Medicare Updates – Total Benefit Solutions Inc

A new Special Enrollment Period has been created allowing select beneficiaries in Pennsylvania to shop for coverage until April 30

April 4, 2026April 3, 2026Lily DaltonNo Comments

A new Special Enrollment Period (SEP) has been opened for certain Pennsylvania UnitedHealthcare Medicare Advantage beneficiaries, allowing them to shop for new coverage through April 30 due to a contract dispute with Lehigh Valley Health Network that eliminated in-network access for affected members as of January 26, 2026. This SEP is separate from the standard Medicare Advantage Open Enrollment Period, which ends March 31. Last week, the Shapiro Administration announced an SEP for UnitedHealthcare Medicare Advantage beneficiaries using Lehigh Valley Health Network Providers. This SEP is a result of contract disputes between Lehigh Valley Health Network and UnitedHealthcare. As of January 26, 2026, over 5,400 UnitedHealthcare Medicare Advantage members lost in-network access… Read More

Part D Premiums Are Decreasing for Many Stand-Alone Drug Plans

November 11, 2025November 11, 2025Aris Herrera

CMS has just released information about Medicare Part D plans for 2026, including plan availability and premiums for the coming year. As this year’s Medicare open enrollment period approaches, there’s some good news for Medicare Part D enrollees when it comes to monthly PDP premiums – lower on average, according to CMS – even as the total number of PDPs available drops yet again. The headline of CMS’s press release emphasized stability in the Part D marketplace, but a quick review of the data shows that the total number of stand-alone drug plans available in 2026 will fall for the third year in a row, as plan sponsors scale back their PDP offerings (for… Read More

The Uncertain Future of Medicare’s Stand-Alone Prescription Drug Plan Market

September 2, 2025September 4, 2025Aris Herrera

Ahead of Medicare’s annual mid-year announcement about the national average premium for Part D prescription drug coverage in 2026 and other plan details, two questions loom large for the insurers that sponsor Part D stand-alone prescription drug plans (PDPs) and the 23 million people in traditional Medicare who are currently enrolled in these plans. Will the Trump administration continue Medicare’s Part D premium stabilization demonstration for a second year, and what will the PDP market look like in 2026 and in subsequent years? The answer to the first question could determine whether monthly PDP premiums remain at a relatively affordable level and whether PDP availability remains stable in 2026. The answer to… Read More

Category: Medicare Updates

A new Special Enrollment Period has been created allowing select beneficiaries in Pennsylvania to shop for coverage until April 30

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Part D Premiums Are Decreasing for Many Stand-Alone Drug Plans

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The Uncertain Future of Medicare’s Stand-Alone Prescription Drug Plan Market

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