What's New

Medicare’s Annual Enrollment Period (AEP) runs from October 15 through December 7, and it’s the one time each year when you can review, compare, and make changes to your Medicare Advantage and Medicare Part D prescription drug plans. Any changes you make during this period will take effect January 1, 2026. With plan benefits, premiums, and provider networks changing annually, it’s important to take a fresh look to ensure your coverage still meets your health and budget needs.

What Should You Do?

• Review your Annual Notice of Change (ANOC) from your current plan
• Make a list of your providers and medications to confirm they’re covered
• Reach out early to schedule a one-on-one review with our team

Beginning October 1, we can walk through your options and help you choose the plan that’s right for you. Don’t wait until the last minute — contact us today to set up your review appointment so you’ll be ready when AEP officially opens.

Many people are well aware of the benefits of telehealth, including convenience and flexibility, as well as access to a broader range of specialists. Under Medicare’s original rules, telehealth services were intended mainly for rural residents , with the aim of connecting patients with remote specialists from an approved medical facility, like a local clinic. During the COVID-19 pandemic, Medicare temporarily made it easier for people to get care from home through telehealth, no matter where they lived. This change allowed beneficiaries to have video or phone visits with their doctors right from their living rooms — a huge help for people with mobility challenges or those living in urban or suburban areas.

Starting October 1, 2025, unless new laws are passed, this pandemic-era home access will end for many services under Original Medicare. The guidelines will revert back to the original rule, meaning in most cases, you will need to be at an approved medical site in a rural area to use telehealth. There are a few notable exceptions, including mental health counseling, substance use disorder treatments, dialysis visits, and a few other services, which will still be covered from your home, wherever you live. If you rely on telehealth, it’s smart to ask your provider now what services you can still get from home, and whether they offer extra telehealth benefits beyond basic Medicare. Some Medicare Advantage Plans may offer more telehealth benefits than the basic coverage in Original Medicare. Stay informed and consult with your licensed insurance agent to help you plan ahead for any changes to your care routine in the coming months.

Centers for Medicare & Medicaid Services (CMS) is launching a new pilot program called the Working to Integrate Safe and Effective Review (WISeR) Model. This model will test whether a more streamlined prior authorization process can help reduce unnecessary and often costly services in Original Medicare, while protecting beneficiaries from care that may not improve their health. The WISER Model will focus on certain services that data shows may sometimes be overused or provide a lower clinical value, including skin and tissue substitutes, electrical nerve stimulators, and knee arthroscopy.

The program will begin in selected geographic areas and is expected to run for up to five years, starting in 2026. If your provider participates, they may work with Medicare contractors to review medical claims and documentation for these services to ensure they meet updated clinical guidelines. There will be no change to what Medicare covers, and beneficiaries should not experience any reduction in medically necessary care. According to CMS , this effort is part of a broader strategy to curb wasteful spending, promote safe and effective treatment, and maintain the integrity of the Medicare program.