UPDATE: December 2020
The big carriers, Aetna, Cigna, Mutual of Omaha, et al have made it known that they have no intention of paying agents for writing Medicare Supplements to Trial Right clients who were 65 when they started with a Medicare Advantage plan and, within that first 12 months, opt to go back to original Medicare where they can, per Medicare, buy ANY Medicare Supplement plan in the market.
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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…
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.