If you are getting close to age 65 and becoming eligible for Medicare, you probably have a bunch of questions. So let me cover the key points with you. You'll find that there are differences between Medicare and your current employer provided health insurance.So let's build our Medicare knowledge and make you more confident heading into those decisions. Let's start by explaining the parts and costs. And yes, there are costs to Medicare.Medicare is not free. Fidelity estimates that the average person on Medi ...

Financial Data and Key Metrics Changes - The company reported same-store NOI growth of 16.4% across the total portfolio, marking the seventh consecutive quarter of double-digit same-store NOI growth [7] - Normalized funds from operation (NFFO) reached $0.44 per fully diluted share in Q3, reflecting a 22% year-over-year increase [22] - The company increased its full-year 2025 NFFO guidance to a range of $1.69-$1.72 per fully diluted share, implying growth in excess of 20% year-over-year at the midpoint [23] - Net debt to EBITDA improved to 3.5x, representing a 0.2-time improvement from the previous quarter and a 1.6-time improvement from Q3 2024 [25] Business Line Data and Key Metrics Changes - Trilogy's same-store NOI grew 21.7% year-over-year, with occupancy averaging 90.2% in Q3, up more than 270 basis points from last year [12] - Shop segment same-store NOI increased 25.3%, with revPOR up 5.6% year-over-year and NOI margins expanding nearly 300 basis points to 21.5% [14] - Integrated senior health campuses' same-store NOI growth guidance was increased to a range of 17%-20% [23] Market Data and Key Metrics Changes - Medicare Advantage accounted for 7.2% of total resident days at Trilogy during Q3, up from 5.8% a year ago, indicating a shift towards higher reimbursement sources [13] - Construction starts across senior housing remain near historic lows, while demographic growth in the 80+ cohort accelerates, supporting a multi-year runway for further occupancy gains [15] Company Strategy and Development Direction - The company is focused on building durable long-term growth through operating alignment with best-in-class regional operators and disciplined capital allocation [10] - The company has closed over $575 million in acquisitions year-to-date, with a pipeline of awarded deals standing at well over $450 million [9][20] - The inaugural corporate responsibility report was published, reflecting the company's commitment to governance, social, and sustainability priorities [11] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the current operating environment for long-term care, citing strong demand tailwinds and positive occupancy trends [8] - The company expects to maintain occupancy gains achieved through the busy spring and summer selling season, despite entering a historically slower winter season [12] - Management anticipates continued pricing power, expecting to price at a rate higher than inflation [31] Other Important Information - The company executed $13 million of non-core dispositions, concentrating capital within its operating portfolio [19] - The company is leveraging Trilogy's centralized revenue management system across other operating partners to optimize revenue [16] Q&A Session Summary Question: What is the maximum occupancy upside from 90%? - Management indicated that the maximum upside from 90% to 100% is 10%, with expectations for metrics to continue moving in their favor due to supply-demand fundamentals [29] Question: How competitive is the current market for acquisitions? - Management noted that while there are more assets coming to market, the competition is not overly intense, with many deals being brought through operating partners [32][80] Question: Can you discuss the acquisition strategy regarding independent living versus assisted living? - Management stated that the strategy encompasses all types, focusing on quality buildings that provide good earnings growth, with a preference for newer products [87]

Financial Data and Key Metrics Changes - The company generated consolidated revenue of $329 million, representing a 13% growth year-over-year, primarily driven by strong growth in healthcare services [4][17] - Senior revenues declined to $59 million from $93 million a year ago, a decrease of 37%, attributed to lower policy production due to new eligibility requirements [4][18] - The company reported a quarterly EBITDA loss of $32 million, which was below the guided loss range of $25-$30 million [8][17] Business Line Data and Key Metrics Changes - The senior business segment experienced a 32% reduction in policy production compared to the previous year, leading to a negative EBITDA of $21 million [5][18] - Healthcare services EBITDA was impacted by changes in drug reimbursement rates, with an expected second-quarter adjusted EBITDA of approximately break-even [6][20] - The life insurance business saw nearly 20% revenue growth, driven by balanced growth in term life and final expense policies [22] Market Data and Key Metrics Changes - The company noted an elevated level of policyholder volatility due to shifts in planned benefits and structures from carriers, which is expected to continue in the upcoming AEP season [9][10] - The Medicare Advantage (MA) market is experiencing a high level of consumer engagement as beneficiaries evaluate options, with a focus on simplifying benefits [34][36] Company Strategy and Development Direction - The company aims to leverage its data-enabled agent-led model as a competitive advantage in the dynamic Medicare Advantage market [9][10] - There is a strategic focus on improving policyholder retention and understanding their plans better, which is seen as critical in the current environment [10][27] - The company is negotiating a longer-term reimbursement agreement with its PBM partner to enhance visibility and predictability for its healthcare services business [6][20] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the long-term economics of healthcare services despite short-term reimbursement challenges [7][20] - The company remains optimistic about the upcoming AEP and OEP seasons, supported by strong agent retention and successful preseason hiring [10][23] - The fiscal 2026 financial outlook remains unchanged at $1.65 billion to $1.75 billion in revenue and $120 million to $150 million in adjusted EBITDA [23] Other Important Information - The company is actively working on improving medication adherence through its SelectRx program, which has shown positive results in reducing hospital days and improving health outcomes [16][12] - The company is expanding its healthcare services offerings to address social determinants of health, enhancing its value proposition to members [31] Q&A Session Summary Question: Concerns about SelectRx reimbursement headwinds - Management reassured that they are in constructive discussions with their PBM partner to solidify a longer-term agreement, emphasizing the clinical value of their solution [24][25] Question: Impact of SelectRx on LTV - Management noted that while they observe improved persistency among SelectRx members, this is not currently factored into the lifetime value calculations [25][26] Question: Strategies for helping policyholders understand their plans - Management highlighted their proactive approach to assist beneficiaries in navigating plan changes, utilizing AI and data to enhance customer engagement [27][29] Question: Market dynamics in the AEP season - Management indicated that the current AEP season is dynamic, with high consumer engagement and a focus on profitability among carriers [34][36] Question: Managing growth in SelectRx - Management emphasized a measured approach to member growth, focusing on profitability and partnerships with payers that value their services [38][40]

Core Insights - Clover Health Investments, Corp. (CLOV) reported break-even adjusted quarterly earnings per share (EPS) for Q3 2025, missing the Zacks Consensus Estimate of earnings of 2 cents, compared to an adjusted loss of 2 cents in the same period last year [1][8] - The company experienced a significant revenue increase of 50.1% year over year, totaling $496.7 million, which exceeded the Zacks Consensus Estimate by 4.5% [2][8] Revenue Breakdown - Clover Health's revenues are primarily derived from two segments: Insurance and Other income. Insurance revenues reached $479.1 million, reflecting a year-over-year increase of 48.5%, driven by a 35% rise in Medicare Advantage membership and strong member retention [3][8] - Other income amounted to $17.5 million, marking a substantial increase of 108.4% from the previous year [5] Operational Performance - Net medical claims surged by 70.5% year over year to $428.9 million. Salaries and benefits expenses decreased by 12.4% to $48.2 million, while general and administrative expenses rose by 39.1% to $48.9 million. Total operating expenses increased by 53.3% to $521 million, resulting in an operating loss of $24.4 million compared to a loss of $8.9 million in the prior year [6][8] Financial Position - At the end of Q3 2025, Clover Health had cash and cash equivalents of $190.1 million, slightly up from $188.6 million at the end of Q1. Net cash provided by operating activities from continuing operations was $1.2 million, down from $129.5 million a year ago [7][8] Guidance and Outlook - The company raised its 2025 Insurance revenue outlook to a range of $1.85-$1.88 billion, suggesting a 39% year-over-year growth at the midpoint, while lowering the adjusted Net Income forecast to $15-$30 million from a previous estimate of $50-$70 million [9][10] - Insurance Benefit Expense Ratio (BER) is projected to be between 90-91%, up from the previous estimate of 88.5-89.5%. Average Medicare Advantage membership is expected to be between 106,000-108,000, indicating a 33% year-over-year growth at the midpoint [10] Market Reaction - Following the earnings report, CLOV shares fell by 17.9% in after-hours trading on November 4, attributed to lower-than-expected earnings and revenue guidance [12] - Year-to-date, CLOV shares have increased by 11.7%, compared to the industry growth of 26.8% and the S&P 500 Index's increase of 18.1% [12] Strategic Insights - Management outlined a path to profitability expansion in 2026, citing a larger base of returning Clover Assistant-managed members and favorable payment dynamics as key drivers [13] - Clover Assistant continues to demonstrate industry-leading clinical quality, with potential for significant long-term opportunities with external payers and providers [14]

UnitedHealth and CVS are pruning their Medicare Advantage businesses to favor profit over size https://t.co/WpkdS6f5S1 ...

Core Viewpoint - UnitedHealth Group's stock has experienced a rally in the third quarter, influenced by Warren Buffett's investment, with upcoming earnings reports potentially impacting share performance [1][6]. Earnings Estimates - Analysts predict UnitedHealth will report third-quarter revenue of $113.06 billion, an increase from $100.82 billion in the same quarter last year [2]. - The company has missed revenue estimates for five consecutive quarters, following a streak of 15 consecutive beats [2]. - Expected earnings per share for the third quarter are $2.79, down from $7.15 in the previous year [2][3]. Analyst Insights - Analysts have been raising price targets for UnitedHealth stock ahead of earnings, with notable increases from firms like Jefferies, Goldman Sachs, JPMorgan, Mizuho, and Barclays [4][6]. - Baird analyst Michael Ha expressed caution regarding the Optum Health division, citing potential headwinds from government changes to Medicare Advantage, estimating an $11 billion impact over three years [5]. Market Reactions - Following Berkshire Hathaway's stake announcement, UnitedHealth shares have rallied over 30%, although they remain 44% below their November 2024 highs [6]. - The stock has historically declined by an average of about 10% after the last four quarterly earnings reports [7]. Key Items to Watch - Buffett's stake in UnitedHealth, valued at $1.84 billion, could serve as a validation point during the earnings call [8][9]. - Investors will be attentive to any commentary regarding pricing pressures from the White House, particularly concerning the proposed TrumpRx platform, which could affect UnitedHealth's Optum Rx division [11][12]. - Analysts will also look for guidance updates, as the company had previously suspended its 2025 performance outlook [13].

Medicare's "dirty little secrets" - the hidden costs, coverage gaps and commission conflicts that could cost retirees thousands. You'll learn why so-called "free" Medicare Advantage plans aren't always what they seem, how switching plans can be risky, and what every retiree needs to know before open enrollment. Bob Powell and three distinguished Medicare experts will show you the truth about Medicare that the brochures don't tell you. Yahoo Finance's Decoding Retirement is hosted by Robert Powell. Find more ...

Core Insights - Medicare Advantage plans are increasingly popular among eligible beneficiaries, with over half enrolled since 2023, driven by additional perks not available in traditional Medicare [2][5] - Significant changes are expected in 2026, including reduced benefits, higher premiums, and a limited selection of plans, which may affect millions of enrollees [7][15] Enrollment and Coverage Changes - The open enrollment period for Medicare Advantage runs until December 7, allowing beneficiaries to modify their coverage for the upcoming year [6] - In 2026, the average Medicare beneficiary will have 39 plan options, down from 42 in 2025, indicating a trend towards fewer available plans [14] Cost Implications - The average monthly premium for Medicare Advantage plans is projected to decrease from $16.40 in 2025 to $14.00 in 2026, but some plans may increase costs and out-of-pocket maximums [18][19] - Medicare Advantage plans will have a maximum out-of-pocket limit of $9,250 for in-network services and $14,750 for combined in- and out-of-network services in 2026 [20] Benefit Reductions - Some Medicare Advantage plans are expected to cut dental and vision coverage and increase co-pays for specialist visits in 2026 [21] - A pilot project providing extra benefits for low-income beneficiaries may be discontinued, affecting those with chronic illnesses [24][25] Provider Network Changes - The network of doctors and healthcare providers for Medicare Advantage plans is subject to change, which may lead to challenges in accessing preferred providers [3][7] - New reporting rules will allow consumers to see more details about supplemental benefits and provider networks, although past inaccuracies in directories have been noted [10][11]

Core Insights - The Cigna Group (NYSE:CI) is highlighted as a strong investment opportunity within the defensive healthcare dividend stocks category [1] - Recent analyst upgrades from Goldman Sachs and Wells Fargo have increased interest in Cigna, with Goldman Sachs initiating coverage with a Buy rating and a price target of $370 [3][4] - Cigna has a consistent track record of dividend increases, having raised its dividend for five consecutive years, currently offering a quarterly dividend of $1.51 per share with a yield of 2.00% [5] Analyst Ratings - Goldman Sachs analyst Scott Fidel initiated coverage of Cigna with a Buy rating, citing a significant downturn in the managed care sector and anticipating a recovery phase starting in 2026, particularly in Medicare Advantage [3] - Wells Fargo raised its price target for Cigna from $340 to $354 while maintaining an Equal Weight rating, reflecting an updated outlook for the sector ahead of Q3 2025 earnings [4] Dividend Performance - Cigna has demonstrated strong appeal to income-focused investors by increasing its dividend for five consecutive years, currently providing a quarterly dividend of $1.51 per share [5]

Medicare Coverage Changes - Medicare open enrollment starts on October 15th and ends on December 7th [6] - Individuals should not wait until the last minute to choose plans due to potential advisor overload [6] Cost Fluctuations - Some Medicare Advantage plan members will see monthly premium increase, for example, from $0 to $48 [2] - Hospital admission costs are increasing for the first 5 days [4] - Drug coverage deductibles are rising, for example, from $420 to $600 [4] Coverage Details - Some drugs are switching from flat co-payments to co-insurance, impacting predictability of costs [5] - Co-insurance requires paying a share (percentage) of the drug cost, which is typically higher than a flat co-pay [5] - Annual Notice of Change documents detail plan changes for Medicare Advantage members [2]