Welcome to the POST-Annual Enrollment Period {See the Video Below!!!} January 1 to March 31, 2020 Now the second fun season begins! We are now heading into what was before called the “Medicare Advantage Disenrollment Period”. This is covered on…
We are ready and our tool is actually MUCH better than using Medicare.Gov We have been using this for two years, quite successfully. Video on the issues of Medicare trying to replace agents: The new look for PlanFinder on Medicare.gov…
UPDATE: 2019 There is a new period, January 1 through March 31, where a senior can now leave an MAPD (Advantage) plan and return to original Medicare. They could also switch from one MAPD to another MAPD during this period….
New updates available on Medicare Advantage and how you can easily offer plan information and enrollments by phone and internet! This page covers, in detail: 1) How we are allowed to sell Medicare Advantage by phone (when most FMO's say…
Update from December 8 – December 31st, 2018 See the video below MAPD people can apply now for February 1 effective date for a Medicare Supplement if they still wish to get off of Medicare Advantage. Once approved by the Medicare…
Due to the devastation in California from the wildfires, FEMA has declared the area a disaster area, triggering CMS to initiate a Special Election Period for all affected directly by the fires and those adversely impacted by those they rely…
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…
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. {“@context”: “http://schema.org”,”@type”: “VideoObject”,”name”: “Lasso Webinar”,”description”: “This video contains Lasso…
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…
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…
Four Videos here on AEP, including a unique Part D opportunity: Here we talk about what you should be doing to get ready for the Annual Election Period (AEP) which is officially from October 15 through December 7th. During…
Lots of updates with reference links added. THIS IS A VERY HELPFUL WEBINAR on MANY topics! You need to know: From December 3, 2016 See the video: {“@context”: “http://schema.org”,”@type”: “VideoObject”,”name”: “Medicare Private Briefing December 3 2016″,”description”: “This video contains Medicare…
Approximately 30% of Americans turning 65 are opting for a Medicare “Advantage” plan. In my experience, this most often happens for the following two reasons:
Sadly, there are many situations that we have seen where a Turning 65-senior has chosen one of these “free” Medicare Advantage plans only to have to experience the limitations and large hospital admission co-payments by having a serious illness that takes them into full usage of their chosen plan.
When they were first turning 65, they thought their great health would continue far into their senior years, only to discover that this is the time frame where most all medical claims are experienced in life. Sadly, when they signed up for a Medicare Advantage plan, particularly an HMO plan, they find that the restrictions now imposed on them, the trade off for little or no monthly premium, now can significantly and adversely not only affect their availability of specialty care (replaced with tight networks) but also expose them to more money spent for medical care than their non-“Advantage” plan senior counterparts.
On the contrary, the biggest proponents of Medigap (Medicare Supplement) plans are those who have had to use them with a serious illness. For example, those with a special kind of cancer who can now choose the best cancer treatment centers in America without consequence because their Medicare Supplement plan allows them to go anywhere. Those who would have otherwise been exposed to a $6,700 out-of-pocket cost with their Medicare Advantage plan for a series of hospital admissions who though, because on a SUPPLEMENT plan instead, pay $0 for their admissions and, more importantly, get to CHOOSE their hospital instead of only being able to go to the one that was the lowest bidder that joined the “Advantage” plan's restrictive network.
In an illuminating article by the non-profit Kaiser Family Foundation, the choice of a Medicare Advantage plan when a senior is turning 65 can prove disastrous for future healthcare choices for the rest of a senior's life. See the article here:
http://kff.org/medicare/perspective/traditional-medicare-disadvantaged/
It is very important that now-Medicare-eligible seniors have the full information on the good, the bad, and the possible devastating effects of picking their Medicare plan.
Chris Westfall is an independent Medicare agent and has been a licensed insurance agent for over 20 years.
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:
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
Have you been asking a prospective client's doctor if they accept your proposed Medicare Supplement plan? This is something we used to do all the time, via a three-way call with the client, and it would help us to enroll…
Excerpt from SeniorAgentPodcast on iTunes:
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.
Also on the topic of telemarketing – CANNOT call folks for Medicare Advantage plans, as said before:
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