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Medicare Blog | Medicare News | Medicare Information

New Medicare Guidance on Lowering Prescription Drug Costs

Posted by www.psmbrokerage.com Admin on Fri, Jul 26, 2024 @ 04:43 PM

RX-1

The Biden-Harris Administration, through the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), has released the final part two guidance for the Medicare Prescription Payment Plan under the Inflation Reduction Act.

This plan allows Medicare beneficiaries to spread their prescription drug costs over the year starting in 2025, capping annual out-of-pocket expenses at $2,000. The initiative aims to provide financial relief and prevent high upfront costs. CMS is also enhancing outreach and education to ensure beneficiaries are aware of these changes.

These efforts complement other measures like the $35 insulin cap and expanded eligibility for the Extra Help program, further alleviating prescription drug costs for Medicare enrollees.

View Press Release

https://www.cms.gov/newsroom/press-releases/biden-harris-administration-releases-final-part-two-guidance-help-people-medicare-prescription-drug 

Fact Sheet

For the fact sheet on the final part two guidance for the Medicare Prescription Payment Plan, please visithttps://www.cms.gov/files/document/fact-sheet-medicare-prescription-payment-plan-final-part-two-guidance.pdf

Timeline

For an updated implementation timeline for the Medicare Prescription Payment Plan, please visit: https://www.cms.gov/files/document/medicare-prescription-payment-plan-timeline.pdf 

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Tags: CMS, Prescription Drugs, AEP, Inflation Reduction Act

Mutual of Omaha Med supp and Dental Cross Sell Bonus

Posted by www.psmbrokerage.com Admin on Fri, Jul 26, 2024 @ 02:45 PM

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Medicare Supplement and Dental Cross Sell Bonus

It's easy to cross-sell Med Supp and dental insurance using Mutual of Omaha's e-App storefront. They also make it super simple to apply for Med Supp and dental insurance coverage by only requiring one signature. Their new cross-sell bonus program will pay a cash bonus on each dental insurance policy when written with a Medicare supplement policy. 

This bonus will be in addition to any other Broker Bonus program Mutual of Omaha is currently offering. Be sure to check out the details in the attached flyer. 

Get complete contest rules and details here.

Looking for more information on Mutual of Omaha? View additional details here.

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Tags: Mutual of Omaha Medicare Supplement, dental plans

Upcoming Changes and Strategic Planning for AEP

Posted by www.psmbrokerage.com Admin on Fri, Jul 26, 2024 @ 10:50 AM

Strategic Planning-1

Upcoming Changes and Strategic Planning for AEP

As we approach the Annual Enrollment Period (AEP), it’s crucial to stay informed about significant changes in the Medicare landscape. These changes, influenced by various market dynamics and regulatory adjustments, could impact your clients' plans and coverage. Here’s a comprehensive overview of what to expect and how to strategically navigate the AEP.

Key Changes to Expect

Insurance carriers are strategically reassessing their plans to mitigate potential financial risks. This involves making tough decisions such as pulling out of specific markets, reducing certain benefits, and even designating some Prescription Drug Plans (PDPs) as non-commissionable. These adjustments reflect a proactive approach to ensuring the long-term sustainability and viability of the plans offered to Medicare beneficiaries.

  Important CMS Update: Inflation Reduction Act and Medicare - View

Strategic Plan for AEP:

In August, kick off your AEP preparations by sending out personalized AEP letters to your clients. Tailor these letters to two specific groups:

For your Medicare Supplement members, reassure them that their trusted Medicare Supplement plan will remain unchanged, but remind them that adjustments to their Part D plan may be on the horizon. Let them know that you are available to assist them through this process and encourage them to use tools like SunFire to ensure their Rx drug lists are up to date.

When addressing your MAPD members, be transparent about the potential of negative changes in most plans. Set clear expectations that these changes will come into effect on January 1, 2025, and promise to keep them informed through email as more details become available.

To further support your clients' understanding, create engaging and informative content where you walk through the Annual Notice of Change (ANOC) step by step. Share these resources to ensure that only your clients have access to this important information.

As October approaches, schedule emails to be sent out on the 1st of the month. These emails should outline the upcoming plan changes and offer a preliminary diagnosis of how these adjustments may impact each client. Ensure that carrier representatives provide you with the ANOC by September so that you can accurately communicate these changes to your clients in a timely manner.

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Client Engagement

To enhance client engagement and ensure a smooth AEP process, consider hosting informative and interactive events such as in-person group meetings and Q&A sessions. These sessions can provide a platform for clients to ask questions, voice concerns, and gain a deeper understanding of their plan options. Additionally, personally reaching out to each member in the early days of October to guide them through the re-enrollment process can offer a personalized touch and instill confidence in their plan decisions.

Sending out Scope of Appointment (SOA) forms to all current clients is a proactive step to prepare for upcoming appointments starting on October 15. By reaching out to clients in September to gather their Rx drug lists and then following up in October to review their plans, you can streamline the enrollment process and ensure that their coverage aligns with their healthcare needs.

These personalized touchpoints and strategic planning efforts can help build trust with clients, demonstrate your commitment to their well-being, and ultimately lead to a successful AEP season for both you and your clients.

Efficiency Tips

When it comes to efficiently managing your client base during AEP, it's essential to make the most of your time and resources. Utilizing bulk meetings and phone calls allows you to reach as many clients as possible in a streamlined manner. By identifying clients who have decided to stay on their current plan, you can easily cross them off your list and focus your attention on those who may need assistance with plan changes.

Instead of time-consuming home visits, consider inviting clients to visit you at a designated location for personalized consultations. This not only saves you time but also provides a professional setting for productive discussions about their plan options.

In today's digital age, leveraging social media can be a powerful tool for client updates and support. Consider creating a private Facebook group where clients can access important information, ask questions, and engage with each other. This interactive platform can enhance communication and foster a sense of community among your clients.

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Handling Non-commissionable PDPs

When handling non-commissionable Prescription Drug Plans (PDPs), it is essential to prioritize your clients' best interests above all else. Regardless of commissions, your primary focus should be advising clients on the plan that suits their healthcare needs and budget most effectively. Position PDPs as a complementary service for your Medicare Supplement clients, emphasizing the importance of comprehensive coverage. By guiding clients towards the most beneficial plans without being influenced by commissions, you can build trust, loyalty, and satisfaction among your client base.

ANOC Highlights

When focusing on deductible and copay/tier changes, it's important to delve into the specifics of how these adjustments could impact your clients' out-of-pocket costs and overall healthcare expenses. By highlighting the potential changes in deductibles, copayments, and tier structures, you can help clients understand the financial implications of their plan choices and make informed decisions. Additionally, as each Annual Notice of Change (ANOC) will provide updates on Rx drug changes, it's crucial to thoroughly review these updates with your clients and explain any modifications to their prescription drug coverage. 

Summary

By following this strategic plan, you can efficiently manage the AEP period, keep clients informed, and ensure they are enrolled in the best possible plans for their needs. By staying ahead of the curve and proactively addressing any potential changes or challenges, you demonstrate your dedication to ensuring that your clients have access to the most beneficial and cost-effective healthcare coverage options available.

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Tags: Online Enrollment, Success Tips, AEP, SunFireMatrix

Introducing LeadStar Seminars powered by LeadingResponse

Posted by www.psmbrokerage.com Admin on Tue, Jul 23, 2024 @ 12:54 PM

leading response

Exclusively for LeadStar Partners – 20% Off Best in Class Seminars, Workshops, and Webinars for Medicare Agents and Financial Advisors that will Revolutionize Your Business.

LeadStar Seminars powered by LeadingResponse can put you in front of highly qualified, motivated prospects. We have the industry knowledge, experience, and expertise to get the right prospects in front of you at the right time.

Their seminars are proven to produce more qualified prospects and more appointments for agents and advisors than online, broadcast, or social media advertising.

Sign up Today to take Advantage of this Exclusive Partnership and Claim Your 20% Discount!

Seminars

Become a leader in your industry with in-person seminars.

  • Proven marketing success for decades
  • Connect with your ideal consumer face-to-face
  • Offer a neutral, yet familiar environment for affluent consumers in your community
  • Leverage the psychological law of reciprocity to supercharge your results.
  • Get access to powerful and proprietary response data that helps you make informed decisions and produce better and more consistent results
  • Save money through several national restaurant partnerships
  • Unrivaled in experience with over 1 million events completed

 

Educational Workshops

Build trust through educating prospects where and when they need it.

  • Be the local authority in your market by hosting your educational workshops at libraries, community colleges, or universities
  • Use topic-specific educational workshops focusing on tax planning, Medicare, estate planning, or Social Security to help consumers research their areas of need
  • Connect with consumers by delivering relevant and quality content
  • Earn and instill trust in your expertise and experience
  • Problem solve with prospects face-to-face

 

Webinars

Reach prospects anytime, anywhere. Book appointments 24/7.

  • Allow prospects to choose how and when they want to connect
  • Unparalleled convenience and engagement with your audience
  • Consistent ROI, even after the event is completed

 

Rest Assured You Are in the Right Hands

We have the highest attendee rates in the industry, and we have registered over 800,000 attendees and over 25,000 events in 2023.

Every agent and advisor is assigned their own specialized subject matter expert to help create unparalleled campaigns that drive high response rates and, better yet, deliver targeted prospects to your events. Learn more.

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Tags: Lead Generation, LeadStar, Seminars

SunFire Spark - AEP Prep Edition

Posted by www.psmbrokerage.com Admin on Tue, Jul 23, 2024 @ 11:37 AM

Important SunFire Updates

Welcome to SunFire's email series designed to help agents prepare for AEP. SunFire combines quality data and smart tools to help brokers, carriers, and providers work more efficiently and effectively. You can learn more about the SunFire Enrollment Platform here.

Phoenix Rising - Customer Intake Form!

As part of the rebuild of the Direct to Consumer (DTC) experience, Phoenix, we are rolling out a new feature that will allow agents to collect key client information:

  • Permission to contact
  • Collect Provider and Prescription information
  • Complete a Scope of Appointment form
  • Access the responses in the SunFire platform to begin an enrollment

View a Demo

Below is a glimpse at the SunFire updates being made over the next few weeks. Be sure to follow our weekly emails for more!

Drug & Doctor Pre-Fill

Save time and improve enrollment quality with Drug & Doctor prefill built into our Customer Lookup feature. With suggested medications and providers based on historical information, you can spend less time collecting data and more time adding value. Drug Prefill launching 8/1. Doctor Prefill following shortly!

Direct-to-Consumer Refresh

A completely rebuilt our direct-to-consumer (DTC) platform, Phoenix, to create a cleaner, more intuitive quote and enroll experience. Build customer trust with a customized, agent-forward interface that streamlines field underwriting, quoting, and enrollment for your customers.

Medicaid Lookup

Medicaid Lookup tool helps you quote and enroll much more quickly and confidently by validating the beneficiary’s Medicaid level directly in SunFire. We’re continuing to improve this tool with Change Health going live by AEP, with expanded states!

Spanish Materials

Provide a great, compliant customer experience to new populations with consumer-facing materials in Spanish. Coming soon in Blaze and Blaze Connect.

Core Flow Enhancements

Made the underwriting and quoting engine work smarter for you with significant enhancements to our core flow:

  • Updated annual cost calculation
  • SNP recommendations
  • SEP recommendations in Customer Lookup
  • New Flex Benefit filter
  • Provider updates

Med Supp Carrier Expansion

Med Supp platform is leading the industry with end-to-end quoting, field underwriting, and enrollments. We’re adding new carriers regularly, with enrollments from HCSC, Humana, and Aflac coming soon!

DVH Carrier Expansion

Access a variety of Dental, Vision, and Hearing (DVH) products with our integrated DVH quoting and enrollment. Enrollments with Aflac products will be rolled out soon!

No-Sale Benefit Activation

Generate revenue and create an excellent customer experience even when it’s not the right time for the customer to enroll. Benefits from SelectRx and Perry Health are coming soon!


SF-2

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CMS Statement on System Changes to Stop Unauthorized Agent and Broker Marketplace Activity

Posted by www.psmbrokerage.com Admin on Tue, Jul 23, 2024 @ 09:53 AM

CMS Statement on System Changes to Stop Unauthorized Agent and Broker Marketplace Activity

The Centers for Medicare & Medicaid Services (CMS) is enhancing measures to protect consumers and ensure the integrity of the Federally-facilitated Marketplace (FFM) by addressing unauthorized changes in enrollments by agents and brokers. Starting July 19, 2024, CMS will block agents or brokers from altering a consumer’s FFM enrollment unless they are already associated with that enrollment.

 Read the full CMS News Release


New agents and brokers must now conduct a three-way call with the consumer and the Marketplace Call Center or direct the consumer to submit changes themselves. These steps aim to prevent unauthorized changes and follow CMS's ongoing efforts to suspend and terminate agents and brokers engaged in unauthorized activities.

In the first half of 2024, CMS received and resolved a high volume of complaints regarding unauthorized plan changes and enrollments, demonstrating its commitment to consumer protection. Additionally, between June 21 and July 10, 2024, CMS suspended 200 agent or broker Marketplace Agreements due to suspected fraud or abusive conduct, reinforcing its dedication to robust oversight and preventing unauthorized activities.

Learn more about ACA Opportunities here.


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Resource: Educating Clients on the Inflation Reduction Act’s Medicare Reforms

Posted by www.psmbrokerage.com Admin on Tue, Jul 23, 2024 @ 08:39 AM

Educating Clients on the Inflation Reduction Act’s Medicare Reforms-1

Introducing essential resources in helping your clients navigate the changes brought by the Inflation Reduction Act (IRA) and its impact on Medicare. These marketing pieces are designed to help you, as an insurance agent, clearly explain the new Medicare Prescription Payment Plan and other key updates to your clients.

       Sample Marketing Letter
       Sample Marketing Flyer
       Sample Trifold Brochure


With the IRA introducing significant reforms, including capping annual out-of-pocket prescription drug costs at $2,000 starting in 2025 and allowing costs to be spread over the year, it’s crucial to stay informed and prepared. Our comprehensive resources will equip you with the knowledge and tools to effectively communicate these changes, ensuring your clients are well-informed and confident in their Medicare choices.

Helpful CMS Resource: https://www.cms.gov/inflation-reduction-act-and-medicare 


Did we mention these materials are customizable to fit your unique brand. You can personalize the materials with your branding elements, making it easy to maintain a consistent and professional image while providing valuable information to your clients. This flexibility allows you to reinforce your brand identity while delivering crucial updates, helping to build trust and strengthen your client relationships. Request more details below or call one of our marketing representatives at 800-998-7715.

Trifold

AEP Support

Our 2025 Annual Enrollment Period (AEP) Guide is here, and we couldn't be more thrilled to share it with you! Carefully curated and packed with valuable insights, this guide is your key to success as you navigate the upcoming enrollment season. From tips on maximizing your productivity to strategies for optimizing your performance, this essential resource has everything you need to excel during this critical time of the year. View Resources.

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Tags: CMS, Marketing, Inflation Reduction Act

2025 Medicare Advantage Broker Compensation Rates

Posted by www.psmbrokerage.com Admin on Fri, Jul 19, 2024 @ 09:22 AM

2025 MA Compensation Rates-1

Each year, CMS publishes the FMV amounts for initial and renewal compensation as well as referral fees. For 2025, the amounts are as follows:

NOTE: CMS rounded the FMV amounts for CY 2025 up to the nearest dollar. The Initial Year amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-year 1. The renewal amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-years 2 and beyond, for a like- plan type.


FMV amounts for initial and renewal compensation

AEP Support

Our 2025 Annual Enrollment Period (AEP) Guide is here, and we couldn't be more thrilled to share it with you! Carefully curated and packed with valuable insights, this guide is your key to success as you navigate the upcoming enrollment season. From tips on maximizing your productivity to strategies for optimizing your performance, this essential resource has everything you need to excel during this critical time of the year. View Resources.

 

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Tags: Medicare Broker Compensation, Medicare Advantage

Biden Administration Delays Medicare Agent Pay Changes Following Court Ruling

Posted by www.psmbrokerage.com Admin on Thu, Jul 18, 2024 @ 01:19 PM

Biden Administration Delays Medicare Agent Pay Changes Following Court Ruling

The Biden administration has delayed implementing a Medicare plan agent pay change that could have disrupted the upcoming Medicare annual enrollment period. This follows a Texas federal court ruling that temporarily blocks the change, and both the Centers for Medicare and Medicaid Services (CMS) and the coalitions that sued agreed to a schedule that pushes decisions on the matter beyond the January 20 presidential inauguration.

This delay increases the likelihood of a normal enrollment period for older clients. CMS initially proposed this change to address concerns about aggressive marketing strategies and market distortions caused by support service payments. By accepting the court's stay, CMS has postponed any potential impacts until 2025. However, insurers' cautious pricing approaches may result in fewer plan options and higher prices in 2025.

Our 2025 Annual Enrollment Period (AEP) Guide is here. Carefully curated and packed with valuable insights, this guide is your key to success as you navigate the upcoming enrollment season. From tips on maximizing your productivity to strategies for optimizing your performance, this essential resource has everything you need to excel during this critical time of the year. View Guide   |   View AEP Resources

 

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Tags: Medicare Advantage, CMS, commissions

Part D Extra Help Program for Medicare Beneficiaries

Posted by www.psmbrokerage.com Admin on Mon, Jul 15, 2024 @ 01:59 PM

Extra Help Program-4

The Extra Help program is a federal initiative designed to assist Medicare beneficiaries with the costs associated with prescription drugs under Medicare Part D. This program, also known as the Low-Income Subsidy (LIS), offers several benefits.

  Premium Coverage: Extra Help pays for the Medicare Part D premium, up to a state-specific benchmark amount.

  Lower Prescription Costs: It reduces the cost of prescription drugs, making medications more affordable for beneficiaries.

  No Premium for Basic Plans: Beneficiaries with a basic Part D plan that has a premium at or below the Extra Help limit pay no premium. Enhanced plan holders may still owe a premium even if the plan's premium is below the benchmark.

  Elimination of Late Enrollment Penalty: The program eliminates any Part D late enrollment penalty for those who qualify.

  Special Enrollment Periods: It provides Special Enrollment Periods throughout the year, allowing beneficiaries to enroll in or switch Part D plans.

Eligibility Criteria

  • Automatic Enrollment: Beneficiaries receiving Medicaid, Supplemental Security Income (SSI), or enrolled in a Medicare Savings Program are automatically enrolled in Extra Help.

  • Income and Asset Limits: Other beneficiaries can qualify based on limited income and assets, specifically if their income is below $1,903 per month for individuals or $2,575 for couples.

Application Process

Extra Help significantly reduces the financial burden of prescription drugs for Medicare beneficiaries, ensuring they can access necessary medications without excessive costs. For detailed information and to apply, beneficiaries can visit the SSA website.

Additional Details
https://www.medicare.gov/basics/costs/help/drug-costs 

 

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Tags: Medicare Part D, Extra Help Program

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