Blog
Legacy Health & Humana | 10.25.2026
Legacy Health has officially announced that it will end its contract with Humana Medicare Advantage, effective Dec. 31, 2026.
If you have a Humana Medicare Advantage plan and see Legacy providers - this affects you, starting on January 1, 2027.
Book a consultation here; you have until December 7th, 2026, to make a change that will be effective on January 1, 2027.
After that, there is one more opportunity to make a change - the Medicare Advantage Open Enrollment Period from January 1 - March 31, 2027.
Press release here.
The Portland Clinic & UnitedHealthcare | 10.17.2026
For UnitedHealthcare Medicare Advantage beneficiaries:
The Portland Clinic will no longer accept United’s Medicare Advantage plans in 2027. If you want to continue seeing providers at The Portland Clinic in 2027, they will accept the following plans:
Devoted Health Medicare Advantage
Regence Medicare Advantage
CareOregon Advantage Plus (closed to new patients)
This does not apply to current patients with Medicare Supplement (MediGap) plans.
Full details here: https://www.theportlandclinic.com/medicare-information/
If you are affected by this change, please book an appointment to determine next steps.
Please note: Several network changes within the market have impacted brokers and agents as inquiries come in heavier than usual. We understand anxiety is high and appreciate your patience. Please remember the enrollment period closes on December 7th; if you are not able to book an appointment right away, the timeframe remains the same - and changes are all effective January 1, 2027.
UnitedHealthcare & Providence Health Systems | 10.14.2026
For those with UnitedHealthcare plans, please take note of the following network update between United and Providence (from United):
Providence’s hospitals and providers in Oregon and Washington will no longer be in UnitedHealthcare’s network for people enrolled in the following plans, effective Jan. 1, 2027:
UnitedHealthcare Individual Medicare Advantage plans
Group Retiree plans
Chronic Special Needs Plans (C-SNP)
UnitedHealthcare members enrolled in the following plans are not impacted:
Employer-sponsored commercial plans in Oregon and Washington
Dual Special Needs Plans (D-SNP) in Washington
Medicare Supplement plans
This will affect many people across the Portland Metro area; please see United’s press release for full details.
If you are affected by this network change, we suggest taking the following actions:
Gather provider and prescription information
Please note: Several network changes within the market have impacted brokers and agents as inquiries come in heavier than usual. We understand anxiety is high and appreciate your patience. Please remember the enrollment period closes on December 7th; if you are not able to book an appointment right away, the timeframe remains the same - and changes are all effective January 1, 2027.
Providence Market Exit | 05.23.2026
Providence Health Plans released an update on May 20 announcing their transition out of most lines of their health insurance business, beginning in 2027.
Life is 10% what happens to you and 90% how you respond to it.
-Charles Swindoll
This quote applies a lot to Medicare and the insurance business overall. We are following the Providence exit closely and are prepared to be in response - not react - mode, come fall and Annual Enrollment.
Check back at the Providence link to keep updated, and schedule an appointment anytime to discuss. There is always a pivot.
Link to article: Providence Update
Link to book a meeting: Meet with Mark
CMS Releases 2026 Part A and Part B Pricing | 11.17.2025
2026 standard monthly Part B premiums: $202.90 (an increase of $17.90 from $185.00 in 2025 - this does not include IRMAA, if applicable.)
2026 annual Part B deductible: $283 (an increase of $26 from the annual deductible of $257 in 2025.
Visit https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles to see the full list of changes for 2026 pricing.
The Oregon Clinic No Longer Accepting UnitedHealthcare Medicare Advantage Plans Effective January 1, 2026 | 10.24.2025
Patients of The Oregon Clinic are currently receiving letters stating the following:
“The Oregon Clinic will not be able to see UnitedHealthcare Medicare Advantage plan members starting January 1, 2026. Patients undergoing certain types of treatment may be eligible for continuity of care benefits. Please reach out to UnitedHealthcare to learn more about continuity of care.”
If you are affected by this sudden and impactful decision to our seniors, please reach out. It is imperative that you understand exactly what this means for your coverage and your care.
Schedule a consultation today to understand your options for 2026.
Samaritan Exiting Advantage Plans in Benton, Lincoln and Linn Counties | 09.08.2025
Samaritan has announced that it is ending its Medicare Advantage plans in Oregon at the end of 2025.*
While carriers leaving an area isn’t a new concept, it can still be a surprise to those who receive the notices, and leave them feeling unsure of what to do next.
The potential silver lining: When a plan leaves an area, options become available that you may not be aware of, and we are here to guide you candidly and honestly through those options.
Having all available information in order to make to make informed decisions on your healthcare is paramount. To support this effort, we have added three events for Lincoln County, OR, residents during the Annual Enrollment Period:
Sat. 10/25, 9:00-10:00am, Cafe Chill in Waldport
Sat. 10/25, 12:00-8:00pm, Yachats Commons
Sat. 11/8, 9:00-10:00am, Cafe Chill in Waldport
Add these meetings to your calendar from our events page.
Topics we will cover:
Remaining Medicare Advantage options
Supplement (MediGap) plans
Utilizing only Original Medicare (Parts A&B)
Come learn what is available to you in Lincoln County for 2026.
*https://philomathnews.com/samaritan-health-dropping-medicare-advantage-plans-at-end-of-year/
Understanding Surprise and Balance Billing: A Guide for Medicare Beneficiaries | 08.01.2025
We’re shining a light on an important issue: many beneficiaries encounter unexpected bills, often leading to frustration and confusion. It can feel like companies rely on individuals not having the information or energy to challenge them. That’s where we come in.
Read on to empower yourself with essential knowledge about balance billing, also known as surprise billing…
What is Balance Billing?
Balance billing, or surprise billing, happens when healthcare providers charge you the difference between their fees and what your insurance covers. This often occurs unexpectedly, especially in emergencies or when receiving care from out-of-network providers at in-network facilities.
Protections Under the No Surprises Act (Effective January 1, 2022)
The No Surprises Act, part of the Consolidated Appropriations Act of 2021, provides essential protections:
Emergency Care: All emergency services are treated as in-network, regardless of the provider, with no prior authorization needed.
Non-Emergency Services: If you receive care at an in-network facility but can’t choose your provider, you cannot be balance billed.
Air Ambulance Services: Similar protections apply, preventing balance billing from out-of-network air ambulance providers.
Dispute Resolution: Payment disputes between providers and insurers are resolved through an Independent Dispute Resolution (IDR) process, keeping you out of the conflict.
Positive Impact So Far
A 2024 survey found that the No Surprises Act prevented over 10 million surprise bills in the first nine months of 2023, with nearly 80% of out-of-network providers accepting initial in-network payments from insurers.
Medicare Beneficiaries and Balance Billing
Original Medicare: Strictly prohibits balance billing. Providers who don’t accept assignment can only bill you up to a capped amount, and private contracts require your consent in advance.
Medicare Advantage Plans: Offer similar protections against surprise billing in emergencies or when referred by in-network providers.
What You Can Do
Know Your Rights:
Emergency and air ambulance services are always billed as in-network.
Out-of-network care at in-network facilities is protected.
Decline Network Waivers:
If presented unexpectedly, especially during emergencies, do not sign them.
Review Your Explanation of Benefits (EOB):
If you receive a surprise bill, file a complaint with CMS or your State Insurance Commissioner, and consider appealing under the No Surprises Act.
Consult Your Broker:
A knowledgeable advisor can help you navigate these rules and ensure you’re informed of your rights.
Current Landscape for Beneficiaries
As of this writing, no federal changes are expected that would weaken balance billing protections for Medicare or Medicare Advantage enrollees. In fact, Congress is considering stronger enforcement laws, and the Centers for Medicare & Medicaid Services (CMS) is enhancing dispute resolution processes and improving hospital billing transparency to further support beneficiaries.
Bottom Line
The No Surprises Act and Medicare regulations provide strong safeguards against balance billing. Recent policy updates continue to reinforce these protections. Navigating complex healthcare billing can be challenging, so having a dedicated broker year-round is essential to avoid unexpected costs.
If you receive a surprise bill, don’t pay it immediately. Reach out to us; we’ll review your coverage together, then guide you through the next steps.
Need help with a bill you’ve received or with understanding your rights? Book an appointment - we provide support all year, not just during enrollment season!
The Hidden Cost of Commission Cuts: Why UnitedHealthcare’s Move Matters to You | 06.18.2025
Across the country, UnitedHealthcare is cutting commissions for brokers and agents on Institutionalized Special Needs Plans (ISNPs) and $0 premium Medicare Advantage plans—plans used by the most vulnerable seniors in our community.
We have always been upfront about how the Medicare system works—including how we get paid. It’s part of our commitment to transparency, trust, and ethics. So when something happens that threatens the integrity of that system—and our ability to serve you well—we speak up.
Recently, a national advocacy organization, NABIP, issued a strong public statement about UnitedHealthcare’s decision to slash commissions for Medicare Advantage plan enrollments in several markets across the country. We support NABIP’s message 100% and want to explain what this could mean for our Oregon clients if these cuts expand to our state.
What’s Happening?
UnitedHealthcare, one of the largest Medicare Advantage plan sponsors, has reduced how much it pays independent brokers like us to help enroll and support members in their plans. These changes have already taken effect in other states, and there is concern that Oregon could be next.
This move may sound like an internal business decision—but it has real consequences for you, the Medicare beneficiary.
Why Should You Care?
Brokers and agents don’t just enroll people in plans. We…
Walk you through complex coverage options
Help you understand drug formularies, networks, and out-of-pocket limits
Assist with claims issues, prior authorizations, and billing errors
Are your advocate year-round, not just during Annual Enrollment
When commissions are cut too low, fewer professionals can afford to offer that level of service, potentially leading to:
Fewer local brokers offering support on certain plans
A shift toward high-pressure, national call centers instead of personalized help
Seniors being left to figure things out on their own, often with confusing or misleading information
We are a small, community-rooted business. We don’t charge for our help; our compensation comes from the plan sponsors (see the explanation here). But if those sponsors cut rates to the point where brokers can’t operate sustainably, it chips away at the very foundation of Medicare advocacy.
What This Means for Our Clients
We aren’t going anywhere. We will always tell you the truth about what’s changing in the industry. If UnitedHealthcare or any other plan reduces our ability to serve you effectively, we’ll be honest about it and help you navigate other options. We’ll continue to educate, advocate, and support the people who trust us with their Medicare journey.
We Support NABIP’s Call to Action
As NABIP members, we’re grateful for their leadership in standing up for the ethical, sustainable delivery of Medicare. We hope more people—clients, lawmakers, and carriers alike—pay attention to this issue before it becomes the new normal.
Final Thoughts
The Medicare system works best when seniors are informed and supported—and when agents are treated with fairness and respect. Our promise at Medicare Mark Fuchs LLC is to always operate with clarity, ethics, and your best interest at heart.
…What can I do?
—> Fill out this 5-question survey that NABIP developed to advocate with legislators on behalf of brokers and agents to recognize their value in working with Medicare beneficiaries. You have the option to remain anonymous!
—> If you have questions or concerns about your plan or how these changes might impact you, please don’t hesitate to contact us to book an appointment.
Serving Oregon’s Medicare community with integrity, transparency, and heart.
Read NABIP’s full statement here.
Enrollment Delays: Start Your Medicare Plan Early | 05.27.2025
Currently, delays at the Centers for Medicare & Medicaid (CMS) are causing carrier applications to go pending, giving the potential for coverage start dates to be delayed.
We have no insight into the inner workings of CMS, so we can only report on what we have experienced and confirmed with some of our contracted carriers.
This post serves to inform you, not alarm you. Read on for information and recommended action…
What’s Happening:
We’ve confirmed with multiple insurance carriers that new enrollments are showing as “pending” due to slower turnaround times at the Centers for Medicare & Medicaid Services (CMS). This is not typical.
Normally, once a plan application is submitted, it moves through the process quickly. But right now, things are taking longer — and it’s impacting when coverage actually begins.
Why This Matters:
If you're new to Medicare, the delay could mean a gap in your coverage if you don't plan ahead.
Your Medicare enrollment window is seven months:
Three months before your 65th birthday (or retirement date if you're already over 65)
The month of your birthday
And three months after your birthday
However - with CMS running behind, you can’t assume that submitting your paperwork even weeks in advance is enough.
Our Strong Recommendation: Whether enrolling in Original Medicare (Parts A & B), a Medicare Supplement plan, or a Medicare Advantage plan, give yourself AMPLE time.
👉 For those over 65, still working, planning to retire, and currently covered under employer insurance: We recommend starting the process of applying for Part B a full SIX MONTHS before your planned retirement. This allows for:
SSA processing time (also currently slower than normal)
CMS lag in approving and activating coverage
Ensuring the plan of your choice is in place when you need it
The punchline? Don’t wait - start early, secure your coverage, and protect your peace of mind.
If you're unsure of your timeline or would like to talk through your plans, book a time to talk here.