See the video below.. but the short conclusion: It is established that cold calling seniors as the basis for generating Medicare Advantage sales, using the premise of Medicare Supplement calls, is known as “bait and switch” and is illegal, per…
AT&T retirees are the latest in a long list of large employers to drop seniors from their employee benefits program. See the video: Update: October, 2018 New AT&T FAQ Clearly Explains the Reimbursement for Non-AON Plans See the Document Here. …
The Lasso Medicare MSA launches for 2019 business. Enrollment begins AEP 2018 for January 1, 2019 start date. Here is my take on it, then the overview webinar is below. See the CMS Guide to MSA Accounts (Good info)…
Data provided by CMS (Center for Medicare/Medicaid Services) can help you pinpoint where you should focus your marketing efforts. This information helps to find the Medicare Advantage saturation numbers for each county in the U.S. Why? They will tell you,…
After a meeting in Palm Springs with some top producers, I came away with some good news for those in the Medicare business.
On location in San Diego, here's my update on the industry and what's coming.
Remember, we can write a Medicare Supplement up to 6 months prior to their Part B start date.
Some notable exceptions to these include carriers that do not allow it (see your Agent Guides).
We know these to be Anthem, Humana, and Cigna (90 days).
What do you use when they have no Medicare card yet and you're writing a T65 application? See below!
See the video:
In the first quarter of the year, starting in 2019, seniors will be able to make ONE change in or out of MAPD or PDP into another one, if they wish. This expands the “disenrollment period”, which has been in existence…
by Leslie Small | FierceHealthcare
Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government.
In its second round of online provider directory reviews, the Centers for Medicare & Medicaid Services found that 52% of the provider directory locations listed had at least one inaccuracy.
Those errors included providers who weren’t at the location listed, providers who didn’t accept the plan at that location, providers who weren’t accepting new patients despite the directory saying that they were, and incorrect or disconnected phone numbers.
When CMS conducted its first review of MAOs’ provider directories, it found that 45% of locations listed were inaccurate. While the report does say that the first and second reviews aren’t directly comparable “due to minor updates to the review methodology,” at the very least, the latest review’s results indicate the problem isn’t getting any better.
CMS also noted that its findings were not skewed by a few organizations but instead were widespread in the sample reviewed, which was about one-third of all MAOs. “Very few organizations performed well in our review,” the agency said.
At a minimum, provider directory errors can make members frustrated with an MAO, the report noted. But they can also cast doubt on the adequacy and validity of the MAO’s network as a whole, and even more seriously, prevent members from accessing services that are critical to their health and well-being.
RELATED: Study takes stock of MA hospital networks
Based on the results of its reviews, CMS has sent 23 notices of noncompliance, 19 warning letters and 12 warning letters “with a request for a business plan” to Medicare Advantage insurers.
However, the agency emphasized that MAOs themselves “are in the best position to ensure the accuracy of their plan provider directories.” It also said it was encouraged by pilot programs aimed at developing a centralized repository for provider data that would be accessible to multiple stakeholders.
In the near term, CMS added, MAOs should perform their own audits of their directory data and develop better internal processes for members to report errors.
See the original article here:
https://www.fiercehealthcare.com/cms-chip/medicare-advantage-provider-directory-errors-network-adequacy
If you are selling in Texas, you are probably familiar with the TRS (Texas Retirement System). It has been getting lots of buzz lately as seniors are fleeing the program and wanting to be on original Medicare with a Medicare…
If so, in addition to the AHIP test, there is now another, separate test administered only through CMS and it is required.
This test is on Waste, Fraud, and Abuse, as there always had been in the AHIP test already, but now it's required separately.
Courtesy of United Healthcare, this is a link to the instructions as to how to find and take this simple test:
Today it was officially announced that CIGNA and Anthem have struck a deal to become, for now, the largest health insurer in America. The terms of the final deal finally having weathered the storm of a two-month long negotiation, the deal is said to be worth $48 Billion to CIGNA for its acquisition into Anthem.
The independent market is still waiting to hear how this will impact the Medicare Supplement and Medicare Advantage distribution channels. The deal might take two years to get through regulator's approval.
As always, we'll have the specific news when it's available as to how this will impact the individual agent. – Stay tuned!
-CW
See the announcement:
A report from PublicIntegrity.org details new, and not-so-new investigations into Medicare Advantage potential fraud and abuse around the country. In multiple states, and across providers, Congress is trying to get a handle on the overpayments that are happening with this managed care approach to replacing original Medicare.
See the story here:
Why Medicare Advantage costs taxpayers billions more than it should
Regulators have kept problems secret, and there's no fix in sight
Should you use your personal name, when calling for clients, or use a company name?
That is the question answered in this webinar:
<!@split@>
See the video:
Now See their video: My Notes, with the timestamp I'm referring to: 4:32 You can offer any of our Med Supps Guaranteed Issue (if they're cancelled off of their MAPD plan). This is true of any company, by the way….
This was the update webinar from July 18, 2014. Update from the companies active in the marketplace right now. Covered the Yes Yes Yes closing formula to get the client on your side. See the video: Mentioned in the webinar:…
A bipartisan group of senators, as well as the very powerful AHIP group lobbied the administration to not cut funding. With the mid-term elections coming quickly, the administration listened and has decided to put off the cuts to Medicare Advantage….
Medico's New: Hospital Indemnity Plan. This new plan is more competitive, easier to sell, and through their electronic application, easy to enroll. You can contract with Medico now for a pending state and they will begin processing of your contract….
In a recent story by Forbes online, they state:
“The Obama team has made a warm embrace of managed care options when it comes to Obamacare and Medicaid. But for Medicare, they want to deny low-income seniors these options. All of the administration's old arguments on why they resisted these private Medicare plans have been largely mooted, or never materialized.”
The Forbes.com article goes on to site a study that says at least 13% of Medicare Advantage plans expect to be eliminated by 2015. The agent in the Medicare market must strongly consider having a deeply rooted anchor in the Medicare Supplement market, as we do.
As always, I'll continue to keep you updated on the changes and opportunities in this awesome marketplace, here on MedicareAgentTraining.com.
Source: More Cuts In Store For Medicare Plans — Here Are The Options That Will Shrink Most For Seniors
http://www.forbes.com/sites/scottgottlieb/2014/01/06/more-cuts-in-store-for-medicare-plans-heres-the-options-that-will-shrink-most-for-seniors/?goback=%2Egde_2479603_member_5826692941543927812#%21
On the Friday webinar for members, held January 3, 2014, I laid out the predictions from all of the experts on the decline for Medicare Advantage business in the near future. This is for a variety of reasons, not the least of which was the shenanigans employed by the president just prior to the election, where Medicare Advantage would be propped up to shield seniors from the cuts in the ACA – until just AFTER the election.
See the webinar on this topic here:
Today, an article was written by Bloomberg pointing to the same conclusion.
http://www.businessweek.com/ap/2014-01-03/analysts-expects-slower-medicare-advantage-growth
It is an interesting read, and further proves my prediction was correct. Medicare Supplements are the wave of the future, not Medicare Advantage!
Make sure that you're a member of MedicareAgentTraining.com to get the latest, even before the pundits, on what's happening in our market. If you're not a member, you can join here.
Webinar Replay from December 13, 2013 – Year-Round Opportunities This is a year-round business… see the video: Click the image to start the video: > Topics Covered: Cross selling opportunities NOW: First, see this webinar on cross selling final expense…
See the video: <!@split@> (NOTE, As of 2019, this period is now called the MAPD OEP – and there is now the option (January 1 to March 31) to change Medicare Advantage plans OR leave Medicare Advantage and return…
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