It was a busy week for Medicare.

Between August 17 and August 21, 2026, developments emerged involving prescription drug prices, Medicare Advantage, Medicare Supplement insurance, physician reimbursement and potentially even how beneficiaries access specialty care.

Some of these developments could eventually affect what Medicare beneficiaries pay.

Others could influence which doctors accept Medicare or how physician practices schedule care.

And one involves a name most people probably didn’t expect to hear in a Medicare insurance conversation:

Costco.

Here are five Medicare developments worth knowing about this week—and what they could eventually mean for beneficiaries.

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Monday: Medicare’s Drug Price Negotiation Program Reaches a Major Regulatory Milestone

The week began with an important deadline for Medicare prescription drug policy.

On August 17, CMS closed the 60-day public comment period for proposed rule CMS-4215-P, which would formally codify significant parts of the Medicare Drug Price Negotiation Program into federal regulations.

CMS issued the proposed rule on June 12, 2026.

Why is this significant?

Because Medicare drug-price negotiations have been implemented largely through guidance during the program’s early years.

CMS is now proposing to create a more permanent regulatory framework governing issues such as:

• Drug selection
• Negotiation procedures
• Manufacturer participation
• Maximum Fair Prices
• Renegotiation
• Compliance requirements
• Program administration

CMS describes the proposal as establishing a more permanent framework for Medicare drug-price negotiations while creating greater certainty around how future negotiation cycles operate.

Why Medicare beneficiaries should care

This isn’t simply Washington paperwork.

The rules being established now could influence how Medicare negotiates prices for some of the country’s highest-cost medications for years to come.

And the program is expanding.

Part B drugs—including certain medications administered by physicians or other healthcare providers—are becoming increasingly relevant to the negotiation framework.

That could include expensive medications administered through:

infusions, injections and other provider-administered treatments.

For beneficiaries dealing with cancer, autoimmune disorders and other serious conditions requiring specialty medications, the evolution of Part B drug negotiation is particularly important.

What happens next?

Closing the comment period does not mean every proposal automatically becomes law exactly as written.

CMS must evaluate comments from stakeholders before determining what ultimately appears in the final regulations.

For consumers, the takeaway is:

Medicare’s drug-price negotiation system is moving from its early implementation stage toward a more permanent regulatory structure.

CMS Medicare Drug Price Negotiation Program regulations and guidance

Source: Health Affairs

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Tuesday: Hospitals Push Medicare for Upfront Negotiated Drug Prices

Monday’s deadline also produced an important debate over how negotiated prices actually reach the healthcare system.

The American Hospital Association submitted comments asking CMS to require manufacturers to make Medicare’s negotiated Maximum Fair Price, or MFP, available prospectively at the point of sale.

In simpler terms:

Hospitals want the lower negotiated price available upfront rather than having to pay more first and reconcile the difference afterward.

The AHA argued that retrospective rebate arrangements can create substantial administrative work for hospitals, pharmacies and other healthcare organizations.

That can involve tracking eligible claims, reconciling payments, monitoring manufacturer refunds and resolving discrepancies.

The organization therefore urged CMS to establish a national prospective point-of-sale approach.

Why does this matter?

Imagine purchasing something for $1,000 even though you’re ultimately supposed to pay $700.

Instead of simply paying $700 at the beginning, you’re required to:

Pay $1,000 → document the transaction → request the difference → track the reimbursement → reconcile everything later.

Multiply that process across thousands of expensive medications and healthcare transactions.

That’s essentially the administrative concern hospitals are raising.

The AHA argues that making negotiated prices available prospectively could provide greater pricing certainty and reduce administrative burden.

Consumer advocates also weighed in

Families USA submitted comments supporting CMS’s move to codify the negotiation program while calling for additional changes, including closing potential loopholes involving modifications to existing drugs and reconsidering aspects of how negotiated prices are established.

So Monday’s deadline produced a larger policy debate:

It’s not only about negotiating a lower price.

It’s also about how that lower price is implemented throughout the healthcare system.

Read the American Hospital Association’s CMS drug-pricing comments

Topic Source: American Hospital Association

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Wednesday: Costco Is Entering the Medicare Market

Then came one of the week’s biggest consumer-facing Medicare stories.

Costco is moving into Medicare insurance.

Costco and nonprofit insurer SCAN Health Plan are planning a limited rollout of co-branded Medicare products.

Current reporting indicates the partnership plans to introduce:

Medicare Advantage products in two states

and

a Medicare Supplement product in a third state.

The rollout remains subject to regulatory approval, and the specific markets haven’t yet been publicly identified.

That’s an important distinction.

Costco itself isn’t simply becoming a traditional health insurer.

The company is partnering with SCAN, an organization already operating in the Medicare market.

The partnership is expected to explore integration with services familiar to Costco customers, including:

• Pharmacy
• Vision
• Hearing
• OTC-related benefits

SCAN described the partnership as its first comprehensive Medicare-plan collaboration with Costco.

Why Costco?

Trust.

Millions of Americans already associate Costco with:

value + convenience + purchasing power.

Bringing that brand into Medicare could be an interesting test of whether consumer loyalty from retail can transfer into health insurance.

The potential market for the initial products includes roughly five million Medicare-eligible consumers, according to reporting on the partnership.

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But Don’t Choose a Medicare Plan Because You Like Costco

This is the most important consumer takeaway from Wednesday’s news.

Suppose the new plans eventually become available in your area.

You shop at Costco.

You use Costco Pharmacy.

You buy glasses there.

Maybe you use its hearing services.

So a Costco-branded Medicare plan sounds perfect.

Not necessarily.

A familiar brand should never replace a Medicare coverage comparison.

Before choosing any Medicare Advantage plan, beneficiaries should still examine:

• Doctors
• Specialists
• Hospitals
• Prescription formulary
• Pharmacy network
• Copayments
• Premium
• Maximum out-of-pocket limit
• Prior authorization
• Referral requirements
• Supplemental benefits

That’s especially important with Medicare Advantage because benefits and networks can vary by plan and location.

We’ve previously explained how to evaluate supplemental Medicare Advantage benefits here:

Transportation, OTC and Fitness Benefits: How Delray Beach Residents Should Compare Plans

The same principle applies to Costco:

Brand recognition is not a substitute for checking whether the plan actually fits your healthcare needs.

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What About Costco Medigap?

The Medicare Supplement side of this announcement is also interesting.

Medigap operates very differently from Medicare Advantage.

Medicare Supplement insurance works alongside Original Medicare to help cover certain costs Original Medicare leaves behind.

That means consumers considering a future Costco/SCAN Medigap product should compare it with other companies offering the same standardized plan letter in their state.

For couples, discounts can also matter.

We’ve recently covered that here:

Medigap Household Discounts: What Boynton Beach Couples Should Ask About

Again, the Costco name may attract attention.

But the actual coverage, premium, eligibility and long-term fit should drive the decision.

Topic Source: SpokesMan

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Thursday: ENT Doctors Warn Medicare Proposal Could Restrict Access to Specialists

Thursday’s story brings us from insurance companies to doctors.

A new survey from the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) surveyed more than 1,400 ear, nose and throat physicians about a proposed Medicare payment change.

The results were striking.

More than 84%

said the proposal could result in longer appointment waits, fewer referral options and more difficulty obtaining timely specialty consultations.

67%

said they would have to see fewer Medicare patients.

14%

said they could stop accepting Medicare patients entirely.

Those are survey responses—not predictions guaranteed to occur.

But they highlight how strongly many physicians feel about the proposed policy.

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What’s the Medicare Payment Proposal Doctors Are Worried About?

This leads directly into Friday’s story.

CMS’s proposed 2027 Medicare Physician Fee Schedule includes a policy affecting situations where a physician provides a separately identifiable office evaluation and management service on the same day as certain procedures.

Under the proposal, the most expensive applicable service would be paid at 100%, while the other applicable procedure or E/M service would be paid at 50%.

The AMA has stated that it intends to strongly oppose the proposal.

For ENT doctors, same-day evaluation and treatment can be common.

A patient might visit because of:

• Ear problems
• Sinus issues
• Nosebleeds
• Throat problems
• Hearing concerns

During that appointment, the physician may determine that a procedure is also medically necessary.

Physician groups argue that reducing payment for one of those services could change the economics of providing both during the same visit.

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Why Seniors Should Pay Attention to Physician Payment Policy

Most Medicare beneficiaries don’t spend much time thinking about the Physician Fee Schedule.

But payment policy can eventually influence access.

If physicians believe Medicare reimbursement doesn’t adequately cover the cost of providing care, practices could respond by:

• Limiting Medicare appointments
• Changing scheduling practices
• Performing procedures on different days
• Reducing certain services
• Consolidating with larger healthcare organizations
• In some cases, reconsidering Medicare participation

Again, that doesn’t mean all of those outcomes will occur.

But the AAO-HNS survey shows why physicians are warning policymakers about potential consequences.

For seniors, the issue isn’t merely:

“How much does Medicare pay my doctor?”

It’s:

“Could payment policy eventually affect how easily I can see my doctor?”

That’s the consumer issue worth watching.

Topic Source: PR News Wire

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Friday: AMA Pushes Back Against the Proposed 50% Same-Day Payment Policy

The week’s final major story focused directly on the proposed Medicare payment change.

Under CMS’s 2027 Physician Fee Schedule proposal, when a separately identifiable office E/M service and certain procedures are provided by the same physician or group on the same day, CMS proposes paying the highest-cost applicable service at 100% and other applicable services at 50%.

The American Medical Association opposes the policy.

Its concern is that physicians are performing separate, medically necessary work even when the evaluation and procedure occur during the same appointment.

Why could this matter to a Medicare patient?

Consider this hypothetical example.

You schedule an appointment because you’re having a medical problem.

Your doctor evaluates the issue.

During that same visit, the doctor determines that a procedure is necessary.

From a patient’s perspective, having both handled during one appointment can be convenient.

You don’t need to:

go home → schedule another appointment → arrange transportation → return another day.

Physician organizations worry that reduced reimbursement for same-day services could make that model less sustainable.

The policy remains proposed, not final.

That’s an important distinction.

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The Bigger Story: Medicare Is Being Reshaped From Multiple Directions

Looking across all five stories reveals something bigger.

Medicare isn’t changing in just one area.

Prescription drug pricing is changing.

CMS is working toward a more permanent regulatory framework for drug negotiations.

Drug payment mechanics are being debated.

Hospitals want negotiated prices available upfront rather than through retrospective reimbursement.

New consumer brands are entering Medicare.

Costco and SCAN are testing whether a trusted retail brand can translate into Medicare insurance.

Physician reimbursement is under debate.

Medical organizations are warning that certain proposed payment changes could affect access to care.

And ultimately, all of these issues intersect around one question:

What will Medicare look like for beneficiaries over the next several years?

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Three Things Medicare Beneficiaries Should Take Away From This Week

1. Medicare drug negotiations are becoming more permanent.

The program is moving beyond its earliest implementation phase and toward a formal regulatory framework.

That matters as negotiations expand to additional medications and future years.

2. More recognizable consumer brands may enter Medicare.

Costco’s partnership with SCAN could encourage other major consumer brands to explore similar Medicare partnerships.

But beneficiaries should continue comparing plans based on healthcare needs—not brand loyalty.

3. Provider access deserves attention.

Insurance coverage doesn’t help much if beneficiaries struggle to find physicians willing or able to see them.

That’s why physician reimbursement debates matter even if beneficiaries never personally look at a Medicare fee schedule.

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What Should You Do Right Now?

Probably nothing based solely on these headlines.

The drug-price regulation is still moving through the federal rulemaking process.

The Costco/SCAN products are still subject to regulatory approval and aren’t suddenly available nationwide.

The physician payment policy is proposed rather than final.

So don’t change Medicare coverage because of a news headline.

Instead:

Stay informed.

When your Medicare coverage becomes available for annual review, evaluate what’s actually available in your ZIP code at that time.

For official Medicare information, visit:

Medicare.gov

And for official information about Medicare’s Drug Price Negotiation Program:

CMS Medicare Drug Price Negotiation Program

Topic Source: Cap Radio

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Local Medicare Help in Palm Beach County

Medicare changes constantly.

Drug rules change.

Insurance companies enter and exit markets.

Plan benefits change.

Provider networks can change.

And government policies can affect everything from prescription prices to physician reimbursement.

That’s why Medicare Plan Assistance continues following these developments and breaking them down into information beneficiaries can actually use.

If you’re approaching Medicare eligibility, reviewing your existing Medicare coverage, or preparing for retirement, we can help you understand your options.

📞 Call Medicare Plan Assistance at (561) 808-9410

We help Medicare beneficiaries throughout Delray Beach, Boca Raton, Boynton Beach, Palm Beach County and beyond understand their Medicare choices.

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Final Thoughts

This week’s Medicare news wasn’t dominated by one enormous announcement.

Instead, we saw several developments that together show where Medicare may be heading.

CMS is formalizing drug-price negotiations.

Hospitals are pushing for negotiated prices to work more efficiently.

Costco is bringing a powerful retail brand into Medicare insurance.

Physicians are warning about the potential effects of proposed reimbursement changes.

For beneficiaries, the lesson isn’t to panic or immediately change coverage.

It’s to understand that Medicare is constantly evolving.

Some proposals discussed today may change before they’re finalized.

Some new products may never reach your county.

And some policy changes may take years before beneficiaries notice their effects.

Our job is to keep watching—and explain what actually matters when those changes reach Medicare consumers.

📞 Have Medicare questions? Call Medicare Plan Assistance at (561) 808-9410.

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Frequently Asked Questions

Is Medicare negotiating prescription drug prices?

Yes. Medicare’s Drug Price Negotiation Program allows CMS to negotiate Maximum Fair Prices for selected high-cost drugs under the statutory program. CMS is now working to codify significant program policies through formal regulation.

Did the Medicare drug negotiation comment period end?

Yes. CMS states that the 60-day public comment period for proposed rule CMS-4215-P closed on August 17, 2026.

Is Costco offering Medicare Advantage plans?

Costco and SCAN Health Plan have announced plans for a limited rollout of co-branded Medicare products, including Medicare Advantage in two states and Medicare Supplement coverage in a third. The products remain subject to regulatory approval, and specific markets haven’t yet been publicly announced.

Can I get a Costco Medicare plan in Florida right now?

Don’t assume so. The initial states haven’t been publicly identified in the reporting reviewed for this article, and the products remain subject to regulatory approval. Beneficiaries should wait for official plan availability information before assuming a Costco/SCAN plan will be offered in their area.

Is Medicare cutting all doctor payments by 50%?

No. That’s an important distinction. The proposal concerns payment when certain separately identifiable E/M visits and procedures occur on the same day. Under the proposal, the highest-cost applicable service would receive 100% payment while other applicable services would receive 50%.

Are doctors going to stop accepting Medicare?

There is no basis to say doctors generally will stop accepting Medicare. However, an AAO-HNS survey found that 67% of responding ENT physicians said the proposed payment policy would cause them to see fewer Medicare patients, while 14% said they might stop accepting Medicare entirely. Those are survey responses about a proposed policy, not confirmed future outcomes.

Has the 50% same-day Medicare payment proposal been finalized?

No. It is part of CMS’s proposed 2027 Medicare Physician Fee Schedule. The AMA and other physician organizations are opposing the policy.

Where can I get Medicare help in Palm Beach County?

Medicare Plan Assistance helps beneficiaries understand Medicare enrollment and coverage options. Call (561) 808-9410 for Medicare guidance.