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Medicare Blog | Medicare News | Medicare Information

Medicare Advantage Plan Switching: The Exception or The Norm?

Posted by www.psmbrokerage.com Admin on Thu, Sep 22, 2016 @ 01:47 PM

M/A Plan Switching: The Exception or The Norm?

Each year, Medicare Advantage enrollees have the opportunity to change plans during an annual enrollment period. This opportunity is important because Medicare Advantage plans can make changes in their benefits, cost-sharing, provider networks, and premiums each year, and beneficiaries health needs may change from one year to the next. The open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. It is also the time when beneficiaries in traditional Medicare can switch to Medicare Advantage plans.

Little is known about the extent to which Medicare Advantage enrollees change plans during the annual open enrollment period. Prior research shows that roughly the same share of beneficiaries, 5 percent, shift between Medicare Advantage and traditional Medicare each year that most enrollees tend to stay in a Medicare Advantage plan once in Medicare Advantage and that switching rates from Medicare Advantage to traditional Medicare are higher among high-need, high-cost patients.

This analysis focuses on enrollees in Medicare Advantage plans with prescription drug coverage (MAPDs) who change plans when given the opportunity. It also analyzes the variation in the rate of plan switching by enrollee and plan characteristics and whether people who voluntarily switch plans tend to move to plans with lower premiums, lower out-of-pocket limits, or higher quality ratings. The analysis is based on a five percent sample of Medicare claims data merged with plan data from 2007 to 2014.

Source: http://files.kff.org/attachment/Issue-Brief-Medicare-Advantage-Plan-Switching-Exception-or-Norm

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Additional Updates:
  • 3 Reason why insurance agents fail  - View
  • Express: Mutual of Omaha weekly product updates  - View
  • 2017 Medicare Advantage proposed benefits now available  - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Small Business Guide to Capturing Leads - View
  • Trending Products: Thrivent Financial Med Supp - View / Liberty Bankers Med Supp - View
  • FREE Medicare Supplement Online Quoting Tool for PSM Agents - View

Tags: Humana, Cigna, Medicare Advantage, Medicare, UnitedHealthcare, aetna, AEP

Exclusive: Senior Market Execs Talk AEP Prep

Posted by www.psmbrokerage.com Admin on Wed, Sep 14, 2016 @ 03:20 PM

Exclusive - Senior Market Execs Talk AEP Prep

Are you ready yet?

The start of Medicare’s Annual Election Period (AEP) – Oct. 15-Dec. 7 – is just over a month away, meaning agent preparations are well underway to make sure they will hit the ground running and processes will run smoothly so as to not lose valuable time.

It’s a stressful, pressure-packed time of year for agents in the senior market who can’t afford mistakes that force them to take finite time away from selling to deal with issues, or not having a solid strategy in place to ensure their time is being spent efficiently.

This being the case, Insurance Forums asked top executives from some of the leading IMOs/FMOs in the senior market to share some of their insight and advice about key topics to be aware of and how agents be as prepared as possible in advance of AEP.

We want to give a special thanks to Craig Ritter of Ritter Insurance Marketing, Josh Vandenberg of Precision Senior Marketing, JoAnn Wray of Senior Marketing Specialists and Ryan Kimble of Agent Pipeline, Inc., for taking the time to provide their unique perspective (please see bios for all four execs at the end of this article). Here in Part I we share their responses about opportunities, potential obstacles and advice for dealing with the stress that goes along with AEP planning and execution. In Part II on Thursday, they’ll cover the value of hired help, specific ways they are helping their agents prepare for the coming rush, and what would constitute a successful AEP when Dec. 8 rolls around.

Things to do prior to October 1st:

  • Getting certified/contracted with all needed carriers and plans - link
  • Familiarity with new plans entering the market - link
  • Adhering to CMS compliance and marketing guidelines - link
  • Making sure all necessary supplies are on hand

Please click the below link to read the full article.

Source: http://ifn.insurance-forums.net/medicare/aep-preparation-advice-from-imo-execs-part-one/

Additional Updates:
  • 2017 Medicare Advantage proposed benefits now available  - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Small Business Guide to Capturing Leads - View
  • Trending Products: Thrivent Financial Med Supp - View / Liberty Bankers Med Supp - View
  • FREE Medicare Supplement Online Quoting Tool for PSM Agents - View

Tags: Humana, Cigna, Medicare Advantage, Medicare, UnitedHealthcare, aetna, AEP

Cigna's Medicare problems won't be fixed by annual enrollment

Posted by www.psmbrokerage.com Admin on Fri, Sep 09, 2016 @ 08:24 AM

Cigna HealthSpring Updates


Cigna Corp. has spent the past eight months attempting to resolve the major problems found in its Medicare Advantage plans, but the health insurer does not expect those issues will be rectified by the time Medicare beneficiaries participate in annual enrollment this autumn, according to a regulatory filing released Tuesday.

Cigna and some financial analysts do not think the federal sanctions will hurt the company financially this year even though Cigna is prohibited from enrolling new Medicare Advantage members. Medicare's annual enrollment runs from Oct. 15 through Dec. 7. The muted financial effects likely stem from the CMS sparing Cigna from losing large sums of bonus payments.

However, Cigna has already spent $30 million trying to fix the issues. And as the Bloomfield, Conn.-based insurer has detailed in previous regulatory filings, if the sanctions persist deep into 2017, the impact to Cigna's Medicare customer base, revenue and cash flows “could be material.”

The CMS levied sanctions on Cigna this past January, which banned the company from marketing and selling its Medicare Advantage policies to new beneficiaries. Cigna, which the CMS said has had a “longstanding history of noncompliance,” had multiple problems that posed a “serious threat to the health and safety of Medicare beneficiaries,” according to the letter outlining the problems. For example, Cigna inappropriately denied medical care and prescription drugs to its Medicare members and kept members in the dark about why services were not covered.

Several other health plans have faced sanctions for deficiencies in their Medicare Advantage business. SummaCare, an insurer owned by Summa Health System in Akron, Ohio, was one of the quickest plans to resolve its issues, getting its sanctions lifted within eight months. However, most Medicare plans slapped with the punishment usually need a year to fix everything.

Immediate financial repercussions pop up, even though Cigna downplayed them Tuesday. For example, SummaCare's membership declined by almost 17% while it was under federal sanctions from 2014 to 2015.

Previously, Medicare Advantage plans that were hit with sanctions also had their star ratings lowered. But the CMS surreptitiously rescinded that policy in March, to the immediate benefit of Cigna.

Medicare Advantage has been a booming business for health insurers as more seniors and disabled people choose the managed-care version of Medicare. Even though the Affordable Care Act cut payments to Medicare Advantage insurers, the program's enrollment has exploded, giving companies access to huge sums of taxpayer-funded revenue.

Cigna recorded $6.14 billion in revenue from its Medicare business in 2015. It had 533,000 Medicare Advantage members as of June 30, keeping Cigna among the six largest Medicare Advantage companies.

Because of Cigna's update, Chris Rigg, a health insurance analyst at Susquehanna Financial Group, lowered his 2017 revenue projections for Cigna by $362 million “in order to take a more conservative stance.”

Cigna, which Anthem is attempting to acquire for roughly $53 billion even though the federal government is blocking the deal, did not make anyone available for this story. The company sent a statement that reiterated the information in its regulatory filing and said it “continues to address the matter in full partnership with CMS.”

Source: http://www.modernhealthcare.com/article/20160906/NEWS/160909945/cignas-medicare-problems-wont-be-fixed-by-annual-enrollment

Additional Updates:
  • Competitive Medicare Supplement rates with great incentives from Bankers Fidelity - View
  • How to distinguish yourself and become a leader - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Trending Products: Thrivent Financial Med Supp - View / Liberty Bankers Med Supp - View
  • FREE Medicare Supplement Online Quoting Tool for PSM Agents - View

Tags: Cigna, Medicare Advantage, Medicare

How to Master the Medicare Maze

Posted by www.psmbrokerage.com Admin on Thu, Sep 01, 2016 @ 04:38 PM

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As we head into the AEP, it is always helpful to understand clients’ challenges and the importance of an agent in the decision making process.  While directed towards Medicare beneficiaries, this article provides invaluable insight for insurance agents as well.

Navigating the Medicare maze could cost you plenty… By Phillip Moeller  – September 1, 2016

MEDICARE IS “complicated and often opaque and impenetrable,” says MONEY contributor Philip Moeller, co-author of the bestseller Get What’s Yours: The Secrets to Maxing Out Your Social Security. That’s a shame, given the impact Medicare—the health insurance program covering more than 95% of Americans 65 and older—can have on your life. Medicare households spend 15% of their budget on health care, reports the Kaiser Family Foundation, compared with the U.S. average of 7%. The wrong coverage or a missed deadline can not only cost you thousands but also threaten your health.

To guide you through the morass, Moeller has written Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs, due out on Oct. 4. In the book, Moeller walks you through the system’s many complexities; this Time article provides key pieces of advice drawn from Moeller’s new book.

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Source: http://time.com/money/page/how-to-navigate-medicare-plans/

Additional Updates:
  • PSM Labor Day Office Hours - View
  • 2017 Medicare Advantage proposed benefits and expansion counties now available - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Introducing a New Med Supp from Thrivent Financial  - View
  • Liberty Bankers Life breaks into the Med Supp market  - View
  • Sell Medicare Supplements from virtually anywhere - View
  • FREE Med Supp Online Quoting Tool for PSM Agents - View

Tags: Medicare Advantage, Medicare, Medicare Supplement, Part D

What does your prospect really want?

Posted by www.psmbrokerage.com Admin on Thu, Aug 18, 2016 @ 05:03 PM

What Does Your Prospect Really Want?What do sales professionals want to accomplish on prospecting calls?

• To reach the prospect directly.

• To “qualify” that prospect (usually by asking a lot of questions).

• Assuming they get “good answers” to set up an appointment or some other appropriate next step.

What do prospects want to know when you call them?

• Who are you and what do you want?

You’ll note that these two agendas are in direct opposition to each other. Unfortunately, many sales professionals are creating objections by following their own agenda rather than their prospect’s agenda.

Because sales professionals are generally taught that they need to ‘qualify the prospect’ they often start conversations with a new prospect as follows:

“Hello (Prospect Name). My name is (Name) and I’m with (Company Name). May I take a moment of your time to ask you some questions to determine whether we might be able to help you (Fill in the Blank)?”

Many sales professionals tell me they believe they are being respectful of a prospect’s time by asking, “May I take a moment of your time…” and that this question also serves to help in that all important qualification process.

The above script, however, does not answer the prospect’s two top questions: 1.) “Who are you?” and 2.) “What do you want?” When a prospect doesn’t have the answers to those two important questions, they frequently will not engage. Prospectors end up in a struggle before they’ve even really started.

So what’s the solution?

  1. Do your homework. Pre-qualify your list and make sure that you are only calling prospects that fit your well defined parameters.
  2. Create a solid introduction based on how you (your company, product or service) helps customers.
  3. When you get your prospect on the phone, get to the point. Saying what you have to say clearly and succinctly actually is more respectful of your prospect’s time then floundering around trying to convince a skeptical prospect to answer your questions.

When you follow your prospect’s agenda rather than your own, you will be astonished to discover how easy it can be to engage with prospects.

Source: http://www.lifehealthpro.com/2016/08/16/what-does-your-prospect-really-want?

 

Additional Updates:
  • SilverScript / CVS Retail Pharmacy Opportunity. Reserve your spot today - View
  • 2017 Medicare Advantage proposed benefits and expansion counties now available - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Introducing a New Med Supp from Thrivent Financial  - View
  • Liberty Bankers Life breaks into the Med Supp market  - View
  • Sell Medicare Supplements from virtually anywhere - View
  • FREE Med Supp Online Quoting Tool for PSM Agents - View

Tags: Sales Tips, prospecting

Announcing the CMS Approved 2017 SilverScript Plan Designs

Posted by www.psmbrokerage.com Admin on Wed, Aug 10, 2016 @ 12:32 PM

2017 SilverScript Plan Designs Released

IMPORTANT UPDATE: 

SilverScript has released their 2017 CMS Approved Plan Designs.

Request Info

Did you know that SilverScript® has more members in a Part D plan than any other Part D plan sponsor? CMS reports that SilverScript has more than 5.5 million members and more than four million of these members are actively enrolled in our SilverScript Choice PDP. 

We are confident that SilverScript will be well received by Medicare beneficiaries and agents during the 2017 AEP, too. CMS just approved their 2017 PDP premiums, and plan designs are approved and finalized. We encourage you to have this product in your portfolio for the upcoming enrollment window.

Highlights Include:

  • Competitive Plan Designs with $0 Deductible
  • Unique Formularies
  • New e-App for 2017 Enrollments
  • Simple Certification Process
  • CVS / SilverScript Retail Pharmacy Opportunity
  • Much more!

Request details today and place your business with a proven leader.

2017 Certification Now Available:

The SilverScript Product and Process course is now available via the SilverScript Agent Portal’s Training & Certification page. Now is a great time to complete all of your annual certification requirements.

Remember, you must complete the 2017 annual certification requirements before you can market SilverScript plans this AEP and you must complete the requirements prior to December 7, 2016 (the last day of AEP), in order to be eligible for 2017 renewal commission.

SilverScript now has a direct relationship with the AHIP training website. Agents who have completed 2017 initial training and/or annual re-training certifications through AHIP can have their results automatically submitted to SilverScript. Instructions are on the SilverScript Agent Portal’s Training & Certification page.

Additional Updates:
  • 2017 Medicare Advantage proposed benefits and expansion counties now available - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Introducing a New Med Supp from Thrivent Financial  - View
  • Liberty Bankers Life breaks into the Med Supp market  - View
  • Sell Medicare Supplements from virtually anywhere - View
  • FREE Med Supp Online Quoting Tool for PSM Agents - View

Tags: Part D, PDP, silverscript

Independent agents increase share of Medigap revenue

Posted by www.psmbrokerage.com Admin on Thu, Aug 04, 2016 @ 03:01 PM

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More issuers of Medicare supplement insurance policies are selling the products directly to consumers, but independent agents are generating a higher percentage of the Medigap sales revenue.

Analysts at Gen Re have put data supporting that conclusion in a summary of results from Gen Re's 2015 Medigap issuer survey.

A Medigap insurance policy helps people who have the traditional Medicare Part A hospitalization insurance and the traditional Medicare Part B physician and outpatient services coverage fill in the many traditional Medicare coverage gaps. A Medigap plan can help the enrollee meet Medicare deductibles and pay Medicare co-payment and coinsurance bills.

Gen Re, a Stamford, Connecticut-based reinsurance arm of Warren Buffett's Berkshire Hathaway Company, received 51 completed questionnaires for its 2015 Medigap issuer survey. That was down from 54 in 2014, but it was up from 50 in 2013.

More Medigap issuers reported they are selling the products straight to consumers, without help from agents. The percentage of issuers saying they used the direct-to-consumer channel rose to 55 percent in 2015. That was up from 51 percent in 2014, and up from 41 percent in 2013.

But 87 percent of the active issuers said they sold Medigap coverage through independent agents last year.

The share of sales revenue coming from independent agents rose to 67 percent in 2015. Independent agents accounted for 65 percent of the issuers' sales in 2014, and 59 percent in 2013.

In 2015, 40 of the Medigap issuers that participated in the Gen Re survey were actively selling new Medigap policies.

Revenue from new sales rose 4.2 percent, to $2.2 billion. The number of people covered by the new policies sold rose 3.2 percent.

Revenue from all Medigap policies in force rose 5.7 percent, to $19 billion. The number of people covered by the policies rose 8.5 percent.

Congress created a standardized "letter plan" system for Medigap in 1992. Each new plan sold must offer the standard package of benefits associated with one of the letter plan categories, such as the popular Plan F category.

But the country relies mainly on state insurance regulators to oversee the Medigap market. The Centers for Medicare & Medicaid Services has much less direct involvement with overseeing Medigap plans than with overseeing Medicare Advantage plans or the Affordable Care Act public exchange plan system.

Because CMS gets less information about the Medigap program, it tends to publish less data on that program than on other big public health programs.

Source: http://www.lifehealthpro.com/2016/08/01/independent-agents-increase-share-of-medigap-reven

Related: Medigap enrollment rises 6.5%

Additional Updates:
  • Simple client meeting rules every salesperson should know - View
  • How to hit your quota and do it the right way - View
  • 2017 Medicare Advantage proposed benefits and expansion counties now available - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Introducing a New Med Supp from Thrivent Financial  - View
  • Liberty Bankers Life breaks into the Med Supp market  - View
  • Sell Medicare Supplements from virtually anywhere - View
  • FREE Med Supp Online Quoting Tool for PSM Agents - View

Tags: Medicare Supplement, Medigap

UnitedHealthcare 2017 Medicare Advantage First Looks

Posted by www.psmbrokerage.com Admin on Fri, Jul 29, 2016 @ 08:46 AM

UHC - Strength Stability Hassle Free

IMPORTANT UPDATE: 

UnitedHealthcare has released their 2017 Medicare Advantage First Looks.

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Known for their strength and stability, UnitedHealthcare is poised for a fantastic 2017 AEP. They have introduced some significant market expansions and have continued to focus on providing their members a world class experience second to none in the industry.

We are proud to represent UnitedHealthcare as one of our Medicare Advantage carriers and look forward to making sure our agents are educated on all the benefits they have to offer as an organization. With strong brand name, comprehensive plan designs and a focus on customer service, UnitedHealthcare is the carrier of choice for senior market agents. Their mantra of "Strength, Stability, and Hassle Free" continues to resonate with both members and agents alike in this ever-changing market.

Highlights Include:

  • Significant market expansions for 2017
  • Comprehensive plan designs with the addition of more $0 premium plans
  • New Part D plans
  • Fitness facility benefit including SilverSneakers
  • Great customer retention programs to keep your business on the books and educate members on all the benefits UHC has to offer
  • Customized marketing materials to help you stand out
  • The popular LEAN enrollment tool 
  • and much more!

Request details today and place your business with a proven leader.

Additional Updates:
  • 2017 Medicare Advantage proposed benefits and expansion counties now available - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Introducing a New Med Supp from Thrivent Financial  - View
  • Liberty Bankers Life breaks into the Med Supp market  - View
  • Sell Medicare Supplements from virtually anywhere - View
  • FREE Med Supp Online Quoting Tool for PSM Agents - View

Tags: Medicare Advantage, UnitedHealthcare

Anthem, Aetna sued by U.S. seeking to block insurer mergers

Posted by www.psmbrokerage.com Admin on Fri, Jul 22, 2016 @ 09:25 AM

Anthem, Aetna sued by U.S. seeking to block insurer mergers(Bloomberg) — U.S. antitrust enforcers roundly rejected a pair of proposed deals that would consolidate the nation’s five biggest health insurers into just three.

The Justice Department filed an antitrust lawsuit to stop Indianapolis-based Anthem’s merger with Bloomfield, Connecticut-based Cigna Corp. in federal court in Washington on Thursday and also moved to block Hartford-based Aetna’s planned merger with Louisville, Kentucky-based Humana.

Eight states including Florida and Illinois, plus the District of Columbia, are joining the federal government’s suit to block the Aetna-Humana deal.

Nine states and the District of Columbia joined the U.S. action against the Anthem-Cigna deal, including California, New York and Connecticut. "If permitted to proceed, Anthem’s purchase of Cigna likely would lead to higher prices and reduced benefits," the Justice Department said in the complaint, which was filed in federal court in Washington Thursday.

Anthem, in a statement, said it was fully committed to challenging the DOJ action in court but would remain receptive to efforts to reach a settlement with the Justice Department.

The U.S. action is “an unfortunate and misguided step backwards for access to affordable healthcare for America,” Anthem said. “The DOJ’s action is based on a flawed analysis and misunderstanding of the dynamic, competitive and highly regulated healthcare landscape and is inconsistent with the way that the DOJ has reviewed past healthcare transactions. ”

Cigna said it was “evaluating its options consistent with its obligations under the agreement” and said it doesn’t expect the transaction will close in 2016. “The earliest it could close is 2017, if at all.”

The actions are likely to set off a round of court battles as the insurers are obliged to fight the moves and could spark renewed pursuit of smaller players in the industry if the deals fail.

The cases are U.S. v. Anthem Inc., 16-cv-1493, U.S. District Court, District of Columbia (Washington) and U.S. v. Aetna Inc. 16-cv-1494, U.S. District Court, District of Columbia (Washington).

Source: http://www.lifehealthpro.com/2016/07/21/anthem-aetna-sued-by-us-seeking-to-block-insurer-m?t=medicare

Additional Updates:
  • New Medicare Supplement releases from Mutual of Omaha in Pennsylvania, Tennessee and Texas with "Cash for Apps" incentive. Call today for details at 800-998-7715
  • Medicare Advantage market penetration - Mark Farrah Associates report - View
  • 2017 Medicare Advantage preliminary benefits and expansion counties now available - View
  • 2017 Medicare Advantage Certification instructions now available - View
  • Introducing a New Med Supp from Thrivent Financial  - View
  • Liberty Bankers Life breaks into the Med Supp market  - View
  • Sell Medicare Supplements from virtually anywhere - View
  • FREE Med Supp Online Quoting Tool for PSM Agents - View

Tags: Humana, Cigna, Medicare Advantage, Medicare Supplement, aetna, Anthem, DOJ

Med Supp vs. MA: Which One Is Right for Your Client?

Posted by www.psmbrokerage.com Admin on Fri, Jul 08, 2016 @ 04:57 PM

MED SUPP VS. MA

If you’ve been keeping up with everything that has been happening in senior health care, then you have noticed all the changes within the Medicare program. However, Medicare is more than just insurance.

In many ways, Medicare is a capstone for the years and, in some cases, decades of planning and work that advisors have done to help their clients plan and save for a comfortable retirement. 

Health care costs continue to be the No.1 cause of bankruptcies in the United States, and this is especially true among the elderly. A good, solid, compatible health care plan that works with Medicare can go a long way toward making sure your clients’ retirement years work out the way they, and you, have planned.

The catch is that there are two solutions to these problems. Depending on where you live, both solutions are viable for some clients, but are not the right fit for others. A third option exists: employer or group coverage. I will skip discussing that third option in this article because employer/group coverage is not available to all your clients, and the benefits and costs associated with that coverage are vast. If a group option exists, take a look at it as a viable choice for your client, but do not assume it is better coverage than the private options. It always pays to do some due diligence comparisons with these plans.

So let’s take a look at our two contenders.

Old Faithful: The Medicare Supplement

Medicare supplements have been mostly unchanged since 1990. Prescription drugs were removed from the plans in 2006. Over the years, a few plan letters were eliminated and a few more plan types were added. But for the most part, a Medicare supplement today is still the Medicare supplement of 20 years ago.  That is important. Medicare supplements generally do not change their benefits much from year to year. 

Medicare supplements have plan letters. They range from A through N, with some letters skipped. And the plan letters from 1990 offer pretty much the same things today as they did then. The best way to get a look at Medicare supplement benefits is to review an insurance company’s summary of benefits or the government guide, “Choosing a Medigap Policy.” For most plans, a benefit is covered at 100 percent or not covered at all. If you have a client who wants something fully covered — no copays, no fuss, no annual changes — this could be what they want. And to make things even more convenient, your client can use most supplements with any doctor, any hospital, anywhere in the United States as long as those doctors and hospitals accept Medicare. So there are neither network considerations nor travel restrictions on health care if your client opts for a Medicare supplement.

But the Medicare supplement has two downsides. The first is the premium. Although premiums generally vary by state, county and even ZIP code, they tend to be larger than premiums charged by other plans. Medicare supplement premiums also have a tendency to go up, probably on an annual basis. 

The other downside to a Medicare supplement is underwriting. A supplement requires your client to answer health questions. Depending on your client’s health, the opportunity might be closed to them at a later date. Federal laws require one opportunity to get a Medicare supplement on a guaranteed basis once in a person’s lifetime. This is called an “open enrollment period.” Some states extend or repeat that period beyond the federally mandated minimums, but if your client lives in a state where there is only one open enrollment period in a lifetime, the idea of a supplement and the consequences of its premium should not be overlooked.

This type of plan is a natural extension of financial planning and the other insurance products the advisor offers. The premium is easily projected coverage that’s guaranteed renewable for life.

The Scrappy Contender: Medicare Advantage

OK, that’s a bit of a misnomer. Medicare Advantage isn’t exactly new. This year marks the 10th anniversary of Medicare Advantage in its current form, but Medicare Advantage has a history of more than 20 years in the market under different names. 

Medicare Advantage plans are alternative ways to receive health care. A person in a Medicare Advantage plan is still in the Medicare program (they must continue to pay their Medicare Part B premium), but they choose to replace Medicare Parts A and B’s cost-sharing with the insurance company’s coinsurance and copays. The 20 percent coinsurance of Medicare Part B is still there, just broken down and transformed into more projectable costs. There is no Medicare supplement-style product that will cover leftover costs as thoroughly and completely as Medicare plus a Medicare supplement. But if you have clients with a preference for a reduced “pay-as-you-go” program, this is a way to give them what they want.

Medicare Advantage plans are the right choice for some clients. A Medicare Advantage plan typically has a monthly cost that is lower than a Medicare supplement. In some areas, there are options available at no additional cost beyond the payment of the Medicare Part B premium.

I’ve had financial advisors ask, “If these just change the structure of the Medicare Part B coinsurance, is there any reason to consider these plans over having nothing at all?” The answer is a definite yes. The copays on Medicare are typically a flat 20 percent with no cap on them.

Medicare Advantage gives you a schedule of costs your clients can plan for. Medicare Advantage plans also have a maximum out-of-pocket limit. This means that if the worst happens to your client’s health, there is a fixed amount of cost they can prepare for. Also, many Medicare Advantage plans include prescription drug coverage, adding a level of convenience for some clients.

Medicare Advantage plans have some downsides, however. The two most critical are networks and the out-of-pocket maximum. Typically, that maximum is many times the annual premium of a Medicare supplement. If you are dealing with a client who is concerned about having many out-of-pocket costs, the Medicare Advantage plans might not be a good fit.

And a Medicare Advantage plan is networked. The two most prevalent types of plans around the country are HMO plans and PPO plans. This means that access to doctors might be a concern, depending on your client’s needs and location.

Medicare Advantage plans have another consideration: change. Medicare Advantage plans alter their cost structure annually. This means that the premiums, copays, coverage, drug list and even counties where they provide service can increase, decrease or drop completely. Essentially, every Jan. 1, any client you have in a Medicare Advantage plan has a brand-new plan.

The Referee: You!

We tell our clients that we understand they really don’t need us if they want to buy insurance. Just about every company will sell it to them online, over the telephone or by mail. The reason why you will get clients to buy from you is because you will do the analysis for them. A typical client does not know what they do not know about health care. And by showing the good and the bad about the choices available to them, you are doing as much to help them protect their assets as you would with any other line of product.

Source: http://www.insurancenewsnetmagazine.com/article/-med-supp-vs-ma-which-one-is-right-for-your-client-3062#.V4AWa9IrJhE

Additional Updates:
  • Aetna and UnitedHealthcare have announced their 2017 Medicare Advantage expansion counties. Call 800-998-7715 for details.
  • 2017 Medicare Advantage Certification instructions now available - View
  • Introducing a New Med Supp from Thrivent Financial  - View
  • Liberty Bankers Life breaks into the Med Supp market  - View
  • Sell Medicare Supplements from virtually anywhere - View
  • FREE Med Supp Online Quoting Tool for PSM Agents - View

Tags: Medicare Advantage, Medicare Supplement

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