Medicare Decoder https://medicaredecoder.com/blog/ Medicare, translated into plain English. Straight answers with official CMS figures, no sales calls. en-us Mon, 14 Sep 2026 09:00:00 +0000 The Medicare Advantage Open Enrollment Period: your January–March do-over https://medicaredecoder.com/blog/medicare-advantage-open-enrollment.html https://medicaredecoder.com/blog/medicare-advantage-open-enrollment.html Mon, 14 Sep 2026 09:00:00 +0000 From January 1 to March 31, Medicare Advantage members get one switch: to another Advantage plan or back to Original Medicare. Who qualifies, what it can’t do (Medigap), and how to use it well. Missed Medicare open enrollment? Your actual options after December 7 https://medicaredecoder.com/blog/missed-medicare-open-enrollment.html https://medicaredecoder.com/blog/missed-medicare-open-enrollment.html Mon, 14 Sep 2026 09:00:00 +0000 Missing the December 7 deadline locks most people into their current plan for the year, but real exits exist: the January–March Advantage window, the 5-star switch, Extra Help’s quarterly changes, and SEPs. Medicare star ratings explained: what the stars measure and how much to trust them https://medicaredecoder.com/blog/medicare-star-ratings.html https://medicaredecoder.com/blog/medicare-star-ratings.html Mon, 14 Sep 2026 09:00:00 +0000 Medicare rates every Advantage and Part D plan 1–5 stars each October, measuring care quality, member experience, and service. What the stars actually count, the 5-star switching perk, and their limits. Medicare changes for 2027: what’s confirmed, what’s coming, who should re-shop https://medicaredecoder.com/blog/medicare-changes-2027.html https://medicaredecoder.com/blog/medicare-changes-2027.html Mon, 14 Sep 2026 09:00:00 +0000 Confirmed for 2027: a $2,400 drug cap, $700 Part D deductible, $41.33 base premium, negotiated prices on 15 more drugs including Ozempic at $274, and the end of the standalone-plan subsidy. The full list. How to compare Medicare Advantage plans: the 7-point checklist for 2027 https://medicaredecoder.com/blog/compare-medicare-advantage-plans.html https://medicaredecoder.com/blog/compare-medicare-advantage-plans.html Mon, 14 Sep 2026 09:00:00 +0000 Comparing Advantage plans by premium is how people get hurt. The 7 checks in order: doctors, drugs, out-of-pocket max, star ratings, prior authorization, hospital, then extras. With the total-cost math. What happened to Medicare Plan F? Why it closed, who keeps it, and what to buy instead https://medicaredecoder.com/blog/what-happened-to-medicare-plan-f.html https://medicaredecoder.com/blog/what-happened-to-medicare-plan-f.html Mon, 10 Aug 2026 09:00:00 +0000 Plan F closed to anyone newly eligible for Medicare after January 1, 2020, under a law banning first-dollar Medigap coverage. Grandfathered holders keep it. Why Plan G is the successor, and the closed-pool pricing problem. What does Medicare not cover? The 10 gaps and how people fill each one https://medicaredecoder.com/blog/what-does-medicare-not-cover.html https://medicaredecoder.com/blog/what-does-medicare-not-cover.html Mon, 10 Aug 2026 09:00:00 +0000 Original Medicare excludes dental, vision, hearing aids, long-term care, overseas care, and more. The full gap list with the realistic fix for each, priced honestly. The Medicare give-back benefit: real, modest, and sold hard. Here’s the math https://medicaredecoder.com/blog/medicare-give-back-benefit.html https://medicaredecoder.com/blog/medicare-give-back-benefit.html Mon, 10 Aug 2026 09:00:00 +0000 The Part B give-back is a real Medicare Advantage benefit that reduces your Part B premium, sometimes to a headline number far larger than typical. What plans actually rebate, and when chasing it backfires. The Medicare Part B late enrollment penalty: how it’s calculated, with examples https://medicaredecoder.com/blog/medicare-part-b-penalty.html https://medicaredecoder.com/blog/medicare-part-b-penalty.html Mon, 10 Aug 2026 09:00:00 +0000 The Part B penalty adds 10% to your premium for every 12 months you delayed without qualifying coverage, permanently. Worked examples at 2026 rates, who’s exempt, and the narrow escape routes. The "Medicare flex card": what the ads don’t tell you https://medicaredecoder.com/blog/medicare-flex-card.html https://medicaredecoder.com/blog/medicare-flex-card.html Mon, 10 Aug 2026 09:00:00 +0000 There is no federal Medicare flex card. Flex cards are spending-allowance cards on some private Medicare Advantage plans, with real but modest values. What the ads mean, who actually gets one, and the catch. Medicare’s annual wellness visit vs. a physical: not the same thing, and one bills you https://medicaredecoder.com/blog/medicare-annual-wellness-visit.html https://medicaredecoder.com/blog/medicare-annual-wellness-visit.html Mon, 10 Aug 2026 09:00:00 +0000 Medicare doesn’t cover routine annual physicals. It covers a free Annual Wellness Visit, a different appointment, plus a one-time Welcome to Medicare visit. What each includes and how surprise bills happen. Medicare vs. Medicaid: the difference, who qualifies, and having both https://medicaredecoder.com/blog/medicare-vs-medicaid.html https://medicaredecoder.com/blog/medicare-vs-medicaid.html Mon, 10 Aug 2026 09:00:00 +0000 Medicare is federal health insurance earned by age or disability; Medicaid is need-based coverage tied to income. How each works, the long-term-care split, and how dual eligibility combines them. Medicare vaccine coverage: everything is $0 now, including shingles https://medicaredecoder.com/blog/medicare-covered-vaccines.html https://medicaredecoder.com/blog/medicare-covered-vaccines.html Mon, 10 Aug 2026 09:00:00 +0000 Since 2023, all ACIP-recommended adult vaccines are free under Part D, including Shingrix, and flu, COVID, pneumonia, and hepatitis B shots are free under Part B. The complete list and the one billing trap. Medicare under 65: how disability coverage works, and the 24-month wait https://medicaredecoder.com/blog/medicare-under-65-disability.html https://medicaredecoder.com/blog/medicare-under-65-disability.html Mon, 10 Aug 2026 09:00:00 +0000 SSDI recipients get Medicare automatically after 24 months of benefits; ALS qualifies immediately and ESRD has its own track. What the wait really means, coverage during it, and the Medigap catch for under-65s. Medicare scams in 2026: the 7 active cons and the two-sentence defense https://medicaredecoder.com/blog/medicare-scams.html https://medicaredecoder.com/blog/medicare-scams.html Mon, 10 Aug 2026 09:00:00 +0000 The current Medicare scam playbook: new-card calls, genetic testing kits, flex-card bait, DME fraud, hospice enrollment cons, and fake plan reps. How each works, the red flags, and exactly what to do. Medicare on a spouse’s work record: free Part A through marriage, divorce, or widowhood https://medicaredecoder.com/blog/medicare-spouse-work-record.html https://medicaredecoder.com/blog/medicare-spouse-work-record.html Mon, 10 Aug 2026 09:00:00 +0000 Never paid 10 years of Medicare taxes? You can still get premium-free Part A on a spouse’s record: current spouse (62+), ex-spouse after a 10-year marriage, or a deceased spouse. The exact rules. Medicare observation status: the hospital stay that isn’t, and what it costs you https://medicaredecoder.com/blog/medicare-observation-status.html https://medicaredecoder.com/blog/medicare-observation-status.html Mon, 10 Aug 2026 09:00:00 +0000 A night in a hospital bed under observation is outpatient care: Part B billing, and no credit toward the 3-day stay that qualifies skilled nursing coverage. The MOON notice, the questions to ask, and the defenses. Medicare diabetes coverage: insulin at $35, CGMs, supplies, and the free programs https://medicaredecoder.com/blog/medicare-diabetes-coverage.html https://medicaredecoder.com/blog/medicare-diabetes-coverage.html Mon, 10 Aug 2026 09:00:00 +0000 The full diabetes stack: $35 insulin, continuous glucose monitors under Part B, test supplies, free screenings and prevention programs, foot and eye care, and nutrition therapy. What each part covers. Medicare and Social Security: how they connect, and the traps in the seams https://medicaredecoder.com/blog/medicare-and-social-security.html https://medicaredecoder.com/blog/medicare-and-social-security.html Mon, 10 Aug 2026 09:00:00 +0000 Claiming Social Security auto-enrolls you in Medicare at 65; taking Medicare doesn’t require claiming Social Security. Premium deductions, the hold-harmless rule, the HSA collision, and timing the two. Medicare Special Enrollment Periods: every SEP that matters, in one table https://medicaredecoder.com/blog/medicare-special-enrollment-periods.html https://medicaredecoder.com/blog/medicare-special-enrollment-periods.html Mon, 10 Aug 2026 09:00:00 +0000 Missed a Medicare window? Special Enrollment Periods reopen the door after losing employer coverage, moving, losing Medicaid, plan closures, disasters, and more. The full list with time limits.