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ACA Open Enrollment Is Changing for 2027

Thu, 23 Jul 2026 06:00:04 GMT

Here's What You Need to Know

If you have a health plan through the ACA Marketplace, your renewal or enrollment window is getting shorter for the 2027 plan year. The sign-up period now ends in December, and the old February start date is going away. Read on for what changed and why it matters for you.

The Enrollment Window is Shorter

For the last few years, most people had until January 15 to enroll or renew in a Marketplace plan. Starting in 2026, open enrollment will end one month earlier, on December 15 in many states. In most states, sign-ups still open on November 1, 2026.

Two states start even earlier. In Idaho, open enrollment begins on October 15, and in Georgia it begins on October 19.

Enrollment Periods at a Glance

Here's the national schedule for states that use HealthCare.gov, which covers most of the country:

Enrollment Start : November 1, 2026
Enrollment End : December 15, 2026
Coverage starts : January 1, 2027

Known Enrollment Timeframes for Some State-Run Exchanges

Some states run their own exchanges and set their own deadlines. State-run exchanges can extend enrollment later than December 15, but not past December 31. Here are the 2026 ranges announced so far (for 2027 coverage). Dates can still change, so confirm with your state's marketplace before you enroll.

States starting early:

Idaho: Oct 15 – Dec 15, 2026

Georgia: Oct 19 – Dec 15, 2026

Extended deadlines:

Nov 1 – Dec 23, 2026: Massachusetts

Nov 1 – Dec 31, 2026: CA, CO, CT, KY, MD, MN, NV, NM, OR, RI, VA, WA

If your state is not listed here, you likely follow the national schedule above, with a November 1 to December 15 window.

No More February 1 Start Date

In past years, if you signed up after mid-December, your coverage started February 1. That option is going away. All plans selected during open enrollment will take effect on January 1.

What You Can Do Now

Mark your calendar for November 1, 2026. Know your state's exact deadline. And if you have questions about your plan or your options, we are here to help. Acting early gives you time to compare and helps you avoid a coverage gap.

How to Help Your Employees Avoid the 6 Most Common Health Insurance Selection Mistakes

Wed, 15 Jul 2026 06:00:12 GMT

Helping Your Team Get the Most Out of Their Benefits

Open enrollment is one of the most important, and most misunderstood, moments in your employees' year. Most employees spend less than 30 minutes reviewing their options before making a decision that affects their health and finances for the next 12 months. The result? Many end up in plans that don't fit their needs, face unexpected medical bills, and grow frustrated with benefits they don't fully understand.

As an employer, you can't make the decision for them, but you can make sure they have the information and support they need to choose wisely. Here are six of the most common mistakes employees make during open enrollment, and how you can help them avoid each one.

1. Choosing a Plan Based Only on the Monthly Premium

The lowest-premium plan is almost always the first thing employees gravitate toward. It's easy to understand why, because that number shows up on every paycheck. But premium is only one piece of the cost picture.

A plan with a lower monthly contribution may carry a significantly higher deductible, higher copays, and a higher out-of-pocket maximum. For an employee who needs regular care, that lower-premium plan can end up costing considerably more over the course of the year.

How you can help: During open enrollment communications, show employees the total cost picture, not just the premium. Side-by-side plan comparisons that include deductibles, copays, and out-of-pocket maximums give employees a much clearer basis for decision-making. Real-world examples (e.g. "if you have a $5,000 medical event, here's what you'd pay under each plan") can be especially effective.

2. Not Checking Whether Their Doctors Are In-Network

Employees often assume their current doctors are covered under any plan you offer. That assumption can be costly. If a preferred physician, specialist, or hospital is out-of-network, employees may face significantly higher bills or, in some cases, no coverage at all.

How you can help: Remind employees to verify their providers before enrolling, not after. Include clear instructions on how to use each carrier's provider search tool, and encourage them to check not just their primary care physician but also any specialists they see regularly.

3. Overlooking Prescription Drug Coverage

For employees who take ongoing medications, prescription drug coverage can be just as important as medical coverage, and sometimes more so. A drug that's covered affordably under one plan may fall into a much higher cost tier under another.

How you can help: Encourage employees to look up their specific medications in each plan's formulary before making a selection. If you have employees with chronic conditions or ongoing prescriptions, this step alone can save them hundreds of dollars over the course of the year. Consider including a brief "how to check your formulary" guide in your open enrollment materials.

4. Picking the Wrong Deductible for Their Situation

Some employees automatically choose the lowest deductible plan regardless of their health needs. Others choose a high-deductible plan to save on premiums without fully understanding what that means if they need care. Neither approach is right for everyone.

A high-deductible health plan paired with a Health Savings Account (HSA) can be an excellent option for younger, healthier employees who want to manage costs and build savings. For employees who visit doctors frequently, take ongoing medications, or have chronic conditions, a lower deductible plan may offer better overall value.

How you can help: Provide employees with a simple self-assessment, something as straightforward as "how often did you use your health insurance last year?" that helps them think through which plan structure fits their actual healthcare habits. If you offer an HSA-eligible plan, make sure employees understand the tax advantages and how to use it.

5. Not Understanding the Out-of-Pocket Maximum

The out-of-pocket maximum is arguably the most important number in a health insurance plan, and one of the least understood. For employees facing a serious illness, surgery, or unexpected medical event, this number is the difference between a manageable financial situation and a devastating one.

How you can help: Make the out-of-pocket maximum a centerpiece of your open enrollment education, not an afterthought. Help employees understand that a plan with a slightly higher premium but a lower out-of-pocket maximum may offer far greater financial protection in a worst-case scenario. Frame it simply: "This is the most you would ever pay in a single year."

6. Not Taking Advantage of Their Insurance Advocate

Many employees don't realize that when they enroll in a health insurance plan, they have access to an advocate, typically your broker or benefits team, whose job is to help them understand and use their coverage. Instead of asking for help, employees often struggle through confusing situations on their own, leading to unnecessary stress, claim errors, underutilized benefits, and unresolved billing issues.

How you can help: Make it clear during open enrollment and throughout the year that your employees have a resource available to them. Let them know your broker or benefits team can help explain how coverage works, assist with prior authorizations, help resolve claim issues, and answer questions about medical bills. A simple reminder at the start of the plan year can make a significant difference in how confidently your employees engage with their benefits.

Open Enrollment as an Employee Communications Opportunity

A well-chosen health insurance plan is one of the most valuable things an employee has access to, but only if they understand it. Employers who invest in clear, accessible open enrollment education don't just help their employees make better decisions. Employers who follow these guidelines can reduce frustration, build trust, increase positive benefits utilization, and demonstrate that the benefits they offer are genuinely designed to help.

Are You Getting Enough Nutrients on a GLP-1? | What to Know

Wed, 08 Jul 2026 06:00:16 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.

Your HSA Is One of the Best Financial Accounts You're Probably Not Using

Mon, 06 Jul 2026 06:00:01 GMT

How You Can Cut Your Tax Bill Today and Build Value for Tomorrow

If you have a high-deductible health plan and you're not contributing to a Health Savings Account, y ou're leaving real money on the table every year.

That's not an exaggeration. An HSA is one of the most useful financial tools available to working adults, and most people either don't have one or aren't using it to its full potential.

Here's what you need to know.

What Is an HSA, Exactly?

An HSA is a health savings account tied to a high-deductible health plan (HDHP). You contribute money to it, and you can use those funds to pay for qualified medical expenses, like doctor visits, prescriptions, dental work, vision care, and more. You access the funds with a debit card tied to the account, or through reimbursements to your bank account.

But here's what makes it different from a basic savings account.

The Triple Tax Advantage

Financial professionals love to talk about this, and for good reason. HSAs are often described as triple tax-advantaged.

Contributions are made with pre-tax dollars, meaning they come from your paycheck before taxes are assessed
The money in the account grows tax-free through interest or investment earnings
When funds are withdrawn for qualified medical expenses, those withdrawals are also tax-free

No other account in the U.S. tax code does all three of those things at once. Not a 401(k). Not a Roth IRA. Just an HSA.

Here's what that looks like in practice. If you're in the 24% federal tax bracket and contribute the full individual limit of $4,400 in 2026, you save $1,032 in federal income taxes alone. If you contribute through payroll deductions, you also avoid FICA taxes, saving an additional 7.65% on those contributions.

Your employer may also contribute to your HSA on your behalf, which makes it even better.

The Money Never Expires

This is the part that surprises most people. An HSA is nothing like a Flexible Spending Account (FSA), where you lose any unused funds at the end of the year. Unlike FSAs, HSA funds roll over from year to year with no expiration. You own the account, and it stays with you even if you change jobs. It's your money.

That means if you're in your 20s or 30s and relatively healthy, you can contribute every year and let that money grow for decades, then use it to cover medical expenses later in your life.

What You're Missing By Not Having One

If you have an HDHP and no HSA, here's a simple way to think about the cost of inaction.

Every dollar you put into an HSA reduces your taxable income. Every dollar that grows in the account does so tax-free. Every dollar you spend on qualified medical expenses comes out tax-free. If you're not contributing, you're paying more in taxes than you have to, and you're missing years of compounding growth on money you were going to spend on healthcare anyway.

It Can Work Like a Retirement Account

Here's the part most people miss entirely.

A family maxing out their HSA for 30 years could accumulate over $800,000 in tax-free medical money. That's a significant number.

One strategy worth knowing: pay your medical expenses out of pocket now, save your receipts, and let your HSA balance grow invested. There's no deadline for reimbursing yourself. You can reimburse yourself for past medical expenses at any time, as long as you save the receipts. That means years from now, after you have allowed the money in your HSA to grow via investments, you could pull tax-free cash from your HSA to cover expenses you paid out of pocket earlier in your life.

And after age 65, the rules get even more flexible. After age 65, you can withdraw HSA funds for any purpose without penalty. Non-medical withdrawals are taxed as ordinary income at that point, similar to a traditional IRA, but medical withdrawals remain completely tax-free.

How to Get Started

First, check whether your current health plan is HSA-eligible. Your plan documents or HR department can confirm this. If you have an HDHP, you can open an HSA through your employer's benefits platform or directly through many banks and financial institutions.

Start with whatever you can contribute, even if it's not the maximum. Set up automatic contributions if possible. And keep your receipts for any medical expenses you pay out of pocket.

The earlier you start, the more time your money has to grow.

How to Have a Safe 4th of July Celebration

Mon, 29 Jun 2026 17:46:45 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.

Hidden Health Plan Cost Drivers Employers Shouldn’t Ignore

Mon, 29 Jun 2026 06:00:05 GMT

The Health Plan Cost-Reduction Opportunities That Are Flying Under Your Radar

Premium hikes get all the attention. But for many employers, the bigger cost problems a re hiding in plain sight. They're embedded in gaps your current plan may not be addressing at all, and year after year they quietly add up.

Here are three areas worth a closer look.

Addiction Support Services

Behavioral health, and particularly substance use disorders, remains one of the most expensive and least efficiently managed areas of employer-sponsored health care.

Untreated mental health and addiction issues contribute to higher medical claims, absenteeism, and lost productivity. According to the Center for Prevention and Health Services, untreated mental health concerns can cost a single organization tens of thousands of dollars annually and amount to more than $100 billion nationwide.

Despite those figures, addiction and recovery services have historically received less attention than other wellness initiatives. Inpatient treatment models can be disruptive for employees and expensive for employers, while high relapse rates have made some organizations hesitant to invest more heavily in this space.

But that hesitation has a price tag that shouldn't be ignored.

Employer opportunity: More employers are moving toward structured recovery programs that emphasize ongoing support, medication-assisted treatment, and measurable outcomes. It's a shift from one-time intervention toward sustained accountability, and early results are promising.

Improving Access to Specialty Care

Employees may technically have coverage, but long wait times for specialists can delay treatment and worsen underlying conditions. Nationally, more than 100 million specialty referrals are issued each year, yet patients in many metropolitan areas wait more than a month to see specialists such as gastroenterologists, dermatologists, or cardiologists.

When employees cannot access specialty care in a timely manner, they are more likely to rely on emergency rooms or urgent care, which drives up costs.

Employer opportunities: Some employers are responding by supplementing traditional plans with specialty telehealth solutions or third-party platforms that shorten wait times and improve care coordination.

Before adding anything, it's worth surveying your employees directly. You may find the gaps are more specific, or more serious, than you expected. This allows you to target the most impactful solutions.

Using Your Own Data

Most employers have more information about their workforce's health patterns than they realize, but many just aren't using it.

Carrier-provided dashboards, health risk assessments, and plan modeling tools can show you where utilization is running high, where employees aren't engaging with available programs, and where cost trends are moving in the wrong direction.

Employer opportunities: Reviewing claims data quarterly, rather than annually, gives you a much clearer picture of what's working and what isn't. Understanding which programs are being under-utilized can show you where you have education opportunities with your workforce. Closely assessing usage data for all areas of your benefits package can allow an employer to spot waste, redirect spending, and build a benefits package that actually reflects how employees use their coverage rather than relying on theoretical models. You can also quickly spot which interventions are producing results and which benefits areas are at risk.

That kind of visibility allows organizations to refine benefits with greater precision and financial discipline.

A Practical Starting Point

Rising health care costs aren't going away anytime soon, but understanding where the less obvious cost drivers are gives you a better chance of addressing them.

Start by auditing what data you already have access to. Work with your broker to find solutions to specialty access gaps in your area. And take an honest look at how your current plan handles behavioral health and addiction support.

Small adjustments in these elements of your health plan can have a real impact on the people who are depending on your plan, and on your bottom line.

Brain Health, Medicare, and You

Mon, 22 Jun 2026 23:17:20 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.

Medicare’s New Bridge Program for GLP-1s

Mon, 22 Jun 2026 21:29:22 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 w ill 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).

Safe Travel Starts at Home: 7 Tips for a Healthy Vacation

websitehelp@agencybloc.com (Agency Bloc) — Wed, 11 Mar 2026 19:33:32 GMT

Whether you’re planning a weekend getaway or a long-awaited international adventure, setting off on a trip is always exciting—but can also be unpredictable. That’s why preparing for the unexpected, especially when it comes to your health, is essential. Knowing what your medical coverage includes (and doesn’t) while traveling can help you stay healthy, avoid costly surprises, and soak up the unforgettable moments on your journey.

Let’s walk through some proactive steps you can take before packing your bags—from vaccinations and insurance to emergency planning and fraud protection.

1. Know What Your Health Plan Covers—And Where

Medical surprises aren’t on anyone’s itinerary—but it’s best to be prepared. Start by knowing how your insurance policy covers (or doesn’t) the region you’re traveling to.

Individual health policyholders, review your insurer’s network coverage. Some plans only cover in-network or state-specific services, while others offer broader emergency coverage or travel-specific riders. Consult your insurance agent to get help reviewing your policy.

Medicare beneficiaries, Original Medicare (Parts A & B) typically doesn’t cover medical care outside the U.S., except in limited circumstances. If you have a Medicare Advantage Plan, it may include emergency and urgent coverage abroad, but this varies by provider. Check your plan’s Evidence of Coverage or speak to your plan representative before traveling.

2. Consider Supplemental Insurance

If you're a frequent traveler or heading abroad, look into some options to help cover you. Some options include:

Travel Medical Insurance : Plans offer emergency coverage during trips outside the U.S. and tend to be affordable.
Evacuation Insurance : This covers transport to a qualified medical facility if the nearest care is inadequate. An evacuation clause is often, but not always, included in a travel insurance plan.
Medicare Supplement Insurance (Medigap) : Some Medigap policies cover emergency care abroad, typically up to plan limits and with a deductible.
Critical Illness Insurance : A lump-sum payout can provide financial flexibility in case you’re diagnosed with a covered condition like a heart attack or stroke during travel.

Be sure to read the fine print—some policies require you to be under a certain age, and preexisting conditions may not be covered. Your licensed insurance agent can help talk you through your options.

3. Keep Your Medical Info Handy

Consider using a secure health app or digital wallet to access all your health records quickly. But just in case your phone is inaccessible, bring physical copies of these important documents as well:

Your insurance or Medicare cards
Emergency contact numbers (include the country code +1 if you’re traveling abroad)
A medication list with dosages
Allergy and medical condition alerts

Pack all essential paperwork together in a waterproof sleeve in your luggage, and leave a second copy with someone back home.

4. Schedule Preventive Care Before Departure

Most insurance plans cover preventive care services like wellness visits, vaccinations, and screenings. Before your trip, check these tasks off your list:

Get vaccinated : Make sure you’re up to date on your flu, COVID-19, and tetanus shots. If traveling internationally, check the CDC recommendations for the region you’re visiting, which may include Hepatitis A/B, typhoid, or yellow fever vaccinations.
Stock up on medications : Make sure you have enough for your entire trip, including extras in case of delays. Some health insurance plans offer mail-order pharmacy options.
Visit your provider : Discuss any destination-specific risks and request a travel health consultation if needed.

5. Prepare for Fraud Protection Abroad

Travelers are common targets for scams. If you’re a Medicare beneficiary, protect your Medicare number like a credit card. Fraudsters may try to use it to get free services or access your personal health data.

Tips:

Never share your Medicare number via phone or email.
Use only official websites or verified agents to review your policy while traveling.
Regularly check your policy’s Explanation of Benefits (EOB) for suspicious claims.

6. Create a Medical Emergency Plan

Ask yourself some questions to be ready for an emergency:

Where is the nearest hospital or clinic?
Do they accept your insurance?
What’s the procedure if you need medical evacuation?

If you have any medical conditions, it’s wise to carry an alert card in your wallet, including translated versions if you’re traveling in areas where English is not commonly spoken.

7. Stay Active and Healthy on the Go

To adapt an old phrase: Health never takes a vacation . It’s all too easy to leave good habits behind when you head out on a trip, but taking care of your body is just as important whether you’re at home or away.

Move regularly : Stretch and walk every few hours, especially on long flights or bus rides.
Hydrate, hydrate, hydrate! Drink plenty of water to counter the effects of extra activities, extra sun—and maybe that extra mai tai on the beach.
Eat balanced meals: Meals on the go tend to lack a healthy dose of fiber, which can lead to digestive distress. Be sure to seek out veggies and whole grains or consider bringing a fiber supplement with you.
Rest : Fatigue lowers immunity. Don’t skip on sleep!
Keep germs at bay: Use hand sanitizer, wash your hands frequently, and consider wearing a mask on crowded airplanes or mass transit.

Don’t forget these essentials to keep yourself feeling your best—so you can focus on making great memories.

Conclusion

Travel is one of life’s great joys—but staying healthy and protected while you’re away starts long before you leave home. By understanding your health insurance benefits, considering supplemental coverage, and taking simple precautions, you can set off with confidence. Whether you’re hiking the Rockies or relaxing on a beach in Mexico, being prepared means you can focus on the adventure ahead.

Safe travels!

How Telehealth Is Changing Healthcare for Patients of All Ages

websitehelp@agencybloc.com (Agency Bloc) — Wed, 11 Mar 2026 19:33:30 GMT

As healthcare continues to evolve with technology, telehealth has emerged as a powerful tool for delivering care—breaking down traditional barriers and expanding access for millions of Americans.

Whether you're enrolled in Medicare or are under 65 and navigating your own insurance options, telehealth services offer an array of features and benefits that improve convenience, affordability, and health outcomes.

What is Telehealth?

Telehealth refers to the delivery of healthcare services through digital platforms—such as video calls, phone consultations, or secure messaging—allowing patients to connect with medical professionals remotely. It encompasses a wide range of services, from general wellness visits and chronic disease management to mental health counseling and urgent care.

Telehealth for Medicare Beneficiaries

Medicare has embraced telehealth, especially since the COVID-19 pandemic, making it more accessible than ever. Key benefits include:

1. Expanded Access to Care

Medicare covers telehealth visits with primary care providers, specialists, and mental health professionals—even from the comfort of your home. This is especially valuable for individuals with mobility issues or those living in rural areas with limited local medical resources.

2. Chronic Condition Management

Many Medicare recipients manage ongoing health concerns like diabetes, high blood pressure, or heart disease. Telehealth enables regular check-ins with care teams, medication management, and personalized treatment adjustments—without the need for in-person visits.

3. Mental Health Services

Under Medicare Part B, beneficiaries can access remote behavioral health services, including therapy and psychiatric evaluations. These services are now covered even if the patient is at home, improving accessibility and comfort.

4. Cost Savings

Telehealth visits are often billed at the same rate as in-person visits under Medicare. With reduced transportation costs and less time spent in waiting rooms, it’s a more cost-effective option for many.

Telehealth for Individuals Under 65

For younger adults and families not yet on Medicare, telehealth is increasingly built into private insurance plans, Medicaid, and employer-sponsored coverage. Here’s what to expect:

1. Convenience and Flexibility

Busy schedules, child care responsibilities, and long commutes often make it difficult to attend in-person doctor appointments. Telehealth removes these obstacles by offering flexible appointment times—including evenings and weekends.

2. Affordable Urgent Care

Many virtual health platforms now offer low-cost urgent care services—ideal for common conditions like colds, UTIs, rashes, or minor injuries. Some plans even provide 24/7 access to physicians for a flat monthly fee or copay.

3. Access to Specialists

Need to consult a dermatologist, endocrinologist, or nutritionist? Telehealth makes it easier to see specialists who may not be located nearby. Some networks even facilitate second opinions from top-tier institutions.

4. Mental and Behavioral Health Support

The stigma around mental health is fading, and demand for support is growing. Teletherapy, psychiatric assessments, and even group therapy sessions are available through many online platforms—often with minimal wait times.

Features to Look for in a Telehealth Provider

A quality telehealth platform should offer:

HIPAA-compliant technology to ensure your privacy.
User-friendly interfaces with mobile app support.
Integrated prescription services to send medications directly to your pharmacy.
Multi-lingual options for diverse populations.
Specialist referrals and follow-up coordination.

Find Out What Telehealth Can Do for You

Telehealth is not just a temporary solution—it’s a fundamental shift in how we access and experience healthcare. For Medicare beneficiaries and younger adults alike, telehealth services provide faster, easier, and more comfortable ways to get the care they need.

If you're exploring your health insurance options, don't hesitate to contact a licensed insurance advisor. They can help you understand what services are covered and how to make the most of them. If you want to learn more about how telehealth fits into your current plan, your insurance carrier or medical provider's office can help you.

Scammers Are Targeting Grandparents—Here’s How to Stay One Step Ahead

websitehelp@agencybloc.com (Agency Bloc) — Wed, 11 Mar 2026 19:33:28 GMT

Imagine getting a call in the middle of the night from someone claiming to be your grandchild, panicked and in trouble. They say they’ve been in an accident or arrested —and they desperately need money. Your heart races. You’d do anything to help. That’s exactly what scammers are counting on.

The Federal Communications Commission (FCC) has recently issued a warning about a rise in what's known as the “grandparent scam” —a sneaky and heartless scheme targeting older adults with urgent, emotional phone calls meant to trick them into sending money.

What Is the Grandparent Scam?

These scams usually start with a phone call from someone pretending to be your grandchild (or another close relative). They’ll say they’re in trouble—maybe stuck in jail or in a hospital—and they need money fast for bail, legal fees, or emergency expenses.

To make things even more convincing, they may hand the phone off to someone pretending to be a lawyer or a police officer. And they’ll likely ask you not to tell anyone—saying it’s a “private” or “sensitive” situation.

That sense of urgency is key to the scam. It’s meant to bypass your instinct to double-check and make you act fast—before you have time to think it through or talk to someone else.

Why It Works—and Why It’s Dangerous

These calls often come late at night or early in the morning, when you’re more likely to be caught off guard. The scammer might not even say who they are—just “Grandma, it’s me”—and hope you fill in the blank for them. From there, they use that information to sound more convincing.

Some victims have been asked to send money via wire transfer, cryptocurrency, gift cards, or even in cash via courier—all methods that are difficult or impossible to trace or reverse. According to the FCC, scammers using this method have stolen tens of millions of dollars from seniors across the U.S.

Watch for These Warning Signs

If you or someone you love receives a call like this, here are some red flags that it could be a scam:

High pressure and urgency – You’re told to act immediately

Vague or strange details – They may not identify themselves clearly, or hope you’ll say the grandchild’s name for them

U nverifiable location or story – They say they’re in jail overseas or in a place where you can’t easily check on them
Unusual payment requests – Gift cards, Bitcoin, wire transfers, or cash deliveries
Calls at odd hours – Scammers try to catch you when you’re less alert

What To Do If You Get a Suspicious Call

If something doesn’t feel right, trust your gut. Here’s what you can do to stay safe:

Hang up and verify – Call your grandchild or their parent using a phone number you know is theirs

Talk to someone you trust – A second opinion from a friend or family member can make all the difference

Don’t rely on caller ID – Scammers often “spoof” numbers to make it look like someone you know is calling

Block the number – Use your phone’s settings to block suspicious calls

Report the scam – Contact the National Elder Fraud Hotline at 833-FRAUD-11 and file a complaint with the FCC

What If You’ve Already Sent Money?

First of all, don’t panic—and know that you’re not alone. Scammers are incredibly convincing, and even smart, cautious people have been tricked.

Here’s what to do:

Call your bank or payment service right away – They may be able to stop or reverse the transaction if it's recent
Report it – Contact the FCC, your local police, and the FBI’s Internet Crime Complaint Center at ic3.gov
Let your family know – They can help protect you and others from future attempts

Help Protect Others, Too

The more people know about this scam, the harder it becomes for criminals to succeed. Please share this information with friends, neighbors, and especially your older loved ones. A quick conversation now could prevent a heartache later.

And remember—if you ever get a call like this and aren’t sure what to do, don’t rush. Take a breath, hang up, and check in with someone you trust. Real family emergencies don’t come with secret demands or payments via gift cards.