WhatSupp Insurance Solutions LLC

CMS Just Declared War on Waste and AI Is Leading the Charge What Prior Authorization in Medicare Actually Means and Why It Matters Now If you’re in the Medicare space, you’ve probably heard the news: CMS is bringing prior authorization to Original Medicare. But before you assume this is another bureaucratic burden, let’s take a closer look.

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Once Upon a Time in Medicareland… Back in the good ol’ days—before hospital bean counters ruled the world—if you were 65 or older and on Medicare, you had what felt like a golden ticket: 60 full days in the hospital, paid 100% by Medicare (after your Part A deductible). No coinsurance.

This is good news for people on Medicare!

Medicare payment rates to rise by 5.06% in 2026.
The CMS announced a 5.06% increase in Medicare payment rates for 2026, significantly higher than the 2.2% increase proposed in January. The higher rate takes into account payment data through the fourth quarter of last year, according to the CMS.

Medicare payment rates to rise by 5.06% in 2026 The CMS announced a 5.06% increase in Medicare payment rates for 2026, significantly higher than the 2.2% increase proposed in January. The higher rate takes into account payment data through the fourth quarter of last year, according to the CMS.

Congress averts Medicare cut, extends telehealth
Congress has reached a deal to partially mitigate a 2.8% Medicare pay cut for physicians by providing a temporary 2.5% payment increase through the Medicare Physician Fee Schedule. The deal, part of a continuing resolution to prevent a government shutdown, extends telehealth flexibilities through 2026 but omits the Improving Seniors' Timely Access to Care Act, which aimed to reform prior authorization in Medicare Advantage.

Congress averts Medicare cut, extends telehealth Congress has reached a deal to partially mitigate a 2.8% Medicare pay cut for physicians by providing a temporary 2.5% payment increase through the Medicare Physician Fee Schedule. The deal, part of a continuing resolution to prevent a government shutdown, extends telehealth flexibilities through 20...

Friends and clients, this is probably the most important year to schedule your annual review with us because your Medicare coverage will be impacted by the Inflation Reduction Act and the $2,000 max-out-of-pocket (MOOP) limit on Prescription Drug Plans (PDP).

Prescription Drug Plan / Part D: The $2,000 max-out-of-pocket (MOOP) limit on PDPs will help reduce costs for some of you with expensive prescriptions, but the premiums are going to increase for everyone. Additionally, deductibles will increase, some plans will likely cease to exist, and others will no longer cover your medications. Not reviewing could cost you thousands of dollars, force you to change medications, or leave you without any coverage.

Medicare Advantage Prescription Drug (MAPD) plans / Part C: We have heard that many of your plans are ending, you will be without coverage if you do nothing. However, we can help you switch to another MAPD with benefits less impacted by the new regulations.

While Medicare is taking steps to mitigate potential premium increases through a new demonstration program https://www.kff.org/medicare/issue-brief/what-to-know-about-medicare-part-d-premiums/ it is essential that you review your coverage this year. Please schedule your annual consultation so we can help you avoid the major disruptions.

You can schedule your annual review at www.What-Supp.net .

WhatSupp Insurance Solutions, LLC – Making Medicare Simple By helping you understand what Medicare does and doesn’t cover, you’ll avoid gaps in coverage, pitfalls, and penalties.

Medicare’s Annual Enrollment Period (AEP) is fast approaching.
It runs Oct 15th thru Dec 7th with new plans beginning Jan 1st.
AEP is the only time, in most situations, that you are allowed to make a change to your plan.

Since our calendars fill up quickly, we recommend scheduling your review now. You can schedule your AEP review or New Client consultation on our website.

WhatSupp Insurance Solutions, LLC – Making Medicare Simple By helping you understand what Medicare does and doesn’t cover, you’ll avoid gaps in coverage, pitfalls, and penalties.

Retirees with MA plans likely to spend less on health care A healthy 65-year-old man retiring this year with a Medicare Advantage Part D plan is expected to spend $128,000 on health care expenses throughout his lifetime, and a woman with the same coverage is expected to spend $147,000, according to the Milliman Retiree Health Cost index. The costs are much....

This Memorial Day, our office will be closed as we pay our respects to the brave men and women who made the ultimate sacrifice for our freedoms. We invite you to join us in this important and solemn remembrance.

Should questions or needs arise while we are out office, our team will address them when we resume regular business hours on Tuesday, May 28.

A study found that individuals who drank at least 2 liters of artificially sweetened beverages per week had a 20% increase in the risk of atrial fibrillation. The study, published in the journal Circulation: Arrhythmia and Electrophysiology, linked drinking 2 liters of sugar-sweetened beverages to a 10% higher risk of atrial fibrillation, while having 1 liter of unsweetened fruit or vegetable juice weekly was associated with an 8% lower risk.

Study links AFib risk to sweetened beverage consumption A study found that individuals who drank at least 2 liters of artificially sweetened beverages per week had a 20% increase in the risk of atrial fibrillation. The study, published in the journal, linked drinking 2 liters of sugar-sweetened beverages to a 10% higher risk of atrial fibrillation, while...

The Medicare Prescription Payment Plan seeks to allow seniors to spread out their Medicare prescription drug costs over the year, rather than requiring them to pay in one lump sum.

CMS releases 2nd guidance on Part D monthly payment program The CMS issued a second draft guidance for the Medicare Prescription Payment Plan, a new program taking effect next year that will allow Part D beneficiaries to pay their out-of-pocket costs in monthly installments spread over one year. The guidance outlines education, outreach and communication req...