HOUSTON, Texas – Healthcare costs are on everyone’s mind, especially here in Houston.
Health Reporter Haley Hernandez spoke to Dr. Mehmet Oz, the Administrator for the Centers for Medicare and Medicaid Services (CMS), to get the latest on Medicare open enrollment and what rising healthcare costs mean for you.
Are drug prices going up or down this year?
Drug prices on Medicare Part D are actually going down a bit, according to Dr. Oz.
Dr. Oz said if you go to Medicare.gov and sign in, Medicare already knows what drugs you take; therefore, the website can suggest if switching to a different plan might save you money. It can also help if your doctor isn’t in your current insurance network anymore. All of this can help you get better pricing and care.
Not a fan of websites? No problem. You can call 1-800-MEDICARE and talk to a real person who can help you figure it out.
What about telemedicine during the government shutdown? Can seniors still use it?
Telemedicine has been a game-changer, especially for seniors who can’t always get to a doctor’s office easily. Right now, there’s some uncertainty amid the government shutdown affecting funding.
Dr. Oz said providers have been told to keep offering telemedicine services, and (although not guaranteed), Congress could allow funding to continue — and maybe even pay back some of the money owed.
Will prior approvals for surgeries create barriers for seniors?
Texas is one of six states in a new pilot program requiring prior authorizations for certain surgeries, including treatments for pain, incontinence, and deep-brain stimulation for Parkinson’s disease. Understandably, many seniors worry this might delay or block needed care.
Medicare uses prior authorizations very sparingly, according to Dr. Oz, only when there’s a big risk of fraud or unnecessary procedures. The goal, he said, is to protect patients from fake or unneeded treatments, not to get in the way of care.
This will begin in January 2026. Here’s the explanation of the program from CMS.
Meanwhile, Medicare is pushing insurance companies to clean up their own prior authorization processes, which currently cover thousands of procedures and often slow down care.
When’s the deadline to enroll in Medicare?
Don’t wait too long. The deadline to enroll or make changes is December 7th.
Summary:
- Medicare Part D drug prices are going down this year, according to CMS.
- Visit Medicare.gov or call 1-800-MEDICARE to see if switching plans can save you money.
- Telemedicine may not be available during the government shutdown.
- Medicare is using prior approvals on surgeries to prevent fraud and protect patients, CMS said.
- The Medicare open enrollment deadline is December 7th — don’t miss it!