Jeff Dobbins, MD

04/10/2026

🏥 Medicare Part B went up to $202.90 a month in 2026 — a $17.90 increase from 2025.

That's the premium automatically deducted from your Social Security check if you're enrolled.

Part B doesn't have an annual out-of-pocket cap. Original Medicare (Parts A and B) has no maximum. You pay 20% of approved costs indefinitely after the deductible.

That's the gap that Medigap and Medicare Advantage plans exist to address.

The Part A hospital deductible is $1,736 per benefit period — not per year. A benefit period starts when you're admitted and resets after 60 consecutive days out of care.

If you're admitted twice in a year with no 60-day gap between stays, you pay the deductible twice.

Part D's annual out-of-pocket cap increased to $2,100 in 2026. If you take expensive medications, this cap is meaningful — once you hit it, you pay nothing for covered drugs for the rest of the year.

IRMAA is the hidden cost most people overlook. If your income was above $106,000 (single) or $212,000 (joint) in 2024, you'll pay higher Part B and Part D premiums in 2026. Medicare uses income from two years prior.The Part D late enrollment penalty is permanent. If you skip Part D when you're first eligible and don't have creditable drug coverage elsewhere, you pay 1% of the base premium for every month you were uncovered — for as long as you're enrolled.

04/08/2026

📊 In 2025, more than half of eligible Medicare beneficiaries with Parts A and B were enrolled in Medicare Advantage.

MA plans often attract enrollees with $0 additional premiums, extra benefits like dental or vision, and a built-in annual out-of-pocket cap for Part A and B services — protections Original Medicare does not include on its own.

One major tradeoff is prior authorization: Medicare Advantage plans may require plan approval for certain services, while Original Medicare generally requires prior authorization far less often.

MedPAC estimates Medicare will spend about 20% more in 2025 for MA enrollees than it would for those same beneficiaries in traditional Medicare, due in part to how risk-adjusted payments work and the incentive for plans to document diagnoses completely.

CMS has proposed only a 0.09% average payment increase for MA plans in 2027, down sharply from the 5.06% increase finalized for 2026. If payment growth stays that low, some plans could trim benefits, raise member costs, or exit weaker markets.

One tradeoff many people miss before enrolling: if you switch from Medicare Advantage back to Original Medicare later, getting a Medigap policy can be difficult. In most states, outside protected enrollment windows, insurers can medically underwrite or deny Medigap coverage.

03/22/2026

Most people turning 65 think Medicare is free or close to it.

Then they get their first bill and the shock is real.

Here's what Medicare actually costs you in 2026.

Part A covers hospital and inpatient care. For most people who worked 40 or more quarters it has no monthly premium. But it has a $1,736 deductible per benefit period, and here's the part that catches people off guard — that's per benefit period, not per year. If you're hospitalized twice in a year for separate issues you could be hit with that deductible twice.

Part B covers doctors, outpatient surgery, preventative care, and lab tests. The standard premium is $202.90 per month and higher earners pay even more through IRMAA surcharges. The annual deductible is $283 and after that you pay 20% of the Medicare approved amount for every service.

That 20% is where it gets dangerous.

Part B has NO out of pocket maximum. None. If you have a $100,000 outpatient procedure Medicare pays $80,000 and you owe $20,000 out of your own pocket with absolutely no cap on your exposure.

This is exactly why most people on original Medicare buy a Medigap supplement policy to cover that 20% gap.

Without it you're one serious diagnosis away from a five figure medical bill that Medicare won't touch.

The biggest Medicare mistake I see isn't picking the wrong plan. It's not understanding how the costs actually work until it's too late to change anything.

Learn this before you need it.

03/20/2026

03/20/2026

So how do you feel about foreigners taking jobs from American doctors and nurses?

Breaking Barriers: New U.S. Bill Aims to Remove $100,000 Visa Fee for Healthcare Workers

In a major move that could reshape the future of healthcare staffing in the United States, a bipartisan group of lawmakers has introduced the “H-1Bs for Physicians and the Healthcare Workforce Act” in the House of Representatives this week.

The proposed legislation seeks to eliminate a controversial $100,000 H-1B visa fee that was introduced in late 2025 for foreign doctors and nurses. That fee quickly became a significant barrier, discouraging international healthcare professionals from working in the U.S. at a time when the country is facing severe staffing shortages.

Why This Bill Matters

Healthcare systems across the U.S. are currently under immense pressure. With ongoing nurse shortages, physician gaps, and rising patient demand, many hospitals—especially in rural and underserved communities—are struggling to maintain safe staffing levels.

Supporters of the bill argue that removing the massive visa fee could:

Attract more foreign-trained doctors and nurses

Ease critical staffing shortages

Improve patient care in underserved regions

Support overburdened healthcare workers already in the system

For many healthcare professionals abroad, the $100,000 fee was simply unrealistic. Waiving it could reopen doors for thousands of qualified workers ready to serve where they are needed most.

A Bipartisan Effort

What makes this proposal especially notable is its bipartisan support—a rare sign of unity in today’s political climate. Lawmakers from both parties agree that the healthcare workforce crisis has reached a point where urgent, practical solutions are needed.

Potential Impact on the Healthcare System

If passed, this bill could mark a turning point in how the U.S. approaches healthcare workforce shortages. By making it easier for international professionals to enter the system, hospitals may finally gain some relief from chronic understaffing.

However, critics may raise concerns about long-term workforce planning and reliance on foreign labor. Still, for now, many see this as a necessary and immediate step to stabilize the healthcare system.

Looking Ahead

The bill is still in its early stages, but it has already sparked strong discussion nationwide. For thousands of healthcare workers—and millions of patients—its outcome could have lasting consequences.

As the U.S. continues to navigate its healthcare challenges in 2026, one thing is clear: solutions like this are no longer optional—they are essential.

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03/18/2026

🏥 Hospitals Under Pressure: New Staffing Rules Change Everything in 2026

In 2026, the U.S. healthcare system is entering a new era—one where nurse staffing is no longer optional, but essential for survival. Hospitals across the country are feeling unprecedented pressure as new national standards force them to confront a long-standing issue: not having enough nurses at the bedside.

This year marks a turning point, where policy, workforce realities, and patient safety are colliding in ways the industry can no longer ignore.

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📊 A Historic Rule That Changes the Game

At the center of this transformation is a major decision by the Joint Commission, which has officially made nurse staffing a National Performance Goal in 2026.

This means hospitals must now:

Prove they have adequate nurse staffing levels

Demonstrate safe patient care delivery

Meet these standards to maintain accreditation status

👉 In simple terms:
Hospitals that fail to staff properly risk losing credibility—and potentially funding and operations stability.

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⚠️ Why This Rule Matters Now

For years, nurse staffing has been one of the most controversial issues in healthcare. But until now, enforcement has been inconsistent.

In 2026, that changes.

This new requirement comes at a time when:

The U.S. faces a significant nursing shortage

Patient demand remains high

Nurse burnout is pushing many out of the profession

👉 Hospitals are now being asked to fix a crisis while still in the middle of it

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🚨 Hospitals Feeling the Pressure

Healthcare systems are scrambling to adapt. Many are now:

Increasing recruitment efforts

Offering higher wages and bonuses

Expanding training and onboarding programs

But challenges remain:

There simply aren’t enough nurses to hire

Retention is becoming harder due to burnout

Budget constraints limit how quickly changes can happen

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🤖 Technology Becomes a Lifeline

To meet new staffing expectations, hospitals are turning to innovation:

AI tools to reduce documentation workload

Virtual nursing programs to support bedside staff

Hybrid care models using teams of RNs, LPNs, and techs

These solutions are helping—but they are not a complete replacement for experienced bedside nurses.

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😓 The Human Cost Behind the Numbers

While policies and technology evolve, the reality for many nurses remains difficult.

Across the country, nurses report:

High patient-to-nurse ratios

Emotional and physical exhaustion

Feeling undervalued despite increased demand

This has led to:

Rising turnover

Ongoing labor disputes

Strikes and protest actions in multiple states

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🚨 A System at a Crossroads

The new staffing rules have done something powerful:
They have forced hospitals to confront a truth they can no longer delay.

👉 Safe staffing is not just a workforce issue—it is a patient safety requirement.

Now, healthcare leaders face critical questions:

Can hospitals recruit and retain enough nurses in time?

Will policy enforcement drive real change or create more strain?

How will smaller or underfunded hospitals adapt?

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🔄 What Happens Next?

The impact of these rules will unfold throughout 2026 and beyond.

Possible outcomes include:

Improved patient care and safety standards

Better working conditions for nurses

Or increased financial and operational pressure on hospitals

One thing is certain:
The old system is no longer sustainable.

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💬 Final Thoughts

Hospitals are now under more pressure than ever before—not just from patients, but from policy, workforce realities, and public expectation.

The new staffing rules have changed the conversation.
And in doing so, they may ultimately reshape the future of U.S. healthcare.

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📢 Hashtags

03/17/2026

If you are approaching 65, you might be asking, "Where do I actually sign up?" 🤔 The answer is confusing because there isn't just one website for everything.

Here is the simple breakdown so you don’t waste hours on hold:

1️⃣ For Original Medicare (Parts A & B): You actually apply through Social Security (https://hubs.la/Q0423wKR0). Even if you aren't claiming retirement benefits yet, they handle the paperwork for the government-issued parts of Medicare.

2️⃣ For Advantage & Drug Plans (Parts C & D): Once you have your Medicare ID, you switch over to https://hubs.la/Q0423zTx0. You can create an account, shop for plans, and hit "Enroll" without talking to a single person.

3️⃣ The Exception (Medigap/Supplement): These are the only plans you usually can't do on a government site. For Medigap, you generally need to work with a broker or contact the insurance carrier directly.

💡 Pro Tip: Unless you have a specific issue (like identity theft or complex work history), you can do almost all of this online in minutes.

👇 Tell us below: Have you ever been stuck on hold with Medicare before? 📞

Register for my next free online Medicare workshop by going here: https://hubs.la/Q0423zQN0

03/17/2026

Did you know that if you start with a Medicare Advantage plan, you might not be able to switch back to Original Medicare later?

Here is the issue many people fall into: 👉 The 6-Month Window: When you first join Medicare, you have "Guarantee Issuance," meaning you can join any plan regardless of your health. 👉 The Lock-Out: After 6 months, Medigap (Supplement) plans can deny you coverage based on pre-existing conditions.

Don't choose a plan just for a short-term perk like a gym membership only to face higher financial risk later. You have to think about your health long-term.

Register for my next free online Medicare workshop by going here: https://hubs.la/Q041ckmr0

01/26/2026

The office is open today. Stay warm everyone.

12/26/2025

Dallas is celebrating his First Birthday today. He is hoping everyone had a Very Merry Christmas.