Latest news with #MedicareAdvantage
Forbes
2 hours ago
- Business
- Forbes
When It Comes To Medicare Cards, What's In Your Wallet?
Your Medicare Card is just one of the Medicare-related cards you may have in your wallet. About six years ago, a credit card company debuted a TV commercial, asking about the cards you have in your wallet. It's still around today. I have dealt with a similar situation many times. When an acquaintance has a Medicare question, I ask, 'What type of Medicare do you have?' Blank stare. 'Do you have Original Medicare or Medicare Advantage?' Another blank stare and then a grab for the wallet. Buried in the midst of credit cards, driver's license, whatever, there are the cards in question. Even after finding them, they often have no idea about their coverage and how it works. The majority of beneficiaries today have elected Medicare Advantage. These are Medicare-approved plans, sponsored by private insurance companies, that bundle Part A, hospital insurance, and Part B, medical insurance, services, and usually Part D, prescription drug coverage. Original Medicare is sponsored by the government and consists of Part A and Part B. Many beneficiaries add a stand-alone Part D drug plan and a Medicare supplement insurance plan (Medigap policy) for comprehensive coverage. These two types of coverage have different structures, coverage rules and costs. The type of coverage you chose has a big impact on your medical care. For instance, Original Medicare does not have provider networks, which are a staple of Advantage plans. Medicare Advantage plans can provide additional benefits, like dental and vision care, that Original Medicare cannot. Medicare Advantage plan members can face prior authorization for many services, whereas Original Medicare has considerably fewer situations requiring approval. If you are not clear about which type of Medicare you have, pull out your cards and figure it out. Here are some Medicare Card After enrolling in Medicare, everyone gets a red, white and blue Medicare card. It notes: Protect your Medicare card. Do not let anyone else use this card or your number. Depending on the type you chose, you may have one or two more Advantage This card has the words 'Medicare Advantage' clearly imprinted on the front of the card, along with the type of plan, such as an HMO or PPO. If the card has the MedicareRx logo, the plan includes prescription drug coverage (MA-PD plan). Along with the logo, there will be three numbers for the RxBIN, RxPCN and RxGRP, providing details about the specific drug coverage, important for the pharmacist. If you have a Medicare Advantage card, you will use that for all healthcare appointments. Put your Medicare card away in a safe Medicare The most important card for this type of coverage is the Medicare card. Show that to any healthcare provider. Then there are two other cards that can card must note Medicare Supplement Insurance, along with the type of plan, such as Plan G. Massachusetts, Minnesota and Wisconsin cards will note the type of plan, such as 'Basic Plan' or 'Supplement 1A Plan.' The insurance company then decides what additional information to put on the card is for those who have a stand-alone drug plan, not part of a Medicare Advantage plan. It includes the same MedicareRx logo and details to identify the member and coverage as appears on an MA-PD card. Once enrolled in Medicare Part A and Part B, there are other options for additional coverage, such as a retiree coverage or Federal Employee Health Benefits (FEHB) plan. These beneficiaries will have specific identification cards for their type of Next Once your coverage is identified, it's time to learn about how it works. Check out these resources from can be very confusing. Knowing what Medicare cards are in your wallet is the first step to clarity. To paraphrase commercials, now that you know what Medicare cards are in your wallet, don't leave home without them .
Business Wire
7 hours ago
- Health
- Business Wire
Premier Medical Collaborates with Walgreens to Expand Access to Care Across Central Florida
ORLANDO, Fla.--(BUSINESS WIRE)--Premier Medical, a leading primary and multispecialty care provider in Central Florida, today announces a new collaboration with Walgreens to increase access to high-quality healthcare in local communities. Beginning this summer, Premier Medical, which is a part of the value-driven healthcare company, NeueHealth, will begin operating clinics inside select Walgreens locations, starting with two sites opening in Davenport, Fla., and Orlando, Fla., in July 2025. These in-store clinics will offer a range of services – including primary care, chronic condition management, and dermatology – and will serve patients enrolled in Medicare, Medicare Advantage, commercial, and select Medicaid plans. 'We are excited to collaborate with Walgreens to make personalized care more accessible for Central Florida residents,' said Craig Esquenazi, Director of Operations for Premier Medical. 'This collaboration reflects our commitment to improving the health and well-being of local communities and making the care experience more convenient.' 'We're bringing trusted, high-quality care directly into our stores — making it easier for patients to get the services they need, right in their neighborhood,' said Young Chang, Regional Healthcare Director for Walgreens. Premier Medical is planning additional clinic openings with Walgreens later this year. To find a Premier Medical clinic near you, visit: About Premier Medical Premier Medical is a Central Florida-based medical group dedicated to delivering accessible, high-quality primary and specialty care to diverse communities. With more than 30 years of experience serving the region, Premier Medical has built trusted relationships with patients and families across generations. Premier Medical is proud to be payer agnostic — welcoming patients from Medicare, Medicare Advantage, commercial plans, and select Medicaid plans. As part of NeueHealth, a value-driven healthcare company, Premier Medical offers a comprehensive range of services, including preventive care, chronic disease management, urgent care, dermatology, and telehealth. Through a strong focus on whole-person health, cultural competence, and coordinated care, Premier Medical empowers individuals and families to lead healthier lives and thrive in their communities. About Walgreens Founded in 1901, Walgreens ( has a storied heritage of caring for communities for generations, and proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico, and leading omni-channel platforms. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for retail pharmacy and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Walgreens is the flagship U.S. brand of Walgreens Boots Alliance, Inc. (Nasdaq: WBA), an integrated healthcare, pharmacy and retail leader. Its retail locations are a critical point of access and convenience in thousands of communities, with Walgreens pharmacists playing a greater role as part of the healthcare system and patients' care teams than ever before. Walgreens Specialty Pharmacy provides critical care and pharmacy services to millions of patients with rare disease states and complex, chronic conditions.
Miami Herald
a day ago
- Business
- Miami Herald
UnitedHealth's shocking move to please Wall Street
UnitedHealth (UNH) has stumbled through what has been a testing year. Sliding sales, a gloomy cost forecast, and a surprise profit cut rattled its investors early on. Don't miss the move: Subscribe to TheStreet's free daily newsletter Legal scrutiny added to the fire, along with a CEO scrambling to restore confidence. However, just as we thought we had seen the stock's worst, it has reportedly pulled off a quiet financial move that could prove to be the most shocking of them all. Image source: Alcorn/Bloomberg via Getty Images UnitedHealth kicked off the year with a stark warning. In early January, management told investors to brace for rising medical costs, forecasting a medical care ratio north of 86%, compared to the 85% Wall Street had priced in. Then came the major gut punch in April. UnitedHealth cut its full-year profit forecast from roughly $30 per share to a range of $26 to $26.50. The medical insurance giant blamed unexpected service and care costs, in what was the sharpest guidance cut it had posted since early pandemic turbulence. Related: One Washington move could shake Big Pharma to its core The timing and size of the drop posed serious questions over the sustainability of UnitedHealth's numbers and whether cost pressures were bleeding from the books. Things only got worse. In May, news broke that the Justice Department launched a criminal investigation into Medicare Advantage billing practices. UnitedHealth, which has been no stranger to regulatory scrutiny, was suddenly in the DOJ's crosshairs for potential fraud related to its coding systems. By June, the newly reinstalled CEO, Stephen Hemsley, was doing a lot of the cleanup. He addressed shareholders directly, vowing to "earn back your trust." Consequently, as of mid-July, UnitedHealth stock has tanked over 40% year-to-date. Over the past six months alone, the stock has nosedived 46%. Mr. Market almost missed UnitedHealth's quiet financial moves. According to Bloomberg, in protecting its impressive 60-quarter earnings beat streak, the company resorted to an accounting twist that's now raising eyebrows. UnitedHealth quietly sold stakes in multiple of its business units, generating $3.3 billion in profit, mostly in the back end of last year. These weren't traditional divestitures. The deals, struck with firms like Warburg Pincus and KKR, reportedly included buyback clauses. UnitedHealth therefore has the right (or obligation) to repurchase the same assets at higher prices down the line. Related: JPMorgan reveals 9 stocks with major problems That kind of structure isn't new to private equity circles, but the timing, terms, and secrecy are what's turning heads. People familiar with the transactions say UnitedHealth looked to push those deals to close by December 31, explicitly asking for them not to be publicized. That's prompted speculation over sales engineering, in part, to ensure the businesses didn't break their decades-long earnings streak. In January, UnitedHealth barely beat Q4 expectations. The company topped forecasts by seven cents, even as its medical care ratio rose, signaling higher health care expenses. On its Q4 call and in its annual report, UnitedHealth talked about improving operating costs while noting a $3.3 billion gain. However, it didn't say what was sold or how the profits were booked. More Stock News: Elon Musk's xAI is already shockingly massiveBank of America drops shocking call on Super Micro stockCathie Wood drops bold message on Apple, Tesla stock That detail flew under Wall Street's radar at the time. However, the latest scoop suggests that UnitedHealth may have posted its first earnings miss in more than 15 years, if it wasn't for the last-minute financial engineering. To be fair, UnitedHealth isn't new to profit‑padding allegations. As mentioned earlier, it's already in hot water with the Justice Department's fraud unit for allegedly inflating Medicare Advantage reimbursements through aggressive diagnosis coding, Going further back, it weathered an SEC probe in 2006 over backdated stock options, which eventually led to a massive $350 million settlement and the resignation of then‑CEO William McGuire. Related: Google Brain founder has an unexpected one-word message on AI The Arena Media Brands, LLC THESTREET is a registered trademark of TheStreet, Inc.
Yahoo
a day ago
- Health
- Yahoo
Percentage of Patients with Telehealth Claims for Mental Health Conditions Increased Nationally and in Every Region in April
Diabetes Entered Top Five Telehealth Diagnostic Categories in South in April for First Time in 2025 NEW YORK, July 15, 2025 /PRNewswire/ -- The percentage of patients with a telehealth claim for a mental health condition increased nationally and in every US census region in April, according to FAIR Health's Monthly Telehealth Regional Tracker. Mental health conditions remained the top diagnostic category for patients with a telehealth claim nationally and in every region. Nationally, patients diagnosed with mental health conditions accounted for 63.0 percent of patients with a telehealth claim in April, up from 61.6 percent in March. The data represent the commercially insured population, excluding Medicare Fee-for-Service, Medicare Advantage and Medicaid. Diabetes mellitus entered the top five telehealth diagnostic categories in the South in April for the first time in 2025. This diagnostic category entered in fifth position, accounting for 2.0 percent of patients with a telehealth claim; encounter for examination, which ranked in third position in March, fell out of the top five in April. In 2025 thus far, diabetes has not ranked among the top five telehealth diagnostic categories in any other region, though it did rank in fourth place nationally in January. UtilizationIn April 2025, the percentage of patients with a telehealth claim decreased nationally and also in the Midwest and South but increased in the Northeast and West. Nationally, the percentage decreased from 14.3 percent in March to 14.2 percent in April, a 0.8 percent drop. In the Midwest, the drop was 5.7 percent and, in the South, it was 1.2 percent. In the Northeast, the percentage of patients with a telehealth claim increased 2.0 percent, and in the West, it increased 0.7 percent. During the same period, telehealth claim lines1 increased as a percentage of all medical claim lines nationally and in every region except the Midwest. Nationally, the percentage increased 1.1 percent, from 4.96 percent in March to 5.01 percent in April. The regional increases varied from 2.6 percent in the Northeast to 1.4 percent in the South and 0.4 percent in the West. In the Midwest, telehealth claim lines decreased 8.3 percent. Urban versus RuralAs in March, in April 2025, telehealth utilization was higher in urban than rural areas nationally and in all four regions.2 Nationally, 14.3 percent of patients in urban areas had a telehealth claim, compared to 7.4 percent in rural areas. The largest difference occurred in the West, where the percentage of urban patients using telehealth (18.6 percent) was 2.3 times the percentage of rural patients (8.1 percent). The smallest difference was found in the Northeast, where the percentage of patients in urban areas using telehealth (16.5 percent) was 1.4 times the percentage of patients in rural areas using telehealth (11.4 percent). Age DistributionAs in March, in April 2025, the age groups 19-30 and 31-40 accounted for the largest percentages of patients with a telehealth claim nationally and in every region. On the national level, 23.3 percent of patients in the age group 19-30 had a telehealth claim, and 22.6 percent of patients in the age group 31-40 had a telehealth claim. Nationally and in every region, the age groups 0-9 and 65 and older accounted for the smallest shares (less than 10 percent each) of patients with a telehealth claim. Procedure CategoriesIn April 2025, psychotherapy services and procedures, and established patient office or other outpatient services (including those for mental health conditions), were, as in March, the top two procedure categories nationally and in every region. The order of the two varied by region and, at the national level, by month. Nationally and in the Midwest and Northeast, psychotherapy services and procedures ranked first in April; nationally, this procedure category accounted for 47.49 percent of patients with a telehealth claim. While this category also ranked first in March in the Midwest and Northeast, it ranked second nationally in March (at 46.1 percent of patients with a telehealth claim). In the South and West, established patient office or other outpatient services ranked first in April, as it had in March. On the national level, established patient office or other outpatient services ranked second in April, accounting for 47.48 percent of patients with a telehealth claim (down from 48.9 percent in March, when it ranked first). About the Monthly Telehealth Regional TrackerLaunched in May 2020 as a free service, the Monthly Telehealth Regional Tracker uses FAIR Health data to track how telehealth is evolving from month to month. An interactive map of the four US census regions allows the user to view an infographic on telehealth in a specific month in the nation as a whole or in individual regions. Each year, the infographic introduces varied views into telehealth utilization. In this sixth iteration of the Monthly Telehealth Regional Tracker, each infographic shows month-to-month changes in telehealth utilization, both through telehealth's percentage of medical claim lines and percent of patients with a telehealth claim; that month's top five diagnostic categories; top five procedure categories; age distribution, which captures the percentage of patients within each age group with a telehealth claim; and urban versus rural telehealth usage. For the Monthly Telehealth Regional Tracker, click here. Follow us on X @FAIRHealth About FAIR HealthFAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of commercial healthcare claims data, which includes over 51 billion claim records and is growing at a rate of about 4 billion claim records a year. FAIR Health licenses its commercial data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D, which accounts for a separate collection of over 51 billion claim records; FAIR Health includes among the commercial claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 Type 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. For more information on FAIR Health, visit Contact:Rachel KentExecutive Director of Communications and MarketingFAIR Health646-396-0795rkent@ 1 A claim line is an individual service or procedure listed on an insurance claim.2 Each telehealth service was attributed to a rural/urban designation in a region based on the patient's medical service area, which FAIR Health determines based on the unique geographical pattern of services utilized by the patient. View original content to download multimedia: SOURCE FAIR Health Sign in to access your portfolio
Time of India
a day ago
- Business
- Time of India
UnitedHealth Group stock down after Wolf Research lowers its price target to $330 from $363
Five days after Wolfe Research gave the UnitedHealth Group stock an "Outperform" rating, the research organization tapered down its stock price target to $330 from the initial amount of $363. Goldman Sachs sees UnitedHealth as one of its top healthcare stock picks, according to the report by Insider Monkey. Company facing billing and profit troubles They did this because the company is dealing with medical billing problems right now. Wolfe Research also revised the 2025 earnings estimate to $18 — showing a more cautious or conservative view, as stated by the reports. ALSO READ: Prince Harry ready to make amends and make peace — Kate supports it, but William says 'Not So Fast' by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Join new Free to Play WWII MMO War Thunder War Thunder Play Now The reason is that UnitedHealth is under pressure in Medicaid and health insurance exchanges. The firm thinks Optum Health and Medicare Advantage, two parts of UnitedHealth, are facing big drops in earnings, as stated by Insider Monkey report. Right now, Medicare Advantage is only giving UnitedHealth 1% profit margins, which is much lower than what they normally earn. UnitedHealth is supposed to give a new update about its 2025 earnings soon and explain how it will handle these billing issues, according to the reports. Experts say some AI stocks may be better Insider Monkey says UnitedHealth still has potential, but some AI stocks might be better options right now. They say some AI stocks are more undervalued, could grow faster, and have less risk — especially with Trump-era tariffs and onshoring trends helping them, according to the report by Insider Monkey. Live Events ALSO READ: Putin gets grim warning: Russia's population crisis could wipe out 11 million workers by 2030 FAQs Q1. Why did Wolfe Research lower UnitedHealth's stock price target? Wolfe Research cut the price target to $330 because UnitedHealth is facing medical billing issues and lower profits in key areas like Medicare Advantage and Medicaid. Q2. Is UnitedHealth still a good investment after the price cut? Experts like Insider Monkey say it still has potential, but some AI stocks may offer better short-term growth and lower risk.
