New Requirement for MAPD Sales

Do you sell Medicare Advantage plans or Part D plans?

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:

Click here for the document

 

Medicare Supplement Training

CIGNA Healthspring Medicare Advantage Suspended by CMS

From:
http://www.bloomberg.com/news/articles/2016-01-22/cigna-banned-from-selling-medicare-plans-by-u-s-stock-falls

  • U.S. says Cigna has `longstanding history of non-compliance'
  • Anthem, which agreed to buy Cigna, is committed to deal

Cigna Corp. was banned from marketing its Medicare products to new customers, after the U.S. found deficiencies in how the health insurer ran its plans, citing widespread violations that the government said threatened patients’ health.

“Cigna has experienced widespread and systemic failures impacting Cigna enrollees’ ability to access medical services and prescription medications,” the U.S. said in a Jan. 21 letter to the insurer outlining the sanctions. “Cigna has had a longstanding history of non-compliance” with requirements from the Centers for Medicare and Medicaid Services, or CMS.

Cigna and other insurers offer a privately run alternative to traditional Medicare, which includes insurance coverage for hospital and doctor care, known as Medicare Advantage, as well as prescription drug coverage, or Part D. CMS found problems involving Cigna’s appeals and grievances process, as well as with its drug coverage, the insurer said Friday in a regulatory filing.

 Because of those deficiencies, Cigna won’t be allowed to market or sell Medicare Advantage policies or Part D drug plans to new clients. The government said it “determined that Cigna’s conduct poses a serious threat to the health and safety of Medicare beneficiaries.” Cigna clients who are affected by the issues cited by CMS can drop their Cigna coverage and buy policies from other insurers.

Shares of Cigna, which is being bought by Anthem Inc. for about $48 billion, rose 0.1 percent to $140.33 at 10:09 a.m. in New York. Anthem remains committed to the deal, spokeswoman Jill Becher said in an e-mail.

Private Medicare Alternative

“Cigna is working to resolve these matters as quickly as possible and is cooperating fully with CMS on its review,” the health insurer said in the filing, adding that the sanctions don’t affect benefits offered to current enrollees.

For now, the ban mainly affects Cigna’s marketing to people who age into Medicare, the U.S. health program for people 65 and older. Medicare beneficiaries are allowed to shop for new plans every year during a period known as open enrollment that runs from Oct. 15 to Dec. 7.

Cigna, which mainly offers coverage via employers, expanded in Medicare with the acquisition of HealthSpring Inc. in 2012. The company has about 543,500 Medicare Advantage clients and about 1.1 million people in its prescription drug plans, according to data compiled by Bloomberg Intelligence.

United American Suspended from Medicare Part D Program

As of August 1, 2015, United American (a Torchmark company) has been suspended indefinitely from participation in the Medicare Part D program.

Read the notice here

Video review and analysis:

 

Medicare Supplement Training

Is it legal to call folks about their Medicare plan?

Is it legal to cold call for Medicare plans?

Excerpt from SeniorAgentPodcast on iTunes:

Can I legally call someone and talk about Medicare Supplement plans?

This is a question that was asked by a new agent this week.

The agent said she had heard that you can lose your license, pay a fine, etc. for cold calling someone about Medicare plans.

What the agent is referring to is the marketing of Medicare Advantage Plans.
You can find the marketing rules from CMS about Medicare Advantage plans here.

However, in most all states, it is perfectly legal to telemarketing / cold call, door knock, and approach seniors about Medicare Supplement plans. Only one state, that I know of, has restrictions on the marketing of Medicare Supplement plans.

That state is Ohio. Their law prohibits the following for both Medicare Advantage AND Medicare Supplement marketing.

(2) Any of the following unsolicited contacts with a medicare-eligible person:
(a) Door-to-door solicitation including leaving information such as a leaflet, flyer, or door hanger at a residence, or leaving information such as a leaflet or flyer on someone's car;
(b) Approaching individual prospective applicants in common areas (e.g., parking lots, hallways, lobbies, sidewalks, etc.);
(c) Telephonic solicitation including leaving electronic voicemail messages;
(d) These prohibitions on marketing through unsolicited contacts do not extend to mail and other media (e.g., advertisements, direct mail), or unsolicited contacts with prospective applicants with whom the entity or insurance agent has a business relationship.
Near the end of this podcast, I have several suggestions for various new ways to market Medicare Supplement plans through centers of influence.

Those referenced interviews are found at MedicareAgentTraining.com

 Hear the audio of the podcast answer here.

Medicare Advantage Plan Reductions Hurting Seniors for 2014

In this briefing, Chris Westfall goes through the Medicare Advantage changes that are now being followed in the media. Seniors considering a Medicare Advantage plan for 2014 should watch this video and see the writing on the wall.

Update since video:
20% of RI docs leave the MA plan:
http://www.providencejournal.com/breaking-news/content/20131022-ri-medical-society-united-is-cutting-20-percent-of-doctors-from-its-medicare-plans.ece

See the video briefing:

 

References:

http://avalerehealth.net/news/avalere-analysis-reveals-first-drop-in-medicare-advantage-offerings-since-2

http://www.kaiserhealthnews.org/Stories/2013/October/15/medicare-open-enrollment-begins.aspx

http://www.providencejournal.com/breaking-news/content/20131021-unitedhealthcare-dropping-r.i.-doctors-from-medicare-advantage-network-poll.ece
https://MedicareAgentTraining.com – for agents only
Seniors should visit: http://SeniorSavingsNetwork.org

Medicare Supplement Study – March 1 Webinar

March 1 Webinar
This is a presentation on the results of a comprehensive study looking at the Medicare Supplement industry and senior satisfaction.