's Protection for Everyone You Love.

Long-term care insurance isn't about expecting the worst. It's about making sure that if something happens, your family has choices. You have choices. The savings you worked to build stay intact. The legacy you wanted to leave behind remains yours to give.

Long-term care insurance is an investment in your family's future.

Ready to learn more? Give us a call and let's talk about what long-term care planning could look like for you and your family.

How to Find the Best Home Health Care

Wed, 17 Jun 2026 16:00:07 GMT

U.S. News & World Report Now Rates Over 12,000 Agencies

Choosing a home health agency for yourself or a loved one is rarely a simple decision — and it often has to be made quickly, during an already stressful time. Now, a trusted and familiar name is stepping in to help make that process a little easier.

In February 2026, U.S. News & World Report released its first-ever Best Home Health ratings, evaluating more than 12,000 Medicare-certified home health agencies across the country. The goal is straightforward: give patients, families, and caregivers an independent, data-backed resource to help guide one of the most important care decisions they may ever face.

What the Ratings Measure

The ratings combine clinical performance measures — such as timely initiation of care and hospitalization outcomes the potential to prevent future hospitalizations— with patient experience surveys to provide a comprehensive assessment of care quality. The underlying data comes directly from the Centers for Medicare & Medicaid Services (CMS), giving the ratings a strong foundation in publicly available, government-reported information.

For agencies with both a Quality of Patient Care Star Rating and a Patient Survey Rating, U.S. News incorporates both by averaging the two measures into a composite score, reflecting performance across multiple dimensions of care.

What the Results Show

Of the approximately 12,000 agencies evaluated, 1,319 earned the "High Performing" Best Home Health distinction for exceeding expectations in care quality and patient experience, while 5,288 were rated "As Expected" for meeting baseline standards.

The ratings also revealed some encouraging findings about what top-performing agencies are actually delivering. Patients treated by top-rated agencies were more likely to improve in key activities of daily living — such as getting out of bed, bathing independently, and taking their medications correctly — compared to patients nationwide. These may sound like small wins, but for someone recovering from surgery or a serious illness at home, they represent meaningful milestones on the road back to independence.

Where the Top Agencies Are

The distribution of top-rated agencies varies widely by state. California leads the nation with 151 best home health agencies, followed by Texas (133) and Florida (105). Availability in other states ranges considerably, so where you live can make a real difference in how many highly rated options are accessible to you.

Why This Matters for Your Coverage

Home health care services — including skilled nursing, physical therapy, occupational therapy, and more — are a critical component of the recovery journey for millions of Americans, and a need predominantly covered by Medicare for seniors when certain eligibility requirements are met. Understanding what your plan covers, and how to access quality care within your benefits, is just as important as knowing which agencies have earned strong ratings.

Experts advise that the search for home care should ideally happen before a hospital stay whenever possible, not during the stress-filled hours following a discharge. Talking with your doctor about home health options ahead of time — and making sure you understand your coverage — can make a difficult situation much more manageable. Coverage of home health services is based on the plan of care provided by your doctor, so ensure the plan clearly and fully describes all the home health care s/he feels is needed.

If you have questions about how your Medicare or insurance plan covers home health services, speaking with a licensed insurance broker can help you understand your options before you need them. A little preparation today can go a long way when it matters most.

Medicare’s New Bridge Program for GLP-1s

Wed, 10 Jun 2026 16:00:04 GMT

Medicare Part D to Cover GLP-1s for Weight Loss

A significant shift in Medicare drug coverage is underway. Starting July 1, 2026, the Medicare GLP-1 Bridge program will temporarily allow coverage of certain weight-loss medications — including Wegovy, Zepbound (KwikPen formulation), and Foundayo — for eligible Medicare Part D beneficiaries.

For many seniors who have struggled with the high cost of these medications, this pilot program represents one of the most notable changes to Medicare prescription coverage in years.

Why This Program Matters

Historically, Medicare has been prohibited by law from covering drugs prescribed specifically for weight loss. That long-standing restriction has put GLP-1 medications financially out of reach for many beneficiaries, with cash prices that can range from roughly $150 to nearly $700 per month, depending on the drug and dosage.

The Bridge program is designed to fill that coverage gap on a short-term basis while the Centers for Medicare & Medicaid Services (CMS) studies whether broader access could improve long-term health outcomes.

How the Bridge Program Works

The Medicare GLP-1 Bridge will run from July 1, 2026, through December 31, 2027 . Here's a quick overview:

Covered medications (as of June, 2026): Wegovy (injection and tablets), the KwikPen formulation of Zepbound, and Foundayo
Monthly copay: A flat $50 per prescription, regardless of dosage
Eligibility requirement: Enrollment in a Medicare Part D standalone plan or a Medicare Advantage plan with drug coverage (MA-PD). See the next section for additional eligibility criteria.
Prior authorization: Required, submitted by your prescribing provider
Processing: Handled through a centralized CMS system rather than individual Part D plans

Because the program operates outside the standard Part D benefit, prescribers and pharmacies will route claims through a central processor designated by CMS.

Who May Be Eligible

Eligibility is based on body mass index (BMI) and related health conditions. According to CMS, a beneficiary must be at least 18 years old and fall into one of these clinical categories at the time GLP-1 therapy is initiated:

BMI of 35 or higher (no additional condition required); or
BMI of 30 or higher , plus a diagnosis of heart failure with preserved ejection fraction, uncontrolled hypertension, or chronic kidney disease (stage 3a or higher); or
BMI of 27 or higher , plus a diagnosis of pre-diabetes, previous heart attack, previous stroke, or symptomatic peripheral artery disease

The medication must also be prescribed alongside structured lifestyle modifications, including nutrition and physical activity guidance consistent with FDA-approved labeling.

It's important to note that beneficiaries already taking GLP-1 drugs for Medicare-covered health conditions such as Type 2 diabetes or certain cardiovascular indications will continue to access those medications through their existing Part D plan. The Bridge program is specifically for weight-loss prescriptions.

A Quick Look at GLP-1 Medications

This class of drugs, GLP-1 receptor agonists, mimic a hormone that helps regulate blood sugar and appetite. They slow digestion, help people feel full longer, and may support meaningful weight reduction when combined with lifestyle changes.

For beneficiaries with weight-related health concerns, sustained weight loss may help with:

Heart disease
High blood pressure
Type 2 diabetes
Sleep apnea
Joint problems

As with any medication, GLP-1 drugs carry potential side effects and aren't right for everyone. Conversations with a qualified provider are essential.

Important Limitations to Understand

While the Bridge program offers significant savings, there are a few notable trade-offs:

The $50 copay does not count toward the Part D deductible or the annual out-of-pocket prescription drug spending cap
Part D low-income subsidies (Extra Help) cannot be applied to these prescriptions
The program is temporary (for now), ending December 31, 2027
Studies suggest many people regain weight after stopping GLP-1 therapy, which raises important planning considerations once the program concludes

What Happens After 2027

CMS originally designed the Bridge as a transition to a longer-term initiative called the BALANCE Model (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth). However, the timeline and structure of that model are still evolving, and ongoing access to GLP-1s for weight loss beyond 2027 is not yet guaranteed.

Beneficiaries who benefit from the Bridge program will want to review their drug plan options carefully during future Annual Enrollment Periods to understand what coverage may be available.

Recap

The Medicare GLP-1 Bridge represents a temporary, targeted opportunity for eligible Part D beneficiaries to access weight-loss medications at a more predictable cost. Like any pilot program, the details may continue to evolve as CMS releases additional guidance.

If you think you may qualify, the best first step is a conversation with your health care provider about whether a GLP-1 medication fits your overall health picture. For program specifics, visit CMS.gov or Medicare.gov , or call 1-800-MEDICARE (1-800-633-4227).

Brain Health, Medicare, and You

Wed, 03 Jun 2026 18:29:32 GMT

Honoring Alzheimer's & Brain Awareness Month

Every June, the Alzheimer's Association invites us to recognize Alzheimer's & Brain Awareness Month. It’s a chance each year to learn and take meaningful steps toward better brain health. For Medicare beneficiaries and the loved ones who care for them, it's also a great time to understand how Medicare can support cognitive health at every stage.

What is Alzheimer’s Disease?

Alzheimer's disease is a progressive brain disorder that gradually destroys memory, thinking skills, and the ability to carry out everyday tasks. It is the most common cause of dementia in older adults, accounting for an estimated 60–80% of cases, and typically develops slowly over many years.

According to the Alzheimer's Association, an estimated 7 million Americans aged 65 and older are living with Alzheimer's disease, and that number is expected to grow as the overall population ages. And Alzheimer's isn't the only concern. Other forms of dementia, mild cognitive impairment, and reversible conditions like depression, anxiety, or medication side effects can affect memory and thinking.

While there is currently no cure for Alzheimer’s, early diagnosis can open the door to treatments, support resources, and planning options that may help individuals and their families navigate the condition.

How Medicare Supports Cognitive Health

Medicare includes several benefits designed to help beneficiaries stay on top of their brain health. Here are a few worth knowing about:

The Yearly "Wellness" Visit

If you've had Medicare Part B for longer than 12 months, you get a yearly Wellness Visit once every 12 months. This isn't a physical exam; it's a personalized visit to help you and your provider build a plan to prevent disease or disability based on your current health.

During this visit, your doctor will perform a cognitive assessment to look for signs of dementia, including Alzheimer's disease. Signs of cognitive impairment can include trouble remembering, learning new things, concentrating, managing finances, or making everyday decisions.

Under Medicare, you pay nothing for the yearly wellness visit if your doctor or other health care provider accepts Medicare assignment.

Cognitive Assessment & Care Plan Services

If your provider notices signs of possible cognitive impairment, Medicare covers a separate, more in-depth visit. During this appointment, your doctor or other health care provider may:

Perform a physical and neurological exam
Review your medical history, and look over your medications
Identify your support system and what caregivers may be able to help with
Create a care plan to address and manage symptoms
Refer you to a specialist, if needed
Share information about community resources, such as rehabilitation services, adult day health programs, and support groups

A spouse, friend, or caregiver is welcome to attend this visit to help share information and ask questions. The Part B deductible and coinsurance apply for this visit.

Additional Dementia Support

Some people living with dementia and their unpaid caregivers may be able to get additional support through the Guiding an Improved Dementia Experience (GUIDE) Model without paying coinsurance. This powerful program provides coordinated services that include care navigation, training and education for caregivers, connections to community resources for dementia, 24/7 access to a support line, and respite services up to $2,500 annually. Not every provider participates, so ask your health care provider whether this program is available to you.

For more information on covered treatments for Alzheimer's disease, visit Medicare.gov.

Brain-Healthy Habits Count, Too

Medical care is just one piece of the puzzle. Many health organizations also point to everyday habits that may support cognitive wellness, such as:

Staying physically active
Eating a balanced, nutritious diet
Getting consistent and quality sleep
Staying socially connected with friends, family, and community
Challenging your brain with reading, puzzles, learning, or new hobbies
Managing chronic conditions like high blood pressure, diabetes, and hearing loss

These habits don't replace medical care, but they can complement and support the preventive benefits Medicare offers.

For Caregivers: You're Not Alone

Caring for someone with memory loss is very demanding. If you're a caregiver, remember that Medicare-covered cognitive care visits are designed with you in mind, too. You can attend appointments, ask questions, and help your loved one develop a clear care plan together. Organizations like the Alzheimer's Association (alz.org) and the Eldercare Locator (eldercare.acl.gov) also offer free resources, support groups, and 24/7 helplines. Don’t neglect your own health, especially your mental health, as you go through this journey.

Take a Moment This June

Alzheimer's & Brain Awareness Month is a reminder to ask questions, schedule that wellness visit, and have honest conversations with the people you love. Brain health is part of overall health, and Medicare offers meaningful tools to help you protect it.

If you have questions about which services your specific Medicare coverage includes, reach out to us for a review.

Know the Signs of a Medicare Scam

Wed, 18 Jun 2025 16:15:43 GMT

It's important to know the signs of a Medicare scam so you can protect yourself. To get your personal information, like your Medicare number, scammers may call, text and email saying things like:

"You need to activate or renew your Medicare card."

"We'd like to send you a free genetic testing kit."

"Medicare has authorized us to send you a free (knee, back or elbow) brace."

"You qualify for a refund on your Medicare costs."

Remember, never give your Medicare card or number to anyone except your doctor or people you know should have it.

Keep in mind: Caller IDs and email addresses can be faked, so if you're not sure who's calling, call us at 1-800-MEDICARE ( 1-800-633-4227 ). And remember, Medicare will never contact you unless you've contacted us first.

Medicare Part D Update

Wed, 18 Jun 2025 15:43:32 GMT

Say Goodbye to the Donut Hole in 2025

If you’re enrolled in Medicare—or helping a loved one navigate their options—you’ve likely heard the term “donut hole” when it comes to prescription drug coverage. But unlike an actual donut, this Medicare term hasn’t been a sweet treat for beneficiaries.

What Was the Medicare Donut Hole?

The “donut hole” referred to a coverage gap in Medicare Part D prescription drug plans. After enrollees reached an initial coverage limit for medications, they entered this gap—where they had to pay a significantly larger share of their drug costs out of pocket. For many, particularly those living on fixed incomes or managing chronic health conditions, this coverage gap created financial strain and made accessing essential medications more difficult.

Over the past decade, the Affordable Care Act gradually reduced the financial burden of the donut hole, but it never fully eliminated it. For many Medicare beneficiaries, the gap remained confusing, frustrating, and costly.

The Good News: The Donut Hole Is Officially Closed

Starting January 1, 2025 , the donut hole will be a thing of the past.

Thanks to the Inflation Reduction Act , Medicare Part D plans will implement a hard cap on out-of-pocket spending. Once you’ve spent $2,000 on covered prescription drugs in a calendar year, you won’t pay anything more for medications for the rest of that year .

This is a major win for seniors and individuals with disabilities who rely on Medicare for affordable access to prescriptions. The new law creates a simpler and more predictable system that’s easier to understand—and budget for.

What This Means for Medicare Beneficiaries

Here’s how this change can benefit you or your loved ones:

✅ Predictable Costs – No more guessing how much your prescriptions will cost once you reach the coverage gap. You’ll know your financial limit up front.

✅ Better Access to Medications – With fewer cost barriers, you’re more likely to stay on track with essential prescriptions.

✅ Peace of Mind – Whether you take one medication or several, this change provides greater financial security and easier planning.

Looking Ahead

As the 2025 change approaches, it’s a good idea to review your current Medicare Part D plan, assess your prescription needs, and understand how these updates may affect your costs.

If you have questions about your Medicare coverage or want help navigating your options, now is the perfect time to reach out. We're here to make Medicare easier to understand—and to help you get the most from your benefits.

Need help reviewing your Medicare drug plan for 2025?
Contact us today for clear, personalized guidance.