If you blinked this week, you missed a lot. Between new CMS payment rules, a Medicare Advantage market that keeps shrinking, and the ongoing tug-of-war between your 2027 raise and your 2027 premium, this was one of the busier weeks of the summer for Medicare news. Here's what actually matters for you.
Since July 1, eligible Medicare Part D and Medicare Advantage members have been able to get GLP-1 medications — Wegovy, Zepbound, and similar drugs — for a flat $50/month copay. This is the first time in Medicare's history that weight-management drugs have been partially covered, and it runs through December 31, 2027.
A few things worth knowing before you assume you qualify:
If you're on one of these medications for weight management, or think you might qualify, this is worth a conversation before you assume it works like the rest of your drug coverage.
The Senior Citizens League is holding its 2027 Social Security COLA estimate at 3.8%, while independent analyst Mary Johnson has it at 3.7% and AARP at 3.6%. The official number won't be announced until mid-October, once September inflation data is in.
Here's the number that matters more than the headline: if the COLA lands at 3.8%, the average Social Security check rises about $73.62/month. But the projected Part B premium increase for 2027 — somewhere between $6.60 and $16 a month depending on whose estimate you use — eats into that gain before it ever hits your bank account. Net gain after the premium bite: somewhere in the neighborhood of $58–$73, not the full raise.
It's not nothing, but it's not what the headline number makes it look like either.
Although there is overall growth in the Medicare industry, even the top dog carriers need to hone in on areas of profitability for survival. The tendency is to shift efforts and resources into areas where you have a stronger foothold of the marketplace or new opportunity.
If your Medicare Advantage plan changed, shrank, or dropped your doctor this year, you weren't imagining it. The total number of MA plans nationally fell 10% for 2026, from 3,719 down to 3,373. UnitedHealthcare, Humana, Aetna, and Elevance have all pulled back in well over 100 counties each, and major health systems — Mayo Clinic, Mass General Brigham, UNC Health, Kettering Health — have gone out of network with one or more of the big carriers.
On top of that, new CMS marketing rules take effect October 1, 2026, right as Annual Enrollment Period ramps up, and several carriers are still finalizing what their 2027 plans will even look like. If you haven't had your plan reviewed since these changes started rolling in, now's a good time — not in October when everyone else is calling too.
ANOC or your Annual Notice of Change will be delivered next month in September, keep an eye out for it! These changes is exactly why you want me in your corner, let's have one ongoing discussion throughout the year, and year-to-year rather than having multiple, exhausting discussions with many agents every year. bobwisecarver.com set up an appointment with me today!
Late July brought a cluster of finalized CMS payment rules for fiscal year 2027, covering skilled nursing facilities, inpatient psychiatric facilities, hospice care, and inpatient rehabilitation facilities. Broadly, these update how much Medicare pays providers in each of these settings starting in FY 2027 — details that matter more to providers than beneficiaries directly, but they're a signal of where CMS's cost-control priorities are heading as more proposed rules (physician fees, hospital outpatient, home health) work their way toward finalization later this year.
Nothing to worry about here, just keeping up with inflation, but we are keeping an eye on this.
There's been some confusion about this one, so let's be precise. Starting January 1, 2027 (or earlier, if a state chooses to move first), states must require certain adults to meet a work requirement to enroll in or keep Medicaid.
The key word is certain. This applies to "applicable individuals" — non-pregnant adults ages 19 to 64 who are not entitled to or enrolled in Medicare, and who are eligible for or enrolled in the Medicaid adult group or in certain Section 1115 demonstration programs.
In plain terms: if you're on Medicare, this rule doesn't apply to you. It's aimed at working-age adults who qualify for Medicaid outside of Medicare entirely — not dual-eligible Medicare/Medicaid beneficiaries.
Before the requirement kicks in, states have to do outreach to current enrollees who could be affected, and they have to keep doing outreach to new applicants and people going through renewal after the rule takes effect. So if this touches your family at all, it's more likely to be an adult child or younger relative on Medicaid — not your own Medicare coverage.
Nothing this week is a reason to panic, but several things are worth a real conversation: whether you qualify for the GLP-1 Bridge, what your actual net gain looks like once the 2027 premium is announced, and whether your current Medicare Advantage plan is even going to look the same by October. AEP starts October 15 — the smart move is figuring these things out now, before everyone else is trying to book the same appointment.
Have questions about how any of this affects your specific plan? Reach out — let's take a look together. bobwisecarver.com
This post reflects CMS and Social Security information available as of August 1, 2026. Some figures — including the 2027 COLA and Part B premium — are still projections and won't be finalized until later this year.