Mark Cuban Has a Medicare Warning Every Retiree Should Hear Before December 7

Medicare open enrollment has finally arrived. The annual chance to change your Medicare coverage began Oct. 15 and runs through Dec. 7.

As you look for ways to improve coverage and possibly lower your financial stress, Mark Cuban has a warning that every senior should hear.

A lack of transparency and higher Medicare costs

When you compare Medicare plans, you may feel frustration over a lack of pricing transparency. Such a reaction is understandable, according to Cuban. According to him, health care prices continue to rise partially due to confidential pricing contracts between insurers and hospitals. In essence, hospitals remain in the dark about the cost of the very services they offer.

During a recent KFF podcast, Cuban said, "The fundamental issue is transparency and trust … [and] there are a lot of hospitals that don't know their costs. They just know their cash balance."

By contrast, businesses in other industries have better access to information about product-level costs. Because hospitals simply do not fully understand the expense of the individual services they provide, they must turn to accounting techniques that spread all costs across many services.

"It's not run like a real business," he said on the podcast.

Fixing the problem is difficult

To fix this problem, Cuban urges governments to change the rules so that all contracts that involve a federal, state, or local agency fully disclose terms and prices. In the end, no fix works unless government officials demand full and public disclosure of pricing contracts and force health insurers and hospitals to be more transparent, Cuban says.

In fact, he proposes mandating public disclosure of contracts in tandem with hospital pricing information. Those that do not comply should face fines of $1 million per day.

"The ONLY way you are going to know the carriers and hospitals followed through and adhered to the rules, without gaming them, is by making them publish their contracts," Cuban wrote in a post on X.

In the past, Cuban has made other criticisms of the Medicare system. For example, he has estimated that every family in the U.S. pays an extra $800 a year to large insurance companies due to soaring Medicare Advantage costs and government outlays that top what is required to fund traditional Medicare.

What you should do to get the best deal on Medicare

The trends Cuban cites are largely outside the control of any individual senior. However, there are many ways to reduce your own Medicare costs and to secure the coverage you need.

With open enrollment now in full swing, here are some of the things you should do.

Check whether your doctors and hospitals remain in network

Every year, the list of doctors and hospitals that remain in a plan's network changes. This might impact your ability to see the doctors of your choice.

The best way to learn about such changes is to read through the Medicare Plan Annual Notice of Change (ANOC) letter you received in September. It explains shifts in coverage, costs, and other aspects of Medicare that go into effect on Jan. 1, 2027.

Learn about prior authorization requirements

Understand how prior authorization requirements differ by plan. Original Medicare typically has fewer such requirements than Medicare Advantage plans.

However, even within Medicare Advantage, requirements vary significantly from plan to plan. So, it often pays to shop around.

Find out where each prescription sits on next year's formulary.

Each Medicare plan's prescription drug formulary also changes from year to year. Make sure your medications remain in your plan's formulary next year.

If your drug remains covered, check to see if it has moved from a lower tier to a higher tier, which could increase costs.

Know the annual out-of-pocket cap

If your prescription drug plan has a deductible, you pay for medication costs out of pocket up to that number. Then, you pay 25% in co-insurance costs until you hit the out-of-pocket maximum.

In 2027, this maximum is $2,400, up $300 from 2026. Knowing this number helps you to better budget as you compare prescription drug plans during open enrollment.

Weigh switching from Medicare Advantage to Original Medicare

Some people may discover that switching from Medicare Advantage to Original Medicare makes sense for them. Open enrollment is the perfect time to make such a change.

However, before you do so, make sure to understand all the implications of such a decision.

For example, if you have had a Medicare Advantage plan for at least a year and then switch to Original Medicare, you will not be protected by guaranteed-issue rights. This means you could be charged a higher premium or even denied coverage.

There are exceptions to this rule, however, such as if your plan withdraws from your area.

Bottom line

Cuban has repeatedly aired concerns about how a lack of transparency is making Medicare more expensive. Ultimately, seniors cannot change this reality.

Fortunately, there are many ways to lower the cost of your own coverage and stretch your retirement dollars further. Open enrollment lasts through Dec. 7, so now is the time to make changes that lower your bills and improve your coverage.

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