Senior Insurance Blog

A The Henry J. Kaiser Family Foundation released a report that provides an analysis of Medicare Advantage enrollment trends among HMOs, PPOs, and PFFS plans.  The report highlights that 11.1 million people were enrolled in private Medicare Advantage plans as of March 2010.  This is an increase from 10.5 million in March 2009.  The report showed that this increase took place despite a reduction of available plans throughout that same period. 

The report also found that three or fewer insurance companies dominate the Medicare Advantage market in every state except New York.  In 14 states, one company enrolls more than half of all Medicare Advantage customers.  Nationwide, both UnitedHealth Group and Humana Inc. control 33% of the total Medicare Advantage enrollment nationwide. 

For the full report follow this link: http://kff.org/medicare/upload/8080.pdf

Medicare Doc Pay Cuts Expected to be Delayed Today

Last night, the House of Representatives voted 417-1 to approve a Senate bill that delays a 21% cut in Medicare payments to doctors.  The bill delays the cuts another six months.  Lawmakers will work on a more permanent solution in that time, but if history is any indication, a permanent solution isn’t coming anytime soon.  Obama has expressed his approval of the bill and is planning to sign it into law today. 

The Medicare doc pay cut delay was a part of a larger bill that included unemployment benefit extensions and more aid to states.  When that bill was filibustered by Republicans, Democrats separated the Medicare doc pay cut delay into its own bill.  Now the hope is that the much more expensive, permanent solution can be passed after congressional elections in November.  The bill being signed today will increase payments to providers by 2.2% and will be paid for with a series of health care and pension changes.

Medicare and Medicaid Implements New Fraud Mapping Tool

The Centers for Medicare & Medicaid Services (CMS) implemented a new fraud mapping tool that will eventually be used throughout all government agencies.  The fraud mapping tool was developed by the Recovery Accountability and Transparency Board to collect massive amounts of information in real time, analyze the data for fraud trends, and then project possible fraud or errors using an array of indicators.  This new tool comes on top of the “Do Not Pay” list created last week.  Both methods aim to achieve President Obama’s goal of cutting improper Medicare payments in half by 2012.

Sentinel Life Medicare Supplement Plan N Approved in CA, IA, and LA

Sentinel Life Medicare Supplement Plan N has been approved for Louisiana, Iowa, and California.  Each of these plans offer competitive rates and generous commissions.  To learn more about these products click here.

Sources: AP, NPR, KFF, KHN

In another sign that Medicare Advantage is falling by the wayside, yesterday CIGNA announced it will not offer CIGNA Medicare Access (PFFS), its individual private fee-for-service medical plan, in 2011.  Customers of these plans will experience no change for this year.  CIGNA will continue to serve its clients, brokers, health care professionals, and contractors into 2011 for 2010 claims.  Now that CIGNA PFFS customers will need to choose a new medical coverage option for 2011, this presents a great opportunity to promote Medicare supplements to them, especially Medicare Supplement Plan N.

Medicare Checks Sent Out to Seniors
As posted on our Twitter feed earlier this week, the Obama administration started sending out $250 checks to seniors who fall into the Medicare prescription drug doughnut hole.  With elections looming on the horizon, Democrats are touting the checks as the first of many benefits to come from health care reform legislation signed into law earlier this year (PP&AC Act).   In some states, Democrats are buying air time to broadcast a 60-second television ad stating how Republicans promised to repeal the healthcare reform bill.  Democrats also sent boxes of “GOP Doughnut Holes” to various media outlets as a sign that the doughnut hole rebate benefit would not exist under GOP leadership.  Of course, as you may already know, in most cases, the $250 is only about 1/14 of the total $3,610 hole. 

Infection Control a Major Issue at Medicare ASCs
Earlier this week, the Journal of the American Medical Association published a new study from the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS), that found 2/3 of ambulatory surgical centers (ASCs) in three states experienced infection control lapses.  CMS defines ACSs as facilities that operate exclusively to provide surgical services to patients who do not require hospitalization or stays in a surgical facility longer than 24 hours.  Roughly 70 ASCs that experienced the infection control lapses serve Medicare patients.  The lapses were typically found in process including hand washing, injection and medication safety, and equipment reprocessing.  To view a video overview of the report click here.

AMA Unleashes its Wrath on Congress for Neglecting Medicare
Due to a glitch with our e-mail system last week, many of you missed last week’s article.  To view that article, click here.

Reminder: Modernized Plan Approvals Info
We just wanted to provide you with a friendly reminder that we offer three methods for checking out the latest modernized plan approvals.   First, we post updates immediately to our Twitter feed, second we post the update to our approval chart, and third if a carrier’s plan is new to the state, we’ll add it to our product availability map.  When it comes to modernized plan info, at PSM we’ve got you covered.

Sources: Reuters, Politico, CNN, JAMA, NPR

You may have read on other blogs that the doctor fix is in, but it’s not. The House of Representatives voted last Friday on May 28 to freeze the scheduled Medicare payment cut until 2011, however the U.S. Senate failed to pass the bill before going on a week-long Memorial Day break.

The 21% Medicare payment cut took effect June 1, but the Centers for Medicare and Medicaid Services (CMS) ordered a temporary freeze on doctor payments, giving Congress time to retroactively approve the bill that freezes the cut.

In response the American Medical Association (AMA) launched a multi-million dollar series of advertisements that will appear in newspapers, radio, and television. The ads aim to pressure senators to pass the bill as soon as possible by criticizing them for taking a vacation while more than 40 million seniors and millions of health care providers are left worrying about the future of their healthcare and businesses respectively. The AMA also hopes to further its goal of getting the government to pass a permanent fix by changing the current Medicare payment formula. Such a fix would cost an estimated $250 billion over ten years, which is why the Senate continues to repeatedly delay the cuts rather than address the root cause of the problem.

Various news outlets, such as Reuters are reporting that some doctors are no longer taking new Medicare patients due to the volatility of the situation.

Ironically, the Medicare payment cut also impacts TRICARE (the health program for military families), as it utilizes the Medicare payment formula. Looks like our Senators celebrated Memorial Day a little too quickly.

The AMA has set up a web page titled "Medicare Payment Action Kit." You can view many different documents it has created on the whole issue. Check it out here.

Starting in the fall of 2011, the Annual Election Period (AEP) will take place beginning October 15 and run through December 7.  This is a change from the current schedule of November 15 to December 31.  

Then on January 1, 2011, the Open Enrollment Period (OEP) will be eliminated.  As many of you already know, this period allowed beneficiaries to switch between “like” plans from January 1 to March 31 each year.

Also in 2011, the first Baby Boomers start to age into Medicare. There are 45 million Medicare eligibles in the country today, and by 2020 that number will grow to over 60 million. If you have any questions regarding these changes, please call us at 1-800-998-7715 or e-mail to info@psmbrokerage.com.

Source: Bravo Health

Over the next few weeks, we will be receiving rate information for Medicare Supplement Plans M and N from our carriers.  Of the two new plans, Plan N is shaping up to be one of the most attractive and popular insurance products on the market.

As many of you know, one of the biggest reasons seniors don’t or can’t get a Medicare Supplement is due to cost.  Plan N has been designed to be a cost-effective solution that competes directly with Medicare Advantage plans.  We believe many cost-conscious seniors will gravitate towards Plan N, as it offers the stability and standardization of a Medicare Supplement at a price point that is 25%-35% cheaper than the comprehensive and popular Plan F.  Thus, Plan N is a perfect alternative to Medicare Advantage because it allows you to increase your customer base and further elevate your income stream.  This incredible combination of lower price and higher accessibility is going to make Plan N the choice for most seniors in 2010, especially those who are healthy and don’t often need medical care.

The primary reason why Plan N is more affordable is because it requires clients to share the cost of their treatment, much like a Medicare Advantage plan.  Unlike a Med Advantage plan however, Plan N has no network restrictions and much lower out-of-pocket liabilities to the client.  Plan N is different from what is traditionally expected from a Medicare Supplement plan, these new benefit changes now make Medicare Supplements much more accessible to lower income seniors and more attractive to those who are healthy and wouldn’t otherwise see the need for one.

Though Plan F is currently the most popular Med Supp plan because it offers the most comprehensive coverage for the money, we think Plan N represents the future of Medicare.  Medicare can’t continue to shoulder the entire cost burden of rising medical costs and a huge boom in the senior population over the next decade.  If there is still going to be a Medicare in the future, CMS is most likely going to structure future plans so that seniors are going to have to share in financing their healthcare.

To obtain the new Modernized plans for your state with the addition on Plans M & N, Click Here

It’s that time of year again, but this time many of you who sell Mutual of Omaha Medicare supplements will see that rate increases are significantly higher than usual. Click the links below to view the new rates for your state(s).

Mutual of Omaha Companies Med Supp Rate Increase Info is for the following states (April 2010):

AL, AR, AZ, CT, IL, KY, MI, ND, OH, OR, SC, SD, and TN

View Rates

Ohio (April 1, 2010):

View Rates

Missouri (April 1, 2010):

View Rates

WellPoint Announces Rate Increases Between 25% - 39% in California

And if you think these are high, they aren’t as bad as those found in the under 65 market. This past week, WellPoint CEO Angela Braly addressed a U.S. House subcommittee regarding insurance rate increases of 25% to 39% announced by her company’s Anthem Blue Cross of California.

The company line is that these rate increases reflect increases in medical costs, as well as the trend of many young and healthy policyholders dropping or reducing coverage during this great recession.

Committee Democrats argued that Anthem e-mails demonstrate that the company seeks to increase its profit margin and to reduce coverage. The politicians pointed out that in 2008, WellPoint paid $115 million to 85 senior executives, and compensated 39 executives more than $1 million each. The company also spent over $27 million on 103 executive retreats.

As you can see, we have implemented both minor and major changes to our site to improve both the design and functionality of our site. We’ve implemented our new logo and color scheme, a new homepage design, added a drop down navigation bar, and most significant of all, we’ve added a new agent resource page that consolidates an array of useful information for you in one spot.

With all the changes to Medicare this year, we’ve created a dedicated Medicare 2010 information page that breaks down everything you need to know in an easy to digest format. We’ve created a tabbed panel for you to easily switch between the different types of information. On this dedicated Medicare 2010 information page you will find a concise overview, a tabled breakdown of all the plans, a list of Frequently Asked Questions provided by Mutual of Omaha, and links to major Medicare websites. We will update this page with any new info that may arise, so we recommend checking this page periodically. Here is a direct link to the page:

http://www.psmbrokerage.com/medicare-supplement-2010

Our resources page features the same tabbed panel structure for clear and easy to access information. On this page you will find a link to the aforementioned dedicated Medicare 2010 information page, a link to our E&O partner, links to helpful technology sites, information on incentives and events, information and links to educational resources, links to major news sites, and a convenient list of carrier contact info. We are always seeking the best resources for our agents; so when we discover them, know that we’ll post that information here first.

http://www.psmbrokerage.com/resources

At PSM, we’re always trying to improve our service to our agents, so we appreciate any feedback you may have on any of the changes we’ve made.

As many of you already know, Medicare's Annual Open Enrollment begins November 15 and will last until the end of the year December 31. The Centers for Medicare & Medicaid Services this week released the final $6.3 million of a total $49.6 million in total funding allocated for State Health Insurance Assistance Programs (SHIPs).

SHIPs use this money to fund local community programs that provide personalized help to Seniors who want to know more about Medicare and other health insurance information. SHIP programs are expected to focus heavily on less fortunate Seniors who typically have little knowledge of the Medicare system and the benefits they are entitled to. For more information on the SHIPs in your state, click here.

For this open enrollment season many in the industry expect to see an increase in Medicare supplement enrollments due to several changes to Medicare Advantage that will occur in 2010. MA beneficiaries can expect to see an average premium increase of nearly 22% (a $7 increase to $39/month). Despite the increases, CMS states that roughly 87% of Medicare beneficiaries will still have access to a MA plan that doesn’t require a premium. Additionally, CMS expects 7% of MA beneficiaries will have to choose a new health plan or a Medicare supplement as their plans (typically PFFS and low enrollment plans) will be discontinued at the end of this year.

CMS will also increase its oversight of Medicare marketing activities. There are now stronger rules governing the commissions that can be paid to independent sales agents and how MA plans identify themselves. CMS will significantly increase its secret shopping activities, including individual marketing sessions. So we advise that you be extra vigilant in your compliance efforts this season. Mutual of Omaha has already published its disenrollment guidelines, which you can check out here.

As usual, Seniors will have access to www.medicare.gov and 1-800-MEDICARE this season. Of course, these are good resources for agents such as yourself, if only to ensure that your information aligns with the official source. For all open enrollment related information, click here.

As always, we’ll keep you updated with the latest news and product information to help make this open enrollment season a successful one for your organization.

Sources: CMS, Senior Journal

The Gerber Life Medicare supplement launch has no doubt inundated your inbox with about 50 emails regarding this product from various entities, so if you’ve made it to this page, I want to personally thank you. Like you, everyone here at PSM is seeing the famous baby face in their dreams at night with the massive amount of activity that has taken place since Tuesday. Our phones have been ringing constantly, and our website has seen 10,000 page views since the release of the product. If you haven’t seen our national press release, check it out at: http://www.prweb.com/releases/Medicare-Supplement/Gerber-Life/prweb2837364.htm If you are still on the fence about this product, we encourage you to call us to learn why this product is set to be one of the most competitive in the market. For reference here is a direct link to our Gerber Life Medicare supplement landing page with more links to rates and contracting information.

Weekly Recap:

Remembering 9/11: PSM will take a moment of silence today to honor those who lost their lives during the events of 9/11.

President Obama’s “Full-Court Press”: Beginning with addressing a joint session of Congress on Wednesday night, President Obama will be making several speeches detailing his vision for health care reform. Of course, the biggest news stemming from the speech seems to be the outburst from Joe Wilson (R-SC) who shouted “You lie” when Obama stated that his health reform vision doesn’t include coverage of illegal immigrants. Here are some of the other details stemming from the speech:

* No one will lose health insurance coverage if they already have coverage.

* Insurance companies will not be able to deny individuals coverage because of pre-existing conditions.

* Inclusion of Sen. McCain’s (R-AZ) plan to cover people without insurance if they can’t afford it and can’t wait four years until the Health Insurance Exchange is established.

* The majority of health care reform will be paid for by cutting Medicare costs.

* The most expensive insurance plans will be taxed, with the revenue paying for reform.

* Medicare malpractice reform is another possible way to pay for reform.

* A public option is not mandatory.

* Those who already have health insurance through a job, Medicare, Medicaid or the VA, will not be required to change coverage or doctors.

* Insurers will be required to cover basic checkups and preventive care.

* Health care reform will not result in euthanasia or death panels for the elderly.

* Out-of-pocket expenses will be capped.

Chronic Conditions Highest Among Elderly Women: Last week, a Health and Human Services report showed that chronic conditions are most prevalent among women because they live longer. This may seem like a no-brainer, but the report does have some very interesting quantitative data that you may find useful to present to your clients. Here are some of the most interesting points:

* Among people age 80 and older, 93% have at least one chronic condition and 78% have two more.

* The growth in Medicare Part B premiums from 2000 to 2018 is predicted to cost seniors an additional $1,577 per year out-of-pocket.

* 98% of Medicare spending is for beneficiaries with one or more chronic conditions.

* Senior women spent on average 17 percent of their income on health care in 2005.

For this and other HHS reports click here.