We are now in the midst of Medicare Open Enrollment, which runs through December 7, making this an important time to remind our patients to review their coverage for the coming year. Plans can change from year to year, so patients should make sure their medications are still covered and consider what they will actually pay for their prescriptions. And we have all seen the TV ads, right? One message that seems to come up again and again is the promise of a Medicare “grocery ca

Flu vaccines can be given during the same visit as most other recommended vaccines for which patients are eligible. This practice, called co-administration or simultaneous administration, is especially helpful when patients may not be able to return for another vaccination appointment and helps keep them up to date on their vaccinations. Non-live flu vaccines can be given alongside other vaccines recommended for older adults, such as COVID-19, shingles, pneumococcal, Tdap/Td,

Breast cancer affects approximately 1 in 8 women in the United States during their lifetime. Mammograms can detect breast cancer early, when it is easier to treat. Women aged 40–74 years are recommended to have a mammogram every two years. Women at increased risk may need more frequent screening based on their doctor’s recommendations. A mammogram typically takes about 20 minutes. Screening is covered by most private health insurance plans and Medicare Part B. The U.S. Center

The annual Medicare Open Enrollment period will begin October 15 and run through December 7. This is an opportunity for beneficiaries to review their current coverage, compare plans for 2027, and assess changes to benefits, provider networks, and out-of-pocket costs. During this period, beneficiaries can: Join, leave, or switch Medicare Advantage (MA) Plans, with or without drug coverage. Join, leave, or switch Medicare drug plans if they have Original Medicare. Switch from O

September and October are generally the best months for older adults to get a flu vaccine. Adults age 65 and older have several flu vaccine options, including high-dose, adjuvanted, recombinant, and mRNA vaccines. For this age group, the CDC recommends preferential use of an enhanced vaccine—such as Fluzone High-Dose, Flublok, or Fluad—when one is available. Please recommend a flu vaccine to your patients and help protect them from severe illnesses. Remember, no one is safe u

Medicare scams remain a concern for the healthcare system and society. The National Council on Aging (NCOA) highlights five warning signs that can help you recognize potential scams. Recognizing these signs can help you educate beneficiaries about how to identify potential scams and protect their personal information. These signs include: Offers of “free” items or services in exchange for beneficiaries' Medicare information. Pressure to switch Medicare plans or pay a fee to e

The owner of Expansion Media and Hybrid Management Group, Steven Richardson, has agreed to plead guilty to his role in a $110 million Medicare fraud scheme involving medically unnecessary durable medical equipment, including back and knee braces. According to the U.S. Department of Justice, Medicare beneficiaries were targeted through telemarketing, and Richardson obtained signed orders from doctors and nurses who had not examined the patients and provided those orders to tel

As pharmacies begin processing GLP-1 prescriptions for beneficiaries through the Bridge Program, practical questions may arise about participation, billing, and reimbursement. For example: Where do pharmacies submit claims? How can pharmacies express interest in participating? What dispensing fee is available to pharmacies? For answers to these and other pharmacy-specific questions, see the Medicare GLP-1 Bridge Program pharmacy frequently asked questions (FAQs).

The Medicare GLP-1 Bridge Program is still ongoing. Launched July 1, 2026, the temporary program provides eligible Medicare beneficiaries access to certain GLP-1 medications for weight management for $50 per month, including Foundayo®, Wegovy® (injection and tablets), and Zepbound® (KwikPen®). The program is scheduled to continue through December 31, 2027. Medicare has established eligibility criteria. To be eligible, beneficiaries must be enrolled in a Medicare prescription

The summer edition of our newsletter is now available! Check it out to learn more about Medicare-covered preventive services for beneficiaries, medical equipment fraud in practice, our latest blog updates, continuing education resources, and more!