CMS has suspended Gold Kidney of Florida from enrolling new members into one of its Medicare Advantage plans after state regulators found significant compliance and financial oversight failures. On Sept. 12, the Florida Office of Insurance Regulation issued a consent…
Payer
Only 20% of Humana members are currently enrolled in Medicare Advantage plans with at least four stars for 2026, according to regulatory filings from the insurer. Preliminary 2026 Medicare Advantage star ratings data was available on CMS plan finder on…
Older, medically complex Medicaid beneficiaries are among those most at risk of losing coverage due to work requirements, according to a study published Oct. 1 in JAMA. A team led by researchers at Yale University in New Haven, Conn., used…
As the Medicare annual open enrollment period kicks off this month, some older adults struggle with choosing a plan. Three-quarters of beneficiaries said the process is confusing, according to an Oct. 1 eHealth poll. “This is not the year for…
From Oct. 15 to Dec. 7, older adults can select from a range of Medicare Advantage plans. Here are updates from the biggest insurers so far: UnitedHealthcare The insurer’s Medicare Advantage plans will reach 94% of those eligible, compared to…
Advertisement
Big insurers — from Humana to Cigna — are shying away from Medicare Advantage, exiting “unprofitable” markets, axing commission payments and even selling their businesses entirely. Now, other insurance companies have a chance to step up and gain market share,…
Almost half of Medicare Advantage enrollment growth since 2024 has been driven by special needs plans, according to an analysis from KFF. 4 notes on special needs enrollment in 2025: 1. In 2025, 21% of MA enrollees are in SNPs.…
Catastrophic health events — such as brain injuries and amputations — are life altering for patients, but these claims also weigh on insurers. From rising utilization and medical costs to expanded eligibility for catastrophic health coverage, the role of these…
Viva Health, under the University of Alabama at Birmingham Health System, said it is investigating a data breach involving 4,945 individuals’ data, according to a news release from Sept. 26 shared with Becker’s. The insurer found a file on its…
AmeriHealth Caritas, a managed care organization, is growing its Medicare Advantage offerings, focusing on its Medicare-Medicaid dual-eligible special needs plans, according to a news release shared with Becker’s. In 2026, the insurer’s MA dual-eligible offering will be available in new…