cooner-insurance-agency

ACA Open Enrollment 2027: What’s Changing and What’s Staying the Same

Wed, 21 Oct 2026 16:15:00 GMT

What to Know About Financial Assistance, Plan Choices, and Coverage Before Open Enrollment Gets Underway.

ACA Open Enrollment is just around the corner. If you’ll be shopping for individual or family health insurance through the Marketplace for 2027, now is a good time to understand what may look different this year.

While the basic structure of ACA Marketplace coverage remains familiar, there are some important things to know before Open Enrollment begins.

Premium Tax Credits Are Still Available, but the Enhanced Subsidies Are Still Gone

Premium tax credits are still available to help eligible households lower the cost of Marketplace coverage in 2027.

However, the temporary enhanced premium tax credits that were available from 2021 through 2025 have expired. Those enhanced credits provided additional financial assistance and temporarily allowed some households with incomes above 400% of the federal poverty level to qualify for help.

For 2027, the traditional ACA income limits remain in place. In general, households with incomes between 100% and 400% of the federal poverty level may qualify for premium tax credits if they meet the other eligibility requirements.

Even if your income hasn't changed, don't assume your financial assistance or monthly premium will be the same for 2027.

The Metal Tiers Aren’t Going Away

The familiar Bronze, Silver, Gold, and Platinum metal levels will still be available for 2027. These categories indicate how you and your insurance plan generally share healthcare costs; they aren't ratings of the quality of care.

Plans within the same metal level can still differ in their premiums, deductibles, copayments, provider networks, prescription coverage, and other details. When Open Enrollment begins, look beyond the metal level and compare how each plan would work for your healthcare needs and budget.

Cost-Sharing Reductions Are Still Available

Cost-sharing reductions, or CSRs, are also sticking around. These additional savings can help eligible consumers lower out-of-pocket costs such as deductibles, copayments, coinsurance, and out-of-pocket maximums.

During the Marketplace enrollment process, you’ll find out whether you qualify based on your income and household information. If you do, you’ll need to choose an eligible Silver plan to take advantage of these additional savings.

Many ACA Protections Haven’t Changed

Despite these changes, many of the fundamentals of Marketplace coverage remain the same.

ACA-compliant Marketplace plans still cover essential health benefits, and insurers generally cannot deny you coverage or charge you more because of a pre-existing health condition.

You'll also still be able to compare plans based on premiums, deductibles, provider networks, prescription coverage, and other out-of-pocket costs.

Get Ready for November 1

You don't need to choose your 2027 plan yet, but you can start getting prepared.

Review how your current coverage has worked for you, gather a list of your doctors and prescriptions, and think about your expected household income for 2027. When Open Enrollment begins, you'll be in a better position to compare your choices and understand how this year's changes may affect you.

ACA Open Enrollment begins November 1 in most states. If you have questions about what's changing for 2027 or want help preparing to review your options, we're here to help.

Your Family's Halloween Safety Checklist

Fri, 16 Oct 2026 16:00:00 GMT

Simple Steps to Keep Trick-or-Treating Fun for Kids, Parents, and Grandparents Alike

Halloween is one of the best nights of the year for kids, and a few small precautions go a long way toward keeping it that way. Run through this checklist before the trick-or-treating starts.

Costumes

Choose bright or light-colored costumes, or add reflective tape so drivers can spot kids after dark.
Skip long capes, oversized sleeves, and trailing fabric. Trips and falls are one of the most common Halloween injuries.
Swap masks for face paint or a hat. Masks can block a child's vision at the worst possible time.
Make sure shoes fit well, especially over tights or extra socks worn under a costume.

Pumpkins and Decorations

When carving pumpkins, let kids draw the face, but carving should be handled with care. For younger children, adults should handle the cutting. Older kids can try a blunt-edge carving saw made for pumpkins under close supervision, but a dull blade still isn't a risk-free one.
Light pumpkins with a flashlight, battery-operated candle, or glow stick instead of an open flame when you can.
Keep any lit pumpkins away from curtains, doormats, and other decorations that could catch fire.
Never leave a lit pumpkin unattended.

Trick-or-Treating

Stick to sidewalks. If there isn't one, walk facing traffic.
Cross at corners and crosswalks, not between parked cars.
Bring a flashlight with fresh batteries, even if the costume already glows.
Keep kids under 12 with an adult at all times.
Trick-or-treat in a group when possible. There's safety in numbers.

The Candy Haul

Feed kids dinner before they head out so they're less tempted to snack along the route.
Look over every piece before anyone digs in. Toss anything unwrapped, torn, or homemade from someone you don't know.
Check labels closely if anyone in the family has a food allergy.
Set a plan for how much candy is okay each day, and stick with it.

Handing Out Candy at Home

Clear the porch and walkway of hoses, toys, and anything else little feet could trip over.
Turn on the porch light and ensure it adequately lights the way for visitors.
Keep pets in another room while trick-or-treaters are coming and going.
Consider a few non-candy treats, like stickers or small toys, for kids with allergies.

Behind the Wheel

Slow down and expect kids near the road, even outside crosswalks and driveways.
Take extra care pulling in and out of driveways in residential neighborhoods.
Turn headlights on early. Visibility drops fast once the sun goes down.

A little planning goes a long way toward a fun, safe night for everyone, from the littlest ghosts and goblins to the parents and grandparents handing out candy on the porch.

Happy Halloween!

What Medicare Advantage Plans Taught Us in 2026

Wed, 14 Oct 2026 16:00:00 GMT

What to Watch for in 2027 Based on Two Years of Changes

For nearly two decades, Medicare Advantage plans grew steadily, becoming the choice for more than half of all Medicare beneficiaries. But starting in 2025, that season of growth reached its apex. The past two years have brought significant changes. Some plans have cut benefits like dental, vision, and hearing coverage. Some insurers have pulled out of entire counties. As a result, millions of beneficiaries have had to shop for new coverage.

If you're on a Medicare Advantage plan, these last two years reveal an important pattern, and it's helpful to understand this as you prepare to look at 2027 plans this month. Read below to learn more about what's been happening and why, plus what to watch for as enrollment season kicks off.

Two Years of Significant Shifts in Plans

The total number of Medicare Advantage plans available nationally declined 10 percent last year, dropping from over 3,700 in 2025 to under 3,400 plans in 2026. Nearly 3 million people with Medicare Advantage plans (about 10 percent of all enrollees) had to find alternative coverage as some health insurers exited markets and scaled back plan options.

The largest insurers led the pullbacks. UnitedHealthcare reduced its coverage in 109 counties, while Humana decreased presence in 194 counties. In some regions, the disruption was more severe. In 122 counties across 13 states, approximately 391,000 beneficiaries lost access to any Medicare Advantage plan at all. Vermont experienced the most dramatic shift: 92.2 percent of Medicare Advantage enrollees in the state had to find alternative coverage. Other rural states were hit hard too: Wyoming now has just three Medicare Advantage-Prescription Drug plans available, South Dakota has four, and Minnesota also saw dramatic reductions.

The changes described here were the second year of a broader trend. So what are the underlying drivers of these changes and what should you do about it?

Why This Is Happening

The root cause centers around profitability. Federal policy changes that aimed to reduce overpayments resulted in lower reimbursement rates from the government to insurers. Meanwhile, following the pandemic, beneficiaries began seeking healthcare they postponed, which drove up medical costs faster than insurers had projected. The combination squeezed profit margins across the industry.

In response, the industry shifted rapidly from prioritizing enrollment growth to prioritizing profitability. The financial pressure remains to this day. CMS projects a 2.48 percent average rate increase for 2027—higher than initially proposed, but still lower than what many insurers need to sustain robust benefit packages. That's why the pattern we've seen these last two years is likely to continue.

What We've Seen Plans Do

Over the past two years, beneficiaries have experienced several types of changes:

Benefit reductions. For example, Aetna, Elevance, and UnitedHealthcare have cut allowances for over-the-counter health and wellness items. UnitedHealthcare and Humana cut OTC benefits for special needs plans. Some deductibles have risen on prescription drugs and medical services.

Network changes. Plans are shifting away from Preferred Provider Organization (PPO) plans, which offer more provider choice. They're prioritizing HMO designs (health maintenance organizations), which have more limited networks.

Geographic targeting. While some carriers expand into select markets, they simultaneously exit others, choosing to focus on areas where they can maintain better margins. Some insurers have pulled out of certain counties or even entire states. This is especially common in rural areas, where profitability is harder to achieve.

Who Should Be Paying Closest Attention

Seniors living in rural areas should pay particular attention. Over the past two years, rural beneficiaries have been disproportionately affected by plan terminations. While rural residents comprise only 14 percent of typical Medicare Advantage enrollees, they represented nearly 23 percent of those whose plans were terminated in 2025.

Certain states have seen more disruption than others. Vermont, Idaho, Wyoming, North Dakota, South Dakota, Maryland, and New Hampshire all saw more than 40 percent of their Medicare Advantage enrollees forced to switch plans between 2025 and 2026.

If you live in a rural area or a state that's seen significant plan activity, pay close attention to 2027 announcements to see if plans have changed in your region, and reach out to us for help.

What to Watch for this Month

Even before CMS releases 2027 plan details in mid-October, there are some important things you can do to prepare:

Review your Annual Notice of Change (ANOC) statement. You should have received this in September. Don't just glance at the plan name and assume everything is the same.

Look for benefit changes. Check whether dental, vision, or hearing benefits have changed. Are OTC allowances being reduced? Has your prescription drug deductible increased? Are out-of-pocket maximums higher?
Examine network changes. Did your plan shift from a PPO to an HMO? Are the doctors and hospitals you use still in-network? This is a critical detail that's easy to miss.

Keep your eyes out for a termination notice. Humana, UnitedHealthcare, Aetna, and other carriers signaled they may make additional plan exits this year. When a plan exits a county, the carrier is required to send impacted members a notice at least 60 days prior. So be sure to open all mail from your current plan, especially if you live in a rural area, in case you receive a notice of plan termination.

Talk to us soon! Don't wait until the last minute. If you receive a termination notice, or you see any changes in your ANOC that concern you, reach out to us for guidance. We can help you interpret the details as you check for changes to your current plan. As soon as plans are released, we can help you select a new plan if needed.

Know Your Options

If your plan does change or exit your area, remember this: you have guaranteed rights. If a Medicare Advantage plan terminates, you can enroll in any Medigap (Medicare Supplement) plan without being denied coverage based on pre-existing conditions, usually for up to 63 days after your coverage ends.

It's also helpful to keep in mind that the changes don't impact everyone. The majority of Medicare beneficiaries still have the same access to multiple Medicare Advantage plans with a range of benefits.

Moving Forward

The Medicare Advantage market has shifted. The days of predictable plans with expanding benefits may be behind us. But understanding the patterns of change and watching for communications puts you in control of your plan.

As 2027 plans are released this month, get in touch with us and we'll have a real conversation about what's changing and what's best for your healthcare needs. We're here to empower you to make informed decisions and stay ahead of change.

Breast Cancer Awareness Month: Turn Awareness Into Action

Wed, 07 Oct 2026 20:56:40 GMT

The Pink Ribbon Is a Reminder, Not the Finish Line

Every October, pink ribbons bring breast cancer into public view. And while awareness certainly matters, a more useful purpose to these cute little ribbons is personal action. To anyone with breasts, this means understanding your risk, paying attention to changes, talking with a healthcare professional about screening, and knowing how your insurance works before you need it.

Breast cancer can affect people with very different backgrounds and risk profiles. Women are affected most often, but men can develop breast cancer too. Some people have a strong family history or an inherited genetic change, while many people diagnosed have no obvious family history. No checklist can tell you with certainty who will or will not develop the disease.

Know What Is Normal for You

Breasts can naturally change with age, hormones, weight, pregnancy, and medications. Because of that variability of risk and of factors throughout life, it's crucial to become familiar with how your own breasts normally look and feel. That can be the key to making an unusual change easier to notice. Warning signs could include a new lump in the breast or underarm, thickening or swelling of tissue, skin dimpling or irritation, changes in size or shape, nipple changes, unusual discharge, or persistent pain.

If you do notice something, don't panic. Many breast changes are not cancer. Still, a new change is worth discussing with a healthcare professional, even if a recent mammogram was normal. Do not wait for a symptom to become severe before speaking up and asking a question.

Make Screening a Conversation

Mammogram can find some signs of breast cancer before symptoms appear. Recommendations about when to begin and how often to get these screenings depend on age, personal history, family history, breast density, genetic risk, and guidance from your healthcare team. Someone at higher risk may need more frequent mammograms or additional tests.

General rules, such as getting a mammogram once a year after the age of 40, are a good starting point, but you should also ask your doctor what is appropriate for you. Useful questions include when you should begin screening, how often you should return, whether you have risk factors that change the plan, and where to schedule the test.

Risk Information May Help You Plan

Some risk factors, including age and inherited genetic changes, cannot be controlled. Others may relate to health history or lifestyle. Gathering information can help guide conversations and provide context. Ask relatives what they know about cancers on both sides of the family, including the type of cancer and age at diagnosis. Share that history with your healthcare professional. If the pattern suggests increased risk, the next step might include a more detailed assessment or a discussion about genetic counseling. Be aware of lifestyle risk factors that you may need to change.

Understand Screening and Diagnostic Care

Insurance often treats a routine screening mammogram differently from a diagnostic mammogram ordered to evaluate a symptom or follow up on a finding. The services may look similar, but network rules and out-of-pocket costs can differ. Additional imaging, such as an ultrasound or MRI, may also have separate requirements regarding timing and referrals.

Before an appointment, consider asking your insurance company whether the facility is in network, whether an order or prior authorization is needed, and what costs may apply if the visit becomes diagnostic. You can also reach out to us for help understanding the terms of your policy. Coverage varies by plan, age, risk level, and the reason for the service, so confirm the details rather than assuming every test will be handled the same way.

Review the Rest of Your Financial Safety Net

A cancer diagnosis can affect more than medical bills. Time away from work, travel for treatment, household help, and other everyday expenses can put pressure on a family. Health insurance is central to treatment, but it may not address every financial consequence.

This month can be a useful time to review your health plan's deductible, out-of-pocket limit, prescription coverage, provider network, and care-management resources. Depending on your situation, you may also want to understand disability, critical illness, cancer coverage, hospital indemnity, or life insurance already in place. These products have limitations and exclusions, and they should not be treated as substitutes for major medical coverage.

Support Can Be Practical as Well as Emotional

If someone you care about is dealing with breast cancer, specific offers are often easier to accept than a general request to call if anything is needed. A ride, a meal, a fun activity, help with errands, childcare, or simply listening can reduce the weight of a difficult week. Respect the person's privacy and follow their lead about what they want to share.

Choose One Step This October

Awareness is truly meaningful when it leads to action. This month, take at least one action to help stop breast cancer. Schedule an overdue appointment, write down your family history, ask your doctor about a screening, or review your coverage. If you have questions about how your insurance may handle mammograms, diagnostic testing, prescriptions, or specialist care, contact our office. We can help you understand the plan language and prepare more informed questions for your healthcare team.

Medicare Scam Calls and Fake Agents Are Getting Harder to Spot

Wed, 23 Sep 2026 16:00:00 GMT

Who's Really on the Other End of That Medicare Call?

The phone rings. The voice on the other end says your name, your age, and your address. It sounds official. It may even sound friendly. And within a minute, you are being asked to confirm your Medicare number. What do you do?

Complaints about Medicare-related scam calls have climbed sharply over the past year. Reports to the Better Business Bureau indicate that these kinds of calls remain a major concern for people Medicare. Some have even described getting dozens of these calls in a single day. Enrollment season tends to make it worse, because legitimate outreach picks up at the same time criminals do.

Here is how these calls tend to sound, and how to protect yourself.

The Three Pitches You Are Most Likely to Hear

Many Medicare scam calls follow similar scripts. Once you recognize a few key patterns, the calls lose a lot of their power.

"You qualify for extra benefits"

A recorded voice says it is reaching out to make sure you receive unclaimed Medicare benefits. The recording asks whether you have Part A and Part B, then transfers you to a live person. The real goal is either to get your personal information or to switch you to a plan you did not ask for.

"Your card is expiring"

The caller warns that your Medicare card is about to expire, or that your coverage could be interrupted unless you verify a few details. Fear and urgency are the strategy here. If you hand over your Medicare number or Social Security number, criminals can use it to steal your identity or bill you for services you never received.

"Something free is on the way"

Free braces. Free hearing aids. Free gift cards or a free smartphone. The offered gift is bait. One woman in Texas received a large box of orthopedic braces she never ordered, and later learned Medicare had been billed more than $700 for them. Her secondary insurer was charged as well, and additional claims were filed for supplies she never requested.

Fraudulent claims can also leave inaccurate information in your medical records, including diagnoses for conditions you do not have.

Fake Agents Are Part of the Problem

Not every scammer sounds like a robot. Some present themselves as licensed insurance agents. They may reference a well-known carrier, quote a plan name, or offer to walk you through your options right now over the phone.

A few things a real agent will not do:

Pressure you to decide something during a first call
Refuse to give you a full name, license number, or office phone number
Ask you to pay by gift card, wire transfer, or a payment app
Tell you that you must act today or lose your coverage
Show up at your door uninvited to sell you a plan

Verifying an agent is simpler than most people expect. Ask for their name and license number, then hang up and call the agency's main office number yourself. You can also check the license with your state Department of Insurance. Anyone who is legitimate will not mind you doing this; they know you need to be careful.

Habits That Keep You Safe

Treat unexpected Medicare calls with skepticism, even friendly ones
Never give your Medicare number, Social Security number, or bank details to someone who called you
Remember that Medicare generally reaches out by mail first and does not call to ask for your Medicare number or banking information
Hang up on anyone who pressures you or claims your coverage is at risk
Read your Medicare Summary Notices and Explanation of Benefits statements and look for charges you do not recognize
Report anything unfamiliar right away

Hanging up may feel rude, but it is the single most effective thing you can do.

If You Think You Already Shared Something You Shouldn't Have

Act quickly, but do not panic. Write down what you shared and when. Review your recent statements. Then report it. You can contact the Senior Medicare Patrol program in your state, call 1-800-MEDICARE, or file a report with the Federal Trade Commission at ReportFraud.ftc.gov.

The Easiest Defense Is a Person You Already Know

Scam calls work because they catch people on their own and unsure. Having a licensed agent you already trust means you have someone in your corner. You have a number you can call to ask whether an offer is real before you respond to it. If you have questions about a call you received, or you want a second set of eyes on your current coverage, reach out to our office. We are here to help you!

Benefits Without an Employer: Health Coverage for Gig Workers

Wed, 16 Sep 2026 16:00:09 GMT

Flexible Work, Fragile Coverage

Independent work is no longer a side story in the American economy. Millions of Americans work as independent contractors. Add in the drivers, couriers, freelancers, consultants, and creators who treat gig income as a supplement, and the number climbs further.

What often gets overlooked is that gig work typically doesn't include traditional employer-sponsored benefits. That means no group health plan, no employer paying part of the premium, and no HR department to call in October for enrollment.

The numbers back this up. KFF (formerly the Kaiser Family Foundation) research shows that about one in five workers isn't offered coverage through their job, a number that nearly doubles for lower-wage workers. For all of them, the individual health insurance marketplace isn't a backup plan. It's the only plan.

The Real Problem Is Not Access. It Is Income That Moves.

Most gig workers can find a plan. What trips them up is that coverage decisions assume you know what you will earn this year, and gig income is rarely that predictable.

A strong quarter followed by a slow one can change what you qualify for. Marketplace subsidies are based on estimated annual income, and if your estimate is off, the difference gets settled at tax time. If you guess too low, you may owe money back. If you guess too high, you pay more each month than you need to.

This is a point not to be ignored. The enhanced subsidy provisions that were in place for several years through the ACA Marketplace expired at the end of 2025, which changed the math for many people compared to previous years. If you shopped for coverage two or three years ago and assumed nothing had shifted, now is a good time to revisit it.

Where Independent Workers Usually Start

There is no one right answer here, and the best fit depends on your income, your health, which state you live in, and your family situation. Broadly, these are the paths people look at:

ACA Marketplace plans, which cover essential health benefits and cannot turn you down for a pre-existing condition
Coverage through a spouse's or partner's employer plan, often the most economical option when it is available
Medicaid or CHIP, depending on your income and which state you live in
Private individual plans outside the ACA marketplace, which may suit higher earners who do not qualify for subsidies
Association or professional group plans available through some trade organizations

Be careful with plans marketed as cheap alternatives to major medical insurance. Some do not cover pre-existing conditions and can leave significant gaps in your coverage. If you take regular prescriptions or have any health history, read the fine print closely or have someone help read through it with you.

"Extras" That Many Gig Workers Forget

When you take a nontraditional work path, you're not just missing the primary health plan, but everything else that was bundled with it.

That usually includes dental, vision, disability coverage, and often a life insurance policy. For someone whose income depends on being physically able to work, disability protection can matter as much as the health plan does. A delivery driver with a broken wrist has no sick leave to fall back on.

Supplemental or ancillary products are worth a close look for exactly this reason. Accident, hospital indemnity, and critical illness coverage can help with the costs a high-deductible plan leaves behind. They are not a substitute for major medical coverage, but an important supplement to fill the gaps and soften a bad time.

Practical Habits That Help

Track your income monthly so your annual estimate stays close to reality
Contact us for help reporting income changes to the Marketplace during the year instead of waiting until you file
Treat premiums as a fixed business expense, not something you cover with whatever is left over
Ask about the self-employed health insurance deduction when you talk with your tax preparer
Know that losing other coverage or a major life change can open a special enrollment window to change your medical insurance plan

Do Not Sort This Out Alone

Open enrollment for individual coverage generally opens in early November, which makes September and October the right time to review what you have. Comparing plans on your own is possible. Doing it well, with variable income and supplemental options in the mix, takes some experience. That's where we come in. Our brokers can compare options across carriers, help you build a realistic income estimate, and point out gaps you might not think to ask about. There is no cost to you for that conversation.

If you work for yourself and you think it's time to review your coverage, reach out to our office. We are here to help you figure out what fits.

Employers Should Make Employee Health Care Literacy a Top Priority

Wed, 09 Sep 2026 16:00:13 GMT

For many U.S. workers, health insurance is confusing, intimidating, and underused. Despite the billions employers spend on benefits each year, a large share of employees don't fully understand how their benefits work or how to use them effectively.

The Cost of Confusion

According to Aflac's 2026 Employee Benefits Trends report, only 38% of employees say they understand everything about their benefits. That means most workers need more guidance on what coverage they actually have and how to use it. This is called health care literacy: the ability to find, understand, and use health information and services.

When employees lack health care literacy, they're more likely to delay care, make poor medical decisions, and rack up unnecessary costs. For employers, that translates into higher claims costs, lower productivity, and frustration with benefit programs that were supposed to help.

The scale of the problem is significant. The Centers for Disease Control and Prevention estimates that better health literacy nationwide could prevent nearly 1 million hospital visits annually and save more than $25 billion in health care costs each year.

What Happens When Employees Don't Understand Their Benefits

Employees who don't understand their coverage often make choices that cost everyone more:

They use out-of-network providers unnecessarily, paying higher costs than they would in-network
They choose expensive care settings, like emergency rooms, for non-emergencies that urgent care or telehealth could handle
They skip preventive care that could catch and treat conditions before they become serious and costly
They misinterpret medical bills or fail to challenge incorrect charges

These behaviors impact more than just the employees themselves. They drive up costs across your entire benefits plan and contribute to absenteeism, as well as 'presenteeism,' when employees show up to work but are too distracted or unwell to be productive.

Adding to the pressure is the fact that health insurance premiums rose 7% last year, and the increase is expected to more than double in 2026. As costs climb, the price of employee confusion climbs with them.

Open Enrollment Alone Isn't Enough

Many employers concentrate their communication efforts on open enrollment. That makes sense, since it's the moment employees choose their plans. But a once-a-year push isn't quite enough to build true health care literacy.

Employees make health care decisions all year long, like when they schedule a test, fill a prescription, or decide where to seek care for a sudden illness. Without ongoing education, even a well-designed benefits package can go underused, and employees may end up making costly choices simply because they didn't know a better option existed.

Employers that take a continuous approach to benefits education are more likely to see employees engage with their coverage and make well informed decisions throughout the year.

Practical Ways to Build Health Care Literacy

You don't need to overhaul your entire benefits strategy to make progress. Small, consistent steps can have a meaningful impact:

Use plain language. Rewrite benefit materials to eliminate jargon. Explain key terms like deductibles, copays, and coinsurance in simple terms, aiming for a sixth- to eighth-grade reading level. After all, even employees with post-graduate degrees may not have the expertise to understand the health care and insurance industry!

Educate year-round. Provide monthly or quarterly communications focused on one topic at a time, such as preventive care, telehealth, or how to read an explanation of benefits statement.

Show real-world examples. Compare costs for common scenarios, like an urgent care visit versus an emergency room visit, so employees can see the financial impact of their choices.

Promote in-network savings. Use visuals or simple tools that show employees how much they can save by staying within their plan's network.

Leverage multiple channels. Combine email newsletters, intranet content, webinars, and short videos to meet employees wherever they're most likely to engage.

Offer decision support. Provide access to benefits counselors, in person or virtually, who can help employees choose plans and understand their coverage.

Encourage preventive care. Regular reminders about screenings, vaccinations, and annual checkups reinforce healthy behaviors and help reduce long-term costs.

Build Trust and Engagement

Employers who invest in health care literacy can become a trusted source of information for their workforce. That trust can increase participation in wellness programs, improve satisfaction with benefits, and strengthen retention.

Workers increasingly expect guidance and want help navigating a complex system. And as the employer, you are well positioned to provide that guidance.

Health care literacy isn't just a nice-to-have. It's a bottom-line investment that pays off in lower costs, healthier employees, and a workforce that trusts you to help them make sense of a system that often seems confusing by design. Start small, stay consistent, and your benefits program will work harder for everyone.

ACA Tax Credit Repayment Risk: What Changed in 2026

Wed, 02 Sep 2026 17:31:14 GMT

Why Keeping Your Marketplace Income Updated Matters More Than Ever

If you receive financial help paying for health insurance through the ACA Marketplace, there's an important tax change to know about for 2026.

Starting with the 2026 tax year, the limits that previously protected some people from having to repay the full amount of excess advance premium tax credits are gone. That means keeping your Marketplace income information up to date is more important than ever. We can help you navigate that process to avoid confusion.

How Advance Premium Tax Credits Work

When you apply for Marketplace coverage, you estimate your household income for the year. If you qualify for a premium tax credit, you can choose to use some or all of it in advance to lower your monthly insurance premium.

When you file your federal tax return, the amount you received in advance is compared with the premium tax credit you actually qualified for based on your final income and other eligibility information.

If you received more in advance than you qualified for, you may have to repay the difference.

What Changed for 2026?

Before 2026, people with household income below certain levels could qualify for limits on how much excess advance premium tax credit they had to repay.

Those repayment caps no longer apply for tax years after 2025. If the advance credits paid on your behalf exceed the premium tax credit you actually qualify for, you must generally repay the full difference. That amount can reduce your tax refund or increase the amount you owe.

This can be especially important for people whose income is difficult to predict, including freelancers, gig workers, and small business owners. A raise, new job, investment gain, retirement distribution, or other income change during the year can also affect the amount of premium tax credit you're eligible to receive.

How to Reduce the Risk of a Surprise Tax Bill

You don't have to wait until tax season to address any changes. If your income, household size, or other relevant circumstances change during the year, ask us how to update your Marketplace application as soon as possible. The Marketplace can recalculate your eligibility and adjust the advance credit applied to your premiums.

You could also be cautious and choose to use only part of the premium tax credit you're eligible to receive. Using less upfront may reduce the risk of owing money back if your income or circumstances change.

Advance premium tax credits can make Marketplace coverage more affordable, but beginning in 2026, there's less protection if you receive more financial assistance in advance than you ultimately qualify for. Keeping your information current throughout the year can help reduce the chance of an unexpected tax bill. We're here to guide you through the process.

ER, Urgent Care, or Primary Care?

Wed, 29 Jul 2026 16:00:07 GMT

A Practical Guide to Knowing Where to Go

It's Saturday afternoon. Your child takes a tumble at the park and his knee is swelling up. Your regular doctor's office is closed. The emergency room sounds like overkill. The urgent care across town is open, but you're not sure if it can handle this kind of thing.

Moments like these are exactly when knowing your options pays off, both for your peace of mind and your wallet.

It Matters More Than Most People Realize

Where you go for care can have a dramatic impact on what you pay. According to multiple healthcare cost trackers, the average emergency room visit can run anywhere from $1,200 to $3,000 or more, and copays are still typically several hundred dollars. Meanwhile, an average urgent care visit typically lands in the $100 to $250 range for the same kind of non-emergency issue, and copays for urgent care visits can be as low as $50.

Research has also suggested that 30% to 50% of emergency room patients could have been treated effectively at an urgent care center , often at a fraction of the cost. That's not just a financial issue. ER overcrowding can mean longer waits for people experiencing true life-threatening emergencies.

The lesson here is that choosing the right "door" for the right situation isn't just about money. It's about getting the best care.

What Urgent Care Does Well

Urgent care centers are designed for the gray zone: situations that need attention quickly, but aren't true emergencies. Most centers can:

Treat common illnesses like colds, flu, strep, and stomach bugs
Handle minor injuries such as sprains, mild burns, and shallow cuts
Perform basic X-rays, lab work, and rapid tests
Provide sports physicals, work physicals, and travel vaccines
Manage straightforward conditions outside regular business hours

For relatively healthy people with a one-off issue, it's often a great fit.

When Urgent Care May Not Fit

Urgent care has a few limitations that are important to keep in mind:

Complex or chronic conditions. Urgent care providers don't typically have access to your full medical history. For ongoing or complicated issues, your primary doctor is in a better position to connect the dots.
Severe or unusual symptoms. If something feels seriously wrong, the ER has the equipment, imaging, and specialists urgent care doesn't.
Older adults and people with significant medical histories. When an urgent care provider is meeting you for the first time, there’s a higher risk that they could miss a previous diagnosis or a medication interaction.
Routine preventive care. Annual physicals, screenings, and care plans are best handled by a primary care provider who can track your health over time.

A useful rule of thumb: urgent care is great for episodes, while primary care is built for patterns.

A Decision Framework

When you need medical support, you usually have four options to consider. Here's a rough framework:

1. Call 911 or go straight to the ER if:

Symptoms suggest a heart attack, stroke, or major trauma
There's uncontrollable bleeding, difficulty breathing, severe chest pain, or loss of consciousness
A serious injury to the head, spine, or possible broken bones with deformity
A child has a high fever that doesn’t come down after giving over-the-counter fever reducing medications

When in doubt, the ER is still your fallback plan. No financial concern is worth risking a life-threatening situation.

2. Visit urgent care if:

You're dealing with minor cuts, sprains, infections, sore throats, ear pain, rashes, urinary symptoms, or low-grade fevers
The issue is non-life-threatening but can't wait for a regular appointment
Your primary care office is closed or fully booked

3. Try telehealth or a virtual visit if:

Symptoms are relatively mild and don't require physical examination
You need a prescription refill, a quick consultation, or guidance on whether to seek further care
Your insurance plan includes it as a covered benefit

4. Call your primary care provider if:

The issue isn't urgent and can wait
You're managing a chronic condition or need ongoing care
You want continuity, meaning a provider who knows your full health history

Many primary care offices reserve same-day slots for sick visits, so a quick phone call to your doctor's office is often a smart first step before heading anywhere else.

A Few Insurance-Specific Tips

This is where a little preparation can save real money:

Know what's in-network. Both urgent care centers and ERs can be in or out of network, and out-of-network care typically costs more. Check your insurance card, member portal, or call the number on the back of your card to confirm before you go, when time allows.
Understand your copays. Look at the back of your insurance card or your benefits summary. Many plans list separate copays for primary care, specialist, urgent care, ER, and telehealth visits.
Ask about facility fees. Hospital-based urgent care centers, and freestanding ERs that look like urgent cares, may bill at higher rates than independent urgent care clinics. When in doubt, ask before you're seen.
Don't skip the after-visit summary. If you go to urgent care, request a summary of your visit and share it with your primary care provider.
Use telehealth when it fits. Many plans offer telehealth benefits at little to no out-of-pocket cost. It's worth checking what's included in your coverage.

A Little Prep Goes a Long Way

The best time to figure out your options isn't in the middle of an emergency. Before you need care:

Identify two or three in-network urgent care centers near your home and workplace
Save your insurance plan's nurse hotline or telehealth number in your phone
Know your primary care provider's after-hours protocol
Keep a list of your medications and allergies somewhere easy to grab

A few minutes of preparation now can save a lot of stress and poor decisions later.

Conclusion

Used wisely, urgent care is a fast, affordable bridge between your doctor's office and the emergency room. Knowing which door to walk through in different situations is one of the most practical health skills you can build.

If you have questions about what your specific health insurance plan covers, your insurance agent or member services team can help you understand the details.

How to Help Your Employees Avoid the 6 Most Common Health Insurance Selection Mistakes

Wed, 22 Jul 2026 16:00:06 GMT

Helping Your Team Get the Most Out of Their Benefits

Open enrollment is one of the most important, and most misunderstood, moments in your employees' year. Most employees spend less than 30 minutes reviewing their options before making a decision that affects their health and finances for the next 12 months. The result? Many end up in plans that don't fit their needs, face unexpected medical bills, and grow frustrated with benefits they don't fully understand.

As an employer, you can't make the decision for them, but you can make sure they have the information and support they need to choose wisely. Here are six of the most common mistakes employees make during open enrollment, and how you can help them avoid each one.

1. Choosing a Plan Based Only on the Monthly Premium

The lowest-premium plan is almost always the first thing employees gravitate toward. It's easy to understand why, because that number shows up on every paycheck. But premium is only one piece of the cost picture.

A plan with a lower monthly contribution may carry a significantly higher deductible, higher copays, and a higher out-of-pocket maximum. For an employee who needs regular care, that lower-premium plan can end up costing considerably more over the course of the year.

How you can help: During open enrollment communications, show employees the total cost picture, not just the premium. Side-by-side plan comparisons that include deductibles, copays, and out-of-pocket maximums give employees a much clearer basis for decision-making. Real-world examples (e.g. "if you have a $5,000 medical event, here's what you'd pay under each plan") can be especially effective.

2. Not Checking Whether Their Doctors Are In-Network

Employees often assume their current doctors are covered under any plan you offer. That assumption can be costly. If a preferred physician, specialist, or hospital is out-of-network, employees may face significantly higher bills or, in some cases, no coverage at all.

How you can help: Remind employees to verify their providers before enrolling, not after. Include clear instructions on how to use each carrier's provider search tool, and encourage them to check not just their primary care physician but also any specialists they see regularly.

3. Overlooking Prescription Drug Coverage

For employees who take ongoing medications, prescription drug coverage can be just as important as medical coverage, and sometimes more so. A drug that's covered affordably under one plan may fall into a much higher cost tier under another.

How you can help: Encourage employees to look up their specific medications in each plan's formulary before making a selection. If you have employees with chronic conditions or ongoing prescriptions, this step alone can save them hundreds of dollars over the course of the year. Consider including a brief "how to check your formulary" guide in your open enrollment materials.

4. Picking the Wrong Deductible for Their Situation

Some employees automatically choose the lowest deductible plan regardless of their health needs. Others choose a high-deductible plan to save on premiums without fully understanding what that means if they need care. Neither approach is right for everyone.

A high-deductible health plan paired with a Health Savings Account (HSA) can be an excellent option for younger, healthier employees who want to manage costs and build savings. For employees who visit doctors frequently, take ongoing medications, or have chronic conditions, a lower deductible plan may offer better overall value.

How you can help: Provide employees with a simple self-assessment, something as straightforward as "how often did you use your health insurance last year?" that helps them think through which plan structure fits their actual healthcare habits. If you offer an HSA-eligible plan, make sure employees understand the tax advantages and how to use it.

5. Not Understanding the Out-of-Pocket Maximum

The out-of-pocket maximum is arguably the most important number in a health insurance plan, and one of the least understood. For employees facing a serious illness, surgery, or unexpected medical event, this number is the difference between a manageable financial situation and a devastating one.

How you can help: Make the out-of-pocket maximum a centerpiece of your open enrollment education, not an afterthought. Help employees understand that a plan with a slightly higher premium but a lower out-of-pocket maximum may offer far greater financial protection in a worst-case scenario. Frame it simply: "This is the most you would ever pay in a single year."

6. Not Taking Advantage of Their Insurance Advocate

Many employees don't realize that when they enroll in a health insurance plan, they have access to an advocate, typically your broker or benefits team, whose job is to help them understand and use their coverage. Instead of asking for help, employees often struggle through confusing situations on their own, leading to unnecessary stress, claim errors, underutilized benefits, and unresolved billing issues.

How you can help: Make it clear during open enrollment and throughout the year that your employees have a resource available to them. Let them know your broker or benefits team can help explain how coverage works, assist with prior authorizations, help resolve claim issues, and answer questions about medical bills. A simple reminder at the start of the plan year can make a significant difference in how confidently your employees engage with their benefits.

Open Enrollment as an Employee Communications Opportunity

A well-chosen health insurance plan is one of the most valuable things an employee has access to, but only if they understand it. Employers who invest in clear, accessible open enrollment education don't just help their employees make better decisions. Employers who follow these guidelines can reduce frustration, build trust, increase positive benefits utilization, and demonstrate that the benefits they offer are genuinely designed to help.

ACA Open Enrollment Is Changing for 2027

Wed, 15 Jul 2026 16:15:00 GMT

Here's What You Need to Know

If you have a health plan through the ACA Marketplace, your renewal or enrollment window is getting shorter for the 2027 plan year. The sign-up period now ends in December, and the old February start date is going away. Read on for what changed and why it matters for you.

The Enrollment Window is Shorter

For the last few years, most people had until January 15 to enroll or renew in a Marketplace plan. Starting in 2026, open enrollment will end one month earlier, on December 15 in many states. In most states, sign-ups still open on November 1, 2026.

Two states start even earlier. In Idaho, open enrollment begins on October 15, and in Georgia it begins on October 19.

Enrollment Periods at a Glance

Here's the national schedule for states that use HealthCare.gov, which covers most of the country:

Enrollment Start : November 1, 2026
Enrollment End : December 15, 2026
Coverage starts : January 1, 2027

Known Enrollment Timeframes for Some State-Run Exchanges

Some states run their own exchanges and set their own deadlines. State-run exchanges can extend enrollment later than December 15, but not past December 31. Here are the 2026 ranges announced so far (for 2027 coverage). Dates can still change, so confirm with your state's marketplace before you enroll.

States starting early:

Idaho: Oct 15 – Dec 15, 2026

Georgia: Oct 19 – Dec 15, 2026

Extended deadlines:

Nov 1 – Dec 23, 2026: Massachusetts

Nov 1 – Dec 31, 2026: CA, CO, CT, KY, MD, MN, NV, NM, OR, RI, VA, WA

If your state is not listed here, you likely follow the national schedule above, with a November 1 to December 15 window.

No More February 1 Start Date

In past years, if you signed up after mid-December, your coverage started February 1. That option is going away. All plans selected during open enrollment will take effect on January 1.

What You Can Do Now

Mark your calendar for November 1, 2026. Know your state's exact deadline. And if you have questions about your plan or your options, we are here to help. Acting early gives you time to compare and helps you avoid a coverage gap.

Are You Getting Enough Nutrients on GLP-1 Medication?

Fri, 10 Jul 2026 14:22:35 GMT

What the Latest Research Says About GLP-1s, Nutrition Gaps, and Getting Enough of What Matters

If you're using a popular GLP-1 medication like Ozempic, Zepbound or Wegovy for weight loss, it's important to be mindful of your nutrition, because you're probably eating significantly less than you used to. A recent review found that total caloric intake dropped by 16% to 39% in patients taking a GLP-1.

These medications help you feel full faster, so you eat less, which can lead to significant weight loss. But that same reduced appetite has a downside: it can mean you aren't taking in enough of the essential nutrients your body needs to stay healthy.

Some people taking GLP-1 medications say they don't feel hungry, skip eating for most of the day, or have just one large meal in the evening. And plenty of people on these drugs never change the kind of food they eat — they simply eat smaller amounts of the same less-healthy choices. The result is fewer calories and less variety, which is a recipe for missing key nutrients.

What the Latest Research Shows

This isn't just anecdotal. A narrative review published in Clinical Obesity in early 2026 pooled six studies covering more than 480,000 adults with diabetes, obesity, or both who were taking GLP-1 drugs. The researchers concluded that nutritional deficiencies should be considered "a common consequence" of GLP-1 therapy, and that doctors should monitor patients accordingly.

A few highlights from that research:

Vitamin D deficiency was the most common problem, affecting about 13.6% of participants after 12 months of treatment in the largest study.
Iron deficiency (around 3.2%) and B vitamin deficiency (around 2.6%) also showed up, along with anemia tied to poor nutrition (about 4%).
Deficiencies tended to worsen the longer people stayed on treatment — more were diagnosed at 12 months than at 6 months.
In a smaller study that tracked detailed food diaries, the gaps were striking: many participants fell short on calcium, nearly two-thirds didn't get enough iron, and almost none met the recommendation for vitamin D.

It's worth noting these findings come largely from observational data, so they show a strong association rather than ironclad proof of cause and effect. Still, the pattern is consistent enough that nutrition deserves real attention while you're on these medications.

What Happens When You Don't Get Enough

Falling short on nutrients can show up in ways that are easy to write off as "just part of losing weight," but shouldn't be ignored:

Fatigue and dizziness — often linked to low iron, low calorie intake, or not drinking enough fluids.
Muscle loss — too little protein can lead to a progressive loss of muscle mass and strength. This is a real concern on GLP-1s, since rapid weight loss can include muscle, not just fat.
Digestive issues like constipation — frequently a sign of too little fiber and water.
Hair and skin problems — a common downstream effect of overall undernutrition.

What to Eat and Drink for Balanced Nutrition

Even when your appetite is low, the right food choices go a long way toward preventing these problems. The key is quality over quantity: with fewer bites to work with, each one should count. Aim to build meals around protein, healthy fats, whole grains, and plenty of fruits and vegetables.

Protein

Lean meats (chicken, turkey)
Fish and seafood
Eggs
Plant-based proteins like beans, lentils, tofu and soy products
Low-fat dairy (yogurt, milk, cheese)

Fiber

Whole grains (oats, quinoa, brown rice)
Vegetables (broccoli, carrots, spinach, kale)
Fruits (apples, oranges, berries)
Nuts, seeds and legumes

Healthy fats

Avocados
Nuts and seeds
Olive oil and other plant-based oils
Fatty fish (salmon, tuna, mackerel)

Hydration

Water (aim for 8–10 glasses a day)
Low-calorie drinks (herbal tea, unsweetened beverages)
Nutrient-dense drinks like low-fat milk or soy milk
Limit sugary sodas, excess caffeine, and alcohol

Additional Tips for Staying Healthy

Listen to your body. Fatigue, muscle loss, or constipation can all be signs that you're not getting enough nutrients or fluids.
Don't skip meals entirely. Going without food all day can lead to malnutrition over time, even if you're not hungry.
Consider meal replacement shakes or bars if your appetite is very low — they can help you hit your protein and vitamin targets when whole meals feel like too much.
Add a daily multivitamin and supplements if your doctor recommends it. Given how often vitamin D, iron, and B vitamins come up in the research, this is a reasonable conversation to have.
Keep moving. Light to moderate exercise — especially walking and resistance training — helps preserve muscle and enhances the benefits of the medication.
Ask about bloodwork. If you've been on a GLP-1 for several months, periodic lab checks can catch a developing deficiency before it causes symptoms.

GLP-1 medications can be a powerful tool for weight loss and metabolic health. Getting the nutrition piece right is what helps you feel strong and energized along the way — not just lighter on the scale.

Rethinking Your Soft Drink Habits

Wed, 24 Sep 2025 23:37:42 GMT

As the summer sun beckons and thirst levels rise, it's tempting to reach for a cold, fizzy beverage. But before you pop open that soda can, consider this: your drink choice has long-term implications for your health.

The Hidden Risks in Your Glass

A comprehensive study by the International Agency for Research on Cancer (IARC) analyzed data from over 451,000 individuals across 10 European countries over a 16-year period. The findings revealed that consuming two or more 250 ml glasses of soft drinks daily—whether sugar-sweetened or artificially sweetened—was associated with a higher risk of all-cause mortality compared to those who drank less than one glass per month.

Delving deeper:

Artificially Sweetened Beverages : Individuals consuming two or more glasses daily had a 26% higher risk of death compared to those who consumed less than one glass per month. Specifically, there was a 52% increased risk of death from circulatory diseases.
Sugar-Sweetened Beverages : Those consuming one or more glasses daily faced a 59% higher risk of death from digestive diseases.
All Soft Drinks : A notable association was found between soft drink consumption and increased mortality from Parkinson's disease.

Alternatives That Aren’t Any Healthier

Think fruit juice or energy drinks are a safer bet? A study involving 13,440 U.S. adults aged 45 and older found that each additional 12-ounce serving of sugary beverages, including 100% fruit juice, was linked to an 11% higher risk of all-cause mortality. Specifically, each additional 12-ounce serving of fruit juice was associated with a 24% increased risk. Watch the sugar content of iced coffee beverages and alcoholic cocktails as well.

Lifestyle Factors Matter, Too

It's essential to note that high soft drink consumption often correlates with other unhealthy lifestyle choices. The IARC study observed that individuals who drank more soft drinks typically had higher body mass indexes and were more likely to smoke. Even after adjusting for factors like diet, physical activity, smoking, and education, the association between soft drink consumption and increased mortality risk remained significant.

Refreshing Alternatives for the Season

Looking to quench your thirst without compromising your health? Here are some delightful, healthier options:

Infused Water : Add slices of citrus fruits, cucumbers, or berries to your water for a refreshing twist.
Herbal Iced Teas : Brew teas like hibiscus or mint, chill them, and enjoy over ice.
Sparkling Water with a Splash : Mix sparkling water with a splash of 100% fruit juice for a fizzy treat.
Homemade Lemonade : Use fresh lemons, water, and a touch of natural sweetener like honey or stevia.
Coconut Water : A natural source of electrolytes, perfect for rehydration.

Final Thoughts

Summer is a time for relaxation and enjoyment. By making informed beverage choices, you can savor the season while prioritizing your health. So, the next time you're reaching for a drink to beat the heat, consider these healthier alternatives. Your body will thank you!

7 Healthy Travel Tips

Wed, 24 Sep 2025 23:37:42 GMT

Whether you’re planning a weekend getaway or a long-awaited international adventure, setting off on a trip is always exciting—but can also be unpredictable. That’s why preparing for the unexpected, especially when it comes to your health, is essential. Knowing what your medical coverage includes (and doesn’t) while traveling can help you stay healthy, avoid costly surprises, and soak up the unforgettable moments on your journey.

Let’s walk through some proactive steps you can take before packing your bags—from vaccinations and insurance to emergency planning and fraud protection.

1. Know What Your Health Plan Covers—And Where

Medical surprises aren’t on anyone’s itinerary—but it’s best to be prepared. Start by knowing how your insurance policy covers (or doesn’t) the region you’re traveling to.

Individual health policyholders, review your insurer’s network coverage. Some plans only cover in-network or state-specific services, while others offer broader emergency coverage or travel-specific riders. Consult your insurance agent to get help reviewing your policy.

Medicare beneficiaries, Original Medicare (Parts A & B) typically doesn’t cover medical care outside the U.S., except in limited circumstances. If you have a Medicare Advantage Plan, it may include emergency and urgent coverage abroad, but this varies by provider. Check your plan’s Evidence of Coverage or speak to your plan representative before traveling.

2. Consider Supplemental Insurance

If you're a frequent traveler or heading abroad, look into some options to help cover you. Some options include:

Travel Medical Insurance : Plans offer emergency coverage during trips outside the U.S. and tend to be affordable.
Evacuation Insurance : This covers transport to a qualified medical facility if the nearest care is inadequate. An evacuation clause is often, but not always, included in a travel insurance plan.
Medicare Supplement Insurance (Medigap) : Some Medigap policies cover emergency care abroad, typically up to plan limits and with a deductible.
Critical Illness Insurance : A lump-sum payout can provide financial flexibility in case you’re diagnosed with a covered condition like a heart attack or stroke during travel.

Be sure to read the fine print—some policies require you to be under a certain age, and preexisting conditions may not be covered. Your licensed insurance agent can help talk you through your options.

3. Keep Your Medical Info Handy

Consider using a secure health app or digital wallet to access all your health records quickly. But just in case your phone is inaccessible, bring physical copies of these important documents as well:

Your insurance or Medicare cards
Emergency contact numbers (include the country code +1 if you’re traveling abroad)
A medication list with dosages
Allergy and medical condition alerts

Pack all essential paperwork together in a waterproof sleeve in your luggage, and leave a second copy with someone back home.

4. Schedule Preventive Care Before Departure

Most insurance plans cover preventive care services like wellness visits, vaccinations, and screenings. Before your trip, check these tasks off your list:

Get vaccinated : Make sure you’re up to date on your flu, COVID-19, and tetanus shots. If traveling internationally, check the CDC recommendations for the region you’re visiting, which may include Hepatitis A/B, typhoid, or yellow fever vaccinations.

Scammers Are Targeting Grandparents—Here’s How to Stay One Step Ahead

Wed, 24 Sep 2025 23:37:42 GMT

Imagine getting a call in the middle of the night from someone claiming to be your grandchild, panicked and in trouble. They say they’ve been in an accident or arrested—and they desperately need money. Your heart races. You’d do anything to help. That’s exactly what scammers are counting on.

The Federal Communications Commission (FCC) has recently issued a warning about a rise in what's known as the “grandparent scam” —a sneaky and heartless scheme targeting older adults with urgent, emotional phone calls meant to trick them into sending money.

What Is the Grandparent Scam?

These scams usually start with a phone call from someone pretending to be your grandchild (or another close relative). They’ll say they’re in trouble—maybe stuck in jail or in a hospital—and they need money fast for bail, legal fees, or emergency expenses.

To make things even more convincing, they may hand the phone off to someone pretending to be a lawyer or a police officer. And they’ll likely ask you not to tell anyone—saying it’s a “private” or “sensitive” situation.

That sense of urgency is key to the scam. It’s meant to bypass your instinct to double-check and make you act fast—before you have time to think it through or talk to someone else.

Why It Works—and Why It’s Dangerous

These calls often come late at night or early in the morning, when you’re more likely to be caught off guard. The scammer might not even say who they are—just “Grandma, it’s me”—and hope you fill in the blank for them. From there, they use that information to sound more convincing.

Some victims have been asked to send money via wire transfer, cryptocurrency, gift cards, or even in cash via courier—all methods that are difficult or impossible to trace or reverse. According to the FCC, scammers using this method have stolen tens of millions of dollars from seniors across the U.S.

Watch for These Warning Signs

If you or someone you love receives a call like this, here are some red flags that it could be a scam:

High pressure and urgency – You’re told to act immediately

Vague or strange details – They may not identify themselves clearly, or hope you’ll say the grandchild’s name for them

Unverifiable location or story – They say they’re in jail overseas or in a place where you can’t easily check on them

Unusual payment requests – Gift cards, Bitcoin, wire transfers, or cash deliveries

Calls at odd hours – Scammers try to catch you when you’re less alert

What To Do If You Get a Suspicious Call

If something doesn’t feel right, trust your gut. Here’s what you can do to stay safe:

✅ Hang up and verify – Call your grandchild or their parent using a phone number you know is theirs

✅ Talk to someone you trust – A second opinion from a friend or family member can make all the difference

✅ Don’t rely on caller ID – Scammers often “spoof” numbers to make it look like someone you know is calling

✅ Block the number – Use your phone’s settings to block suspicious calls

✅ Report the scam – Contact the National Elder Fraud Hotline at 833-FRAUD-11 and file a complaint with the FCC

What If You’ve Already Sent Money?

First of all, don’t panic—and know that you’re not alone. Scammers are incredibly convincing, and even smart, cautious people have been tricked.

Here’s what to do:

Call your bank or payment service right away – They may be able to stop or reverse the transaction if it's recent
Report it – Contact the FCC, your local police, and the FBI’s Internet Crime Complaint Center at ic3.gov
Let your family know – They can help protect you and others from future attempts

Help Protect Others, Too

The more people know about this scam, the harder it becomes for criminals to succeed. Please share this information with friends, neighbors, and especially your older loved ones. A quick conversation now could prevent a heartache later.

And remember—if you ever get a call like this and aren’t sure what to do, don’t rush. Take a breath, hang up, and check in with someone you trust. Real family emergencies don’t come with secret demands or payments via gift cards.