Medicare Advantage

Medicare officials defend the use of home visits that often spot medical conditions that are never treated.

People will be able to sign up for 2025 coverage between Oct. 15 and Dec. 7. Experts say the potential changes make it important for shoppers to study closely any coverages they expect to renew.

New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges. What is the Centers for Medicare & Medicaid Services doing about it?

A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.

President Joe Biden is campaigning on his efforts to cut drug costs for Medicare patients. But independent pharmacists say one strategy makes it unaffordable for them to keep some brand-name medicines in stock.

Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are stuck in the middle, but there’s a way out.

As enrollment in Medicare Advantage plans grows, so do concerns about how well the insurance works, including from those who say they have become trapped in the private plans as their health declines.

Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.

Positive Healthcare is a Medicare Advantage plan and includes prescription drug coverage for people with HIV or AIDS. Also known as PHP, it has offered coverage in Broward, Miami-Dade and Duval.

Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and predicts what kind of care an individual will need. New rules will ensure humans are part of the process.