Medicare Advantage

We are now offering Medicare Advantage in our agency, and you might want to consider it, too. The trend is swinging into the MAPD direction with more traction each year. Many FMO's will tell you this cannot be done by phone. We have a system where it can. This is why we are selling Medicare Advantage (yes, by phone). Here, you will find the presentations on a few Medicare Advantage plans (the ones we are working with). We are able to sell Medicare Advantage 100% over the phone in a fully compliant way. Make sure your contract elsewhere allows YOU to do the same. Medicare Part D Maximum Broker Commissions for 2020 Initial commissions increased from $74/member/year to $78/member/year, a 5.40% increase YOY. Renewal commissions increased from $37/member/year to $39/member/year, a 5.40% increase YOY. Medicare Advantage Maximum Broker Commissions These numbers are broken out by state/region. For CA and NJ, initial MA commissions increased from $601/member/year to $636/member/year, a 5.82% increase YOY. Renewal commissions increased from $301/member/year to $318/member/year, a 5.64% increase. For CT, PA and DC, initial MA commissions increased from $542/member/year to $574/member/year, a 5.90% increase YOY. Renewal commissions increased from $271/member/year to $287/member/year, a 5.90% increase. For Puerto Rico and the U.S. Virgin Islands, initial MA commissions increased from $331/member/year to $350/member/year, a 5.74% increase YOY. Renewal commissions increased from $166/member/year to $175/member/year, a 5.42% increase. In all other states, initial MA commissions increase from $482/member/year to $510/member/year, a 5.80% increase YOY. Renewal commissions increased from $241/member/year to $255/member/year, a 5.80% increase. Here is how we can do this over the phone: (this is available if the MAPD and Part D contracts are under Chris Westfall) This is LeadAdvantagePro: What if you could have a consumer-facing website where they could research Medicare Advantage plans and sign up, themselves, and YOU get the credit! You can! It's called Medicare Insurance Direct, and with our contracts, you have it: (Available to you if your contracts for Part D/MAPD are with Chris Westfall.) If you have your contracts with us, you can sign up for your own enrollment site like this for MAPD and Part D here: https://sellmedicarebyphone.com/medicare-insurance-direct/ RxImport is a very easy way of importing the client's drugs from the drug database. This makes recommending a Part D plan VERY EASY! (Available to you if your contracts for Part D/MAPD are with Chris Westfall.) Yes, there is plenty of time to get contracted and certified for the Annual Election Period. Our method allows you to sell Medicare Advantage over the phone in a fully-compliant way. 1) First thing to do, in order to sell Medicare Advantage, is take the AHIP training: AHIP Certification Discount link is here for 2020. Click Here 2) The second thing to do is contract with the carrier(s) for the area(s) you are marketing. Not sure which one(s) you should contract with? Contact us and ask. You can find the contracts here. 3) The last step, after contracting, is to complete their product certifications. The links to accomplish certification are sent after your contracting is received. 4) After that, you must make sure that your marketing is Medicare Advantage-compliant (No Telemarketing is allowed for Advantage!) Let's look at some of the companies: Aetna/Coventry Medicare Advantage 2020: Anthem MAPD for 2020: Cigna-Healthspring for 2020: Humana Medicare Advantage for 2020: Mutual of Omaha Medicare Advantage for 2020: Silverscript Part D 2019 Overview Need the Silverscript Contract? Click Here New Marketing Rules for 2019:SEE THE CMS RULES HERE - OPENS AS NEW WINDOW Great article from Dwane McFerrin: Understanding the New Medicare Marketing Guidelines By Dwane McFerrin, Vice President, Medicare Solutions Originally published July 30, 2018, last updated August 1, 2018 CMS, AEP, Medicare Supplement, Medicare Advantage Medicare Advantage continues to expand its share in the senior health market. The definition of MA benefits has been expanded, and more plans are available in more areas than ever before. In recent years, the Centers for Medicare & Medicaid Services (CMS) has lightened the regulatory burden on carriers and agents.This year's changes to the Medicare Marketing Guidelines also reduces some of the burden. There have been some definition changes, leading to a name change. CMS has renamed the guidelines the Medicare Communication and Marketing Guidelines (MCMG). The changes were released on July 20, and signal new opportunity for agents to connect with prospects in more ways and provide quality service to MA clients. Reviewing and comparing the guidelines can be a time-consuming task. The compliance professionals here at Senior Market Sales developed the following summary of some MCMG changes for 2019 that represent items we felt would be material to agents marketing MA/PD Plans. However, it is not an exhaustive list and this summary is subject to change. NOTE:All Plans/Part D sponsors are responsible for ensuring compliance with CMS’ current marketing regulations and guidance and may impose additional restrictions for subcontractors, downstream entities, and/or delegated entities, provided they do not conflict with the requirements outlined in the MCMG. Communication and Marketing— “Communications” is a new category of materials and activities to provide information on MA/PD Plans to current and prospective enrollees. “Marketing” is a subset of “communications” and the definition of “marketing” was updated to include only materials that are most likely to lead to a beneficiary to make an enrollment decision. CMS review is required only for marketing materials. The difference between communication and marketing activities and materials is based on the intent and content of what is being conveyed. Medicare Educational Events— CMS now allows agents to set up future marketing appointments, distribute business cards and contact information for beneficiaries to initiate contact, and they may include communication activities and distribution of communication materials. Please keep in mind that agents may not solicit/accept enrollment applications for a January 1, 2019, effective date until October 15, 2018, unless the beneficiary is eligible under another enrollment period. Credentialing— Plans are no longer required to terminate unlicensed agents and are given the flexibility to determine level of disciplinary action against agent. However, Plans may only pay agents/brokers who meet state licensure/appointment requirements and have completed product certification. Plans are required to report all non-credentialed agent sales to CMS. Business Reply Cards (BRC)— No requirement to be submitted through HPMS if no plan specific benefits are mentioned. Restoration of the Medicare Advantage (MA) Open Enrollment Period (OEP)— From January 1 through March 31 annually and allows individuals enrolled in an MA plan, including newly MA-eligible individuals, to make a one-time election to go to another MA plan or Original Medicare. Individuals using the OEP to make a change may also add or drop Part D coverage. The MA disenrollment period (previously from Jan 1stthrough Feb 14th) was eliminated. It is prohibited to knowingly target or send unsolicited marketing materials to any MA enrollee or Part D enrollee during this OEP. Limitation to the Part D Special Enrollment Period for Dual and Other LIS-Eligible Beneficiaries— Revised the SEP for dual-eligible and LIS beneficiaries from an open-ended monthly SEP to one that may be used only once per calendar quarter during the first nine months of the year. Can also be used: 1) within a certain period of time after a CMS or state-initiated enrollment; and 2) within a certain period of time after a change to an individual’s LIS or Medicaid status. It is not available to those identified as “At Risk” or “Potentially at Risk” for prescription drug abuse under drug management programs. Taken as a whole, these changes can be viewed as a significant improvement for agents serving MA clients. The upcoming AEP is an ideal time to start or expand your Medicare Advantage offering. Pay attention to the new terms, or re-definition of terms. “Communications” is a new term, and “Marketing” has been re-defined as a subset of Communications, and means activities and materials that are most likely to draw attention to and influence a beneficiary’s decision-making process and lead to a MA/PD enrollment decision. Marketing requires CMS review. Communications does not. An example of “Communications” would be activities/materials that promote awareness of MA plans in general, and your agency offering that type of plan. While a brochure or social media ad that provides specific details about a plan’s benefits, cost sharing or ranking standards would be considered “Marketing.” The rules regarding educational events are worth noting. It’s now reasonable to include and distribute items defined as “Communication” during educational events. For example, that means you may offer business cards or agency information at educational events, without having to be asked by a contact. The rules for communicating by mail with business replay cards have been relaxed, as long as plan specifics aren’t included. For Agent Use Only See this important comparison of Medicare Supplement vs. Medicare Advantage From the Wharton School of Business, on Medicare Advantage:

MedicareAgentTraining.com

Medicare training on how to sell Medicare Supplements by phone

Medicare Advantage