Mutual of Omaha: Tracking Your PDP and MA Business

Posted by www.psmbrokerage.com Admin on Wed, Oct 31, 2018 @ 01:36 PM

Mutual of Omaha:
Tracking Your PDP and MA Business

The following provides information on tracking the status of your Prescription Drug and/or Medicare Advantage business.

Prescription Drug Enrollments (PDP):
PDP Individual Producer

1. If you submit an enrollment application:

For electronic enrollments
- For enrollments that are in progress, access progress reports by clicking the View Dashboard button within the PDP e-app. The dashboard will provide a status update on the progress of the e-App enrollment.
- For submitted enrollments, call 877-775-1360.
For paper enrollments, call 877-775-1360.

2. CMS approved enrollments (both electronic and paper):

There are two links available to access your report:

Click the link labeled ‘Prescription Drug Plan Approvals’ under the ‘Reports’ tab in Sales Professional Access (SPA), or
Click the link ‘Approved Cases’ located on the ‘Electronic Applications’ page under the button to launch the PDP e-app.

Please note: CMS approved enrollments may take up to 7-10 business days to display

Medicare Advantage Enrollments (MA):
MA Individual Producer

1. If you submit an enrollment application:

For electronic enrollments started or submitted, access by clicking the View Dashboard button within the Medicare Advantage e-app.
For paper enrollments, call 877-259-8657.

2. CMS approved enrollments:

For electronic enrollments, click on the App Tracker icon within the Medicare Advantage Producer Portal. The link to the MA producer portal can be found on the Medicare Advantage product page on SPA.
For paper enrollments, call 877-259-8657

Not appointed to sell Medicare Solutions with Mutual of Omaha? Click Here

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Tags: Medicare Advantage, Medicare Part D, mutual of omaha, medicare updates

Continued Enrollment Growth in Employer-Group Medicare Advantage

Posted by www.psmbrokerage.com Admin on Wed, Oct 31, 2018 @ 01:21 PM

Continued Enrollment Growth in Employer-Group Medicare Advantage

As of October 1, 2018, total Medicare Advantage (MA) membership stood at over 21 million, representing approximately 34% of the 63.3 million Americans eligible for Medicare. Medicare Advantage plans can either be acquired individually through direct purchase policies or through employer/group retiree programs, commonly known as Medicare Advantage Employer Group Waiver Plans (MA-EGWPs). Since the inception of Medicare Advantage in 2003, Individual MA policies have historically dominated the market as 17.1 million beneficiaries purchased MA plans as of October 1, 2018. However, despite a decrease over the years in the number of private sector employers offering retiree health benefits, membership trends in MA-EGWPs have demonstrated notable enrollment growth, especially within the past two years.

Since December 2017, employer-group Medicare Advantage enrollment has increased by over 443 thousand. In fact, over the past four years, group market enrollment has increased by approximately 1 million members, nearly a 125% increase in enrollment since December 2015. This brief provides insights about the current employer-group Medicare Advantage market and assesses membership trends over the past four years by carrier and state.

Read the full article. Click Here

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Tags: Medicare Advantage, medicare updates

Happy Halloween - PSM Office Hours

Posted by www.psmbrokerage.com Admin on Tue, Oct 30, 2018 @ 02:13 PM

Happy Halloween from PSM Our office will be closing today at 2:00 pm CST for a Corporate Event. We will resume normal business hours Thursday November 1st. If you are in need of immediate assistance, please email info@psmbrokerage.com and we will have a representative contact you as soon as possible. We hope everybody has a safe and Happy Halloween.
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Tags: sales, sales team

What Makes a Team Truly Great? 9 Defining Traits [INFOGRAPHIC]

Posted by www.psmbrokerage.com Admin on Mon, Oct 29, 2018 @ 11:00 AM

What Makes a Team Truly Great? 9 Defining Traits [INFOGRAPHIC] What makes a team truly great? Is it the mix of personalities? Is it how teams are measured and rewarded? Does the team leader ultimately determine their success? There is a lot of research and opinion on what ingredients are necessary to build a high-performing team because it is one of the most difficult things to do -- you are essentially forcing people together -- but it's one of the biggest drivers of success in an organization. A poor performing team can negatively impact an entire organization, not to mention be the cause for missing goals or revenue targets. Weekdone created the below infographic detailing some of the defining characteristics of great teams. Learn what you should look for in a high-performing team and how to recruit to create your own.
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How to Be Persistent in Sales Without Annoying Your Prospects

Posted by www.psmbrokerage.com Admin on Mon, Oct 29, 2018 @ 10:50 AM

How to Be Persistent in Sales Without Annoying Your Prospects So you've done the preliminary research on a prospect and it looks like you could really help them out. The next step is to get them on the phone. There will be times when you connect with them on your first try. More often than not, however, you have to try very hard to stand out from the rest of the people interrupting their day. How do you break through inbox clutter and the black hole that is voicemail? And how do you toe that fine line between persistence and harassment? Use these tips for following up with a prospect without bothering them. Check out the details on the 7 tips here
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Tags: sales follow-up, prospecting, phone sales

HHS Proposes to Link Medicare Part B Payment for Prescription Drugs to International Price

Posted by www.psmbrokerage.com Admin on Mon, Oct 29, 2018 @ 10:40 AM

HHS Proposes to Link Medicare Part B Payment for Prescription Drugs to International Price

Friday, President Trump announced a U.S. Department of Health and Human Services (HHS) plan to test a new payment model that aims to substantially lower the cost of prescription drugs and biologics covered under the Medicare Part B program. The new model would, for the first time, base Medicare payment for Part B drugs on the typically lower prices paid in other countries.

Commonwealth Fund research shows that such bold payment models are needed to tackle high prescription drug prices in the U.S., and that paying international prices might move Medicare and beneficiaries’ drug spending in the right direction. If the proposal moves forward, a number of questions about how it will work need to be resolved, and it’s important to note that Part B spending accounts for just a small slice — 5 percent — of the total national drug bill.

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Spending in Medicare Part B

Under Medicare Part B, physicians administer drugs in their offices, often to treat patients with cancer, immunological disorders such as rheumatoid arthritis, and age-related eye conditions like macular degeneration. Medicare’s current payment to physicians, which is based on the average U.S. sales price for these drugs and biologics, is 47 percent higher on average than prices paid by 16 industrialized countries for the same products, according to the administration’s analysis.

Beneficiaries’ cost-sharing is also high for Part B drugs; they pay 20 percent of the Medicare price for each dose. Commonwealth Fund research finds drug costs exacerbate struggles of Americans with serious illnesses, who can face financial ruin even if they have health coverage.

The outline of HHS’s proposed Part B rule, which would be released next spring, reflects an innovative attempt to lower drug spending:

Medicare would pay private-sector vendors, such as wholesalers and pharmacy benefit managers, the international reference price called the “target price” for a select set of drugs in its testing areas.
Vendors would then negotiate with manufacturers for the drugs and biologics (presumably at lower prices than the payment they receive from Medicare) and supply physicians and hospitals with products.
Physicians and hospitals treating Medicare beneficiaries would be required to participate and could choose multiple vendors or change vendors. Medicare would replace its current administrative payment to physicians and hospitals with a flat fee. Currently, providers are paid a percentage of the drug price under Part B. Under the new proposal, they would no longer gain revenue from the price of a drug.
Beneficiaries would pay lower copayments to the extent Medicare’s payments are lower.

Several unaddressed details of the Part B model will determine whether it will save Medicare money and lower what beneficiaries pay for their prescription drugs.

Certain features of Medicare and the pharmaceutical market may present stumbling blocks to achieving the model’s goals. For example, how will a target price enable vendors to negotiate with sole-source manufacturers who retain monopoly pricing power? What levers will vendors have in these circumstances? Could global pricing dynamics spur manufacturers to raise prices in other countries in order to raise the Medicare reference price? Answers to these and other questions raised by HHS could reveal limits of the model design.

Total U.S. Spending

Of course, Part B spending is a small portion of total Medicare drug spending, and the bulk of national drug spending falls outside of Medicare. Medicare Part D, for example, which covers drugs dispensed by retail pharmacies, accounts for a much larger share of total U.S. drug spending (27%). Medicare spending for the highest-cost drugs paid under Part D’s catastrophic benefit has grown at an average annual rate of 18 percent since 2007. That is faster than the 9.8 percent drug spending growth under Part B. Leaving Part D out of the proposal therefore leaves a lot of potential savings on the table.

Moreover, prescription drug costs paid by U.S. workers and employers would not be captured under the Part B model. These costs account for a large share of U.S. drug spending. Insurers estimate that prescription drugs now account for 33 percent of employer-paid health insurance premiums, mainly because of high and increasing prices for the same drugs covered by Part B. The Food and Drug Administration (FDA) has announced a series of steps to encourage more price competition from lower-priced products, such as generics and biosimilars. However, FDA actions will need to be coupled with bolder reforms to patent and exclusivity protections that impede U.S. payers from negotiating prices that approximate those achieved by peer countries.

A Broader Strategy

Rather than linking to prices abroad for a slice of U.S. consumers, HHS could pursue a broader strategy that adapts core elements of the international approach to drug pricing. Other developed countries aggregate purchasing power to gain leverage with drug companies, systematically assess the value of individual drugs to inform their purchasing decisions, and enter into a negotiation process with manufacturers that they can stand behind. Adapting these elements to the U.S. would take bold action, but if we did so we could create our own system — one that could achieve the lower drug costs that other countries are able to provide for their residents.

https://www.commonwealthfund.org/blog/2018/medicare-part-b-payment-prescription-drugs-international-prices

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Tags: Part D, medicare updates

All you need to know about Scope of Appointment Documentation

Posted by www.psmbrokerage.com Admin on Mon, Oct 29, 2018 @ 10:16 AM

Scope of Appointment Documentation

What is the Purpose of a Scope of Appointment form?

The scope of appointment is a CMS requirement used to document an in person appointment witch a beneficiary to ensure that no other types of products are discussed outside of what the beneficiary originally requested.

Below is some information regarding the rules and requirements regarding Scope of Appointments ("SOAs").

A paper or electronic Scope of Appointment must be completed prior to conducting a sales presentation for Medicare Advantage (MA) and Prescription Drug Plans (PDP).

Also, sales presentations are required to be by appointment only and should not be made by marketing through unsolicited direct contact.

Steps to completing a Medicare Scope of Appointment Form (SOA):

Remember, the SOA must be documented for all marketing activities, in-person and telephonically, including walk-ins to an agent or broker office.
The SOA must be completed prior to the appointment and may be a signed hard copy or telephonic recording.
You may not market health care related products beyond the scope that the beneficiary agreed upon prior to the meeting.
For carriers that accept electronic Scopes of Appointment, refer to each carrier's specific guidelines regarding eSOAs.
A new SOA will be required if, during an appointment, the beneficiary requests information regarding a different plan type than previously agreed upon.
Each Medicare-eligible beneficiary present at the marketing appointment (or their authorized representative) must complete an SOA prior to an MA or PDP plan presentation.
Be sure to submit the SOA or the Voice Recorded Appointment ("VRA") confirmation number at the time the application is submitted.
If you make a mistake when completing the SOA, the error should be crossed out and initialed, preferably by the beneficiary acknowledging the error. You cannot use white-out on an SOA.
Following a formal or an informal event, it is necessary to complete an SOA prior to an in-home visit.
You cannot discuss non-health products until 48 hours after the Medicare Advantage appointment.

Cross Selling:

Under no circumstances can you discuss and/or complete an application for a non-health product; e.g., life insurance or annuity at the time of a Medicare Advantage or Part D enrollment.

Returning a minimum of 48 hours later allows the consumer to have a "fresh mind" and gives way to a better understanding of the new product you are discussing.

If you have any questions our marketers are here to help.

Good luck, and happy selling.

Additional Updates:

Your path to AEP success with Precision Senior Marketing - View
Enroll your MA and PDP clients online - at no cost to you - View
2020 Medicare Advantage / Part D Certifications now available - View
2020 Medicare Advantage First Looks now available - View
2020 AEP Road Map - Start your planning today - View

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Tags: Medicare Advantage, Part D, medicare updates

CMS Proposes to Modernize Medicare Advantage, Expand Telehealth Access for Patients

Posted by www.psmbrokerage.com Admin on Mon, Oct 29, 2018 @ 09:45 AM

CMS Proposes to Modernize Medicare Advantage, Expand Telehealth Access for Patients

Proposed rule would strengthen the popular system for private health insurance plans to provide Medicare coverage, increase plan flexibility to offer telehealth benefits, and improve coordination for dual-eligible beneficiaries

In a proposed rule issued today, the Centers for Medicare & Medicaid Services (CMS) took action to build upon the Administration’s ongoing efforts to modernize the Medicare Advantage and Part D programs, which provide seniors with Medicare health and prescription drug coverage through private plans. The changes proposed today would allow plans to cover additional telehealth benefits and would make other much-needed updates, including for individuals who are eligible for Medicare Advantage special needs plans.

“President Trump is committed to strengthening Medicare, and an increasing number of seniors are voting with their feet and choosing to receive their Medicare benefits through private plans in Medicare Advantage. Today’s proposed changes would give Medicare Advantage plans more flexibility to innovate in response to patients’ needs,” said CMS Administrator Seema Verma. “I am especially excited about proposed changes to allow additional telehealth benefits, which will promote access to care in a more convenient and cost-effective manner for patients.”

Medicare Open Enrollment for 2019 is currently underway and runs through December 7, 2018, so seniors can review their coverage options and decide how they would like to receive their Medicare benefits in 2019. CMS offered new flexibilities to Medicare Advantage plans starting in the 2019 plan year, and plans are making additional benefits available including adult day care services, in-home support services, and benefits tailored for patients with chronic diseases like diabetes. The average Medicare Advantage premium will decline by 6.1 percent, enrollment is projected to grow by 11.5 percent, and there will be approximately 600 more plans available across the country next year.

Today’s proposed changes for plan year 2020 would leverage new authorities provided to CMS in the Bipartisan Budget Act of 2018, which President Trump signed into law earlier this year. With respect to telehealth, the proposed changes would remove barriers and allow Medicare Advantage plans to offer “additional telehealth benefits” not otherwise available in Medicare to enrollees, starting in plan year 2020 as part of the government-funded “basic benefits.”

This proposal will allow Medicare Advantage plans broader flexibility in how coverage of telehealth benefits is paid to meet the needs of their enrollees. As Medicare beneficiaries become more tech savvy, CMS is working across the agency to promote beneficiary access to telehealth, but the Medicare fee-for-service program telehealth benefit is narrowly defined and includes restrictions on where beneficiaries receiving care via telehealth can be located. The proposed rule would give MA plans more flexibility to offer government-funded telehealth benefits to all their enrollees, whether they live in rural or urban areas. It would also allow greater ability for Medicare Advantage enrollees to receive telehealth from places like their homes, rather than requiring them to go to a health care facility to receive telehealth services. Plans would also have greater flexibility to offer clinically-appropriate telehealth benefits that are not otherwise available to Medicare beneficiaries.

Today’s proposed changes are a major step towards expanding access to telehealth services because the rule would eliminate barriers for private Medicare Advantage plans to cover such additional telehealth benefits under the MA plan. While MA plans have always been able to offer more telehealth services than are currently payable under original Medicare through supplemental benefits, this change in how such additional telehealth benefits are financed (that is, accounted for in payments to plans) makes it more likely that MA plans will offer them and that more enrollees will be able to use the benefits.

Additional changes proposed today would improve the quality of care for dually-enrolled beneficiaries in Medicare and Medicaid who participate in “Dual Eligible Special Needs Plans” or D-SNPs. These beneficiaries generally have complex health needs. Today’s proposed changes would unify appeals processes across Medicare and Medicaid to make it easier for enrollees in certain D-SNPs to navigate the system. The proposed rule would also require plans to more seamlessly integrate benefits across the two programs to promote coordination.

Today’s proposed rule also improves accountability and bolsters program integrity within the Medicare Advantage and Part D programs. The proposed changes would update the methodology for calculating Star Ratings, which provide information to consumers on plan quality. The new methodology would improve stability and predictability for plans, and would adjust how the ratings are set in the event of extreme and uncontrollable events such as hurricanes.

The proposed rule also includes critical updates with respect to program integrity. First, CMS is making revisions to an earlier regulation that made available to Part D sponsors and Medicare Advantage plans a list of precluded providers and prescribers that have engaged in behavior that bars their enrollment in Medicare. Under the earlier regulation, plans would be required to deny payment for any prescription, service, or item that is prescribed or furnished by an individual or entity on the Preclusion List.

Second, the proposed rule would take steps to help CMS recover improper payments made to Medicare Advantage organizations. CMS conducts Risk Adjustment Data Validation audits to confirm that diagnoses submitted by Medicare Advantage Organizations for risk adjusted payments are supported by medical record documentation. CMS recovers improper payments based on these audits. The proposed rule would strengthen CMS’s ability to return dollars to the Medicare Trust Funds as a result of these audits. If finalized, the proposed changes would result in an estimated $4.5 billion in savings to the Medicare Trust Funds over a ten year period, largely from the recovery of improper payments to Medicare Advantage plans through contract- level Risk Adjustment Data Validation audits. In addition, CMS released an analysis on the application of a Fee-For-Service adjuster in determining the Medicare Advantage payment recoveries. The analysis can be accessed at: https://www.cms.gov/Research-Statistics-Data-and- Systems/Monitoring-Programs/Medicare-Risk-Adjustment-Data-Validation- Program/Resources.html (the Fee-For-Service Adjuster executive summary and technical appendix are available in the “Downloads” section of the webpage).

For a fact sheet on the CY 2020 Medicare Advantage and Part D Flexibility Proposed Rule (CMS-4185-P), please visit: https://www.cms.gov/newsroom/fact-shee ts/contract-year-cy-2020- medicare-advantage-and-part-d-flexibility-proposed-rule-cms-4185-p.

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Tags: Medicare Advantage, Part D, medicare updates

Phoenix Life Insurance Company is now Nassau Life Insurance Company

Posted by www.psmbrokerage.com Admin on Fri, Oct 26, 2018 @ 02:51 PM

As you may know, Nassau Re acquired Phoenix in 2016 and, since then, they have made significant investments and continue to integrate their businesses to build a stronger company for the future. These initiatives allow them to accelerate their growth plans as we head into 2019 and beyond. Earlier this year, they began transitioning their insurance business to the Nassau Re brand. They have now taken the step of renaming two of their insurance subsidiaries: Phoenix Life Insurance Company is now Nassau Life Insurance Company Phoenix Life and Annuity Company is now Nassau Life and Annuity Company Nassau Re has received new capital to support their growth plans, while they continue to commit significant resources to developing additional, competitive products to broaden their suite of offerings and continue to focus on improving ratings over time. This is an important milestone in their growth strategy as they expand the Nassau Re brand in the marketplace and broaden our opportunities to build their business with you. Communications to Existing Policyholders Nassau Re is communicating the news about their brand to all policyholders as they will be seeing and hearing the Nassau Re name going forward when they call the Customer Service Center, visit our website, and receive statements and service forms. They also have new banking instructions and mailing addresses they will need to know. Samples of the policyholder letters, along with Q&As, are posted on www.salesnet.nsre.com for your reference. Those with policies and contracts issued by Phoenix Life Insurance Company and Phoenix Life and Annuity Company will separately receive a Name Change Endorsement form that they should keep with their policy, contract or certificate. New Business Growth in Nassau Life and Annuity Company Next month, their newly issued multi-year guaranteed annuities (MYGAs) will transition from being issued by PHL Variable to Nassau Life and Annuity in most states. Our other products will continue to be issued out of PHL Variable until they are transitioned to Nassau Life and Annuity in the future, and they have additional new products that will be issued by Nassau Life and Annuity throughout 2019. They are confident this transition will be seamless, as there will be no changes to the way you work with us. As always, business issued by all of their entities will be supported by the same service organizations, including our Customer Service Center, Sales Support Desk and other agent resources. Nassau Re is excited about this new chapter in Phoenix’s rich heritage. They remain focused on maintaining your trust, providing good value from their products and delivering quality service.
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Tags: phoenix, Nassau Re

Medicare Advantage Insurer Anthem Wants to ‘Push Innovation Buttons’ with Senior Living

Posted by www.psmbrokerage.com Admin on Fri, Oct 26, 2018 @ 02:40 PM

Medicare Advantage Insurer Anthem Wants to ‘Push Innovation Buttons’ with Senior Living As senior living providers assess how they can seize new opportunities in Medicare Advantage (MA), they should consider one of the nation’s largest insurance companies an interested potential partner. Indianapolis-based Anthem Inc. is the largest for-profit managed health company under the Blue Cross and Blue Shield umbrella. It is also the most prominent insurer to announce benefits packages created under newly relaxed Medicare Advantage rules, which allow for coverage of non-skilled in-home care and other services. The Centers for Medicare & Medicaid Services (CMS) first announced this MA policy change last April. In the months since, senior living operators have been contemplating what the change could mean for them, because the newly allowed benefits cover the sorts of services typically provided in settings like assisted living. However, it’s been unclear how insurance companies that offer MA plans might structure these benefits and when — and if — these insurers will start to offer this type of coverage. Anthem has been one of the first insurance companies out the gate, announcing its new benefits packages in early October. These benefits, which take effect in 2019, could be tapped by plan members residing in senior living communities. And Anthem’s speed in bringing these new offerings to market should be a signal to senior living providers that the insurance company wants to be on the leading edge of innovation. As part of that effort, Anthem is open to developing future benefits and business arrangements that are more tailored specifically to the senior housing sector. “It’s an open question for me, how do we work with these facilities in the future?” Martin Esquivel, vice president of Medicare product management at Anthem, told Senior Housing News. “Going forward, we want to push the innovation buttons and see what we can do together.” Anthem’s offering The new benefits offered by Anthem-affiliated health plans are branded “Essential Extras” in Georgia, Indiana, Kentucky, Missouri, Ohio, Virginia and Wisconsin; “Everyday Extras” in Tennessee, Texas, and New Jersey; and the new benefits are not branded in Anthem’s health plan affiliates in California or Arizona. They cover services such as food delivery, transportation, adult day center visits, installation of assistive devices in the home, and up to 124 hours of in-home non-skilled care. Individuals enrolled in plans with access to “Essential Extras” or “Everyday Extras” will need to choose one of the services offered in the package. “The reason we could jump so quickly [and offer these benefits] is Anthem and its affiliated health plans are committed to offering plans that offer high-quality medical care and other social and support needs,” Esquivel said. “We had a list we were already contemplating, and when the language came through, we were able to add to that list, pressure-test it all, and identify the items we knew we could deliver. Culturally, we were already there.” MA insurers have multiple incentives for offering these sorts of benefits. For one, they might build enrollment by differentiating themselves from competing plans, and give consumers access to services that they want. Insurers also could see bottom-line benefits through better cost control. For example, by covering transportation and in-home assistance with daily activities, Anthem might help prevent a beneficiary from missing doctors’ appointments or experiencing a fall - and this in turn should cut down on costly hospital stays. While the new benefits are most obviously tailored to people who are not living in institutional settings, there are certainly some MA beneficiaries who reside in independent living and assisted living communities, Esquivel acknowledged. Anthem does not track the exact number of its beneficiaries in senior living. There might need to be some discussion among senior living residents, Anthem representatives and leaders at the senior living community about how to coordinate these newly covered services. For example, an assisted living apartment probably already has grab-bars and similar features installed, but a resident might tap the new MA benefit to get a particular type of toilet seat, Esquivel said. Similarly, a senior living community probably already provides some form of transportation, but a resident might want to supplement that through the new MA coverage. And if there are discussions to be had about residents using MA to pay for some services already being offered in senior living settings, Anthem is also open to those conversations. “How do we innovate and leverage what [senior living communities are] offering their consumers today?” Esquivel said. “It could be as simple as a contracting arrangement where they bill [the insurer], or something much more innovative that we haven’t thought of yet.” Anthem may need to ‘get in line’ In light of expanding Medicare Advantage benefits, it’s plausible that residents will be approaching senior living providers and saying, “I’m getting this [service covered] through my MA plan, so I shouldn’t have to pay for it out of pocket,” according to Anne Tumlinson, founder and CEO of Washington, D.C.-based health care consultancy Anne Tumlinson Innovations. However, assisted living companies do not have to quickly reassess their fee structures in response to this move by Anthem. https://seniorhousingnews.com/2018/10/25/medicare-advantage-insurer-anthem-wants-push-innovation-buttons-senior-living/
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Tags: Medicare Advantage, Medicare, Medicare News, Part D

HHS Advances Payment Model to Lower Drug Costs for Patients

Posted by www.psmbrokerage.com Admin on Fri, Oct 26, 2018 @ 11:06 AM

HHS Advances Payment Model to Lower
Drug Costs for Patients

The International Pricing Index (IPI) Model would lower costs for physician-administered drugs by resetting Medicare payments based on international prices and introducing competition .

On Thursday, the U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), announced and sought input on a new “International Pricing Index” (IPI) payment model to reduce what Americans pay for prescription drugs.

Under the IPI model, described in an Advance Notice of Proposed Rule making (ANPRM), Medicare’s payments for select physician-administered drugs would shift to a level more closely aligned with prices in other countries. Overall savings for American taxpayers and patients are projected to total $17.2 billion over five years.

“President Trump promised that he would bring down drug prices and put American patients first,” said HHS Secretary Alex Azar. “With this innovative approach, he is now proposing historic changes to how Medicare pays for some of the most expensive prescription drugs, securing for the American people a share of the price concessions that drug makers voluntarily give to other countries.”

The move from current payment levels to payment levels based on international prices would be phased in over a five-year period, would apply to 50 percent of the country, and would cover most drugs in Medicare Part B, which includes physician-administered medicines such as infusions. The model would correct existing incentives to prescribe higher-priced drugs and, for the first time, address disparities in prices between the United States and other countries. Since patient cost sharing is calculated based on Medicare’s payment amount, patients would see lower costs under the model.

Physicians currently purchase the drugs that they administer to patients and receive payment from Medicare for those drugs at an amount equal to the average sales price plus an “add-on” fee. The add-on is calculated as a percentage of the average sales price of the drug.

This creates several problems. First, the dollar amount of the add-on increases with the price of the drug, which encourages prescribing higher-cost drugs. Second, Medicare accepts sales prices for Part B drugs, with no negotiation. Together, this results in higher out-of-pocket costs that burden American seniors.

The pharmaceutical industry offers deep discounts abroad while taking advantage of the payment system in Medicare Part B which drives the cost in the U.S., even though Medicare is the world’s largest drug purchaser. The IPI model would take on this issue and pay vendors for Part B drugs at a level approaching international prices.

For the first time in Medicare, the IPI model would create a system in which private vendors procure drugs, distribute them to physicians and hospitals, and take on the responsibility of billing Medicare. Vendors would aggregate purchasing, seek volume-based discounts, and compete for providers’ business, thereby creating competition where none exists today.

Under the model, instead of the current percentage-based add-on payment, physicians and hospitals would receive a set payment amount for storing and handling drugs that would not be tied to drug prices. Therefore, the IPI model would remove the financial incentive to prescribe higher-cost drugs. The model also frees physicians from having to “buy and bill” high priced drugs, which creates financial risk that jeopardizes their practice and the ability to serve their community.

The agency is considering a randomized approach to determine which geographies in the country would participate in the model.

The IPI model would achieve several goals:

Reduce costs for Medicare beneficiaries, and thereby increase adherence and access to prescription drugs.
Introduce competition to the system of paying for physician-administered drugs by bringing in private-sector vendors.
Reduce providers’ burden and the financial risk associated with managing drug inventories, so physicians can focus on patient care.
Maintain financial stability for physicians while removing incentives for higher drug prices.
Address the disparity in drug prices between the U.S. and other countries.
Reduce costs to the American taxpayers and Medicare beneficiaries who fund these programs.

The ANPRM ensures an open and transparent approach with opportunity for public input. CMS will carefully review comments and is considering issuing a proposed rule for the IPI in the spring of 2019, with a potential model start in spring 2020.

For a policy brief on the ANPRM, please visit:

https://www.hhs.gov/about/leadership/secretary/priorities/drug-prices/ipi-policy-brief/index.html

For a fact sheet on the ANRPM, please visit: https://www.cms.gov/newsroom/fact-sheets/anprm-international-pricing-index-model-medicare-part-b-drugs

Comments on the ANPRM will be accepted until December 24, 2018 and may be submitted electronically through the CMS e-Regulation website at: https://www.cms.gov/Regulations-and-Guidance/Regulations-and-Policies/eRulemaking/index.html?redirect=/eRulemaking

The ANPRM can be downloaded at: https://www.cms.gov/sites/drupal/files/2018-10/10-25-2018%20CMS-5528-ANPRM.PDF

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Tags: Part D, medicare updates

Venture-Funded Medicare Advantage Plans Launch into 2019 Market

Posted by www.psmbrokerage.com Admin on Fri, Oct 26, 2018 @ 10:59 AM

Venture-Funded Medicare Advantage Plans Launch into 2019 Market New Medicare Advantage plans backed by venture funding are positioning themselves as innovative alternatives to traditional health plans Several Medicare Advantage (MA) plans entering the market for the 2019 plan year are backed by millions in venture capital funding and are planning to compete with established payers by promoting new health plan solutions. The recent uptick in Medicare Advantage competition is not surprising as many payers have experienced billion-dollar profits, high enrollment totals, and health plan expansion opportunities from a booming MA business. Increased participation in the MA market is likely to present competitive challenges between payers vying to attract new health plan enrollees. Many new MA entrants have received significant funds from private investors and venture capital firms to launch innovative health plan offerings in the Medicare Advantage space. These new MA plans also promote tools such as data analytics, care coordination platforms, and technology suites to improve member experiences and set themselves apart from established MA participants. DEVOTED HEALTH LAUNCHES FLORIDA-BASED MEDICARE ADVANTAGE PLAN BACKED BY $300 MILLION INVESTMENT Devoted Health has launched new Medicare Advantage plans in Florida after raising $300 million in Series B funding to implement technologies that enhance operational efficiency and customer service. Devoted Health raised $61.5 million in previous funding rounds to develop technologies that help members navigate healthcare services and receive care at home. Leaders at Devoted Health explained that the organization operates as a combination of a payer and provider to deliver integrated healthcare services. Ed Park, CEO and co-founder of Devoted Health, said partnering with the best possible providers and equipping consumers with user-friendly technology allow the health plan to improve beneficiary experiences. “Having industry-leading technology is central to what we do. With our latest funding, we will continue to grow the world-class team building out our technology and operations and will expand Devoted into additional markets,” he said. Devoted Health has employed advisors, secured investors, and hired executive personnel that have several decades of experience in the Medicare Advantage market. “In various parts of the country, there are local examples of organizations dramatically improving healthcare outcomes and bringing down costs,” said former US Senator Bill Frist, MD, a member of the Devoted Health board and investor. “What makes Devoted so exciting is that they have the team, operating model, technology, and capital to scale this kind of performance nationwide.” BRIGHT HEALTH ENTERS INTO NEW MEDICARE ADVANTAGE MARKET FOR A SECOND CONSECUTIVE YEAR Bright Health has expanded its Medicare Advantage prescription plan option (MA-PD) into Tennessee, making it the second consecutive year the payer has entered a new MA market. The payer has partnered with large healthcare systems across Tennessee in order to provide high-quality health plan coverage. The health systems include Baptist Memorial Health Care, the University of Tennessee Medical Center, and TriStar Health. According to Bright Health executives, the partnership with the three health systems will provide beneficiaries with extensive access to high-quality providers. Collectively, the health systems include 10 hospitals, 13 urgent care centers, six centers of excellence, over 1,000 physicians, and multiple specialist organizations. “Bright Health is committed to expanding access to the growing number of people in need of individual health plans and quality healthcare – both in Tennessee and across the country,” said Bob Sheehy, Bright Health's co-founder and chief executive officer. “Baptist Memorial, TriStar and The University of Tennessee Medical Center have each demonstrated a unique ability to provide superior, personalized care to millions of patients each year, and we are thrilled to partner with them to meet the healthcare needs of hardworking Tennesseans.” Bright Health has continued to expand at an accelerated rate due to successful fundraising campaigns. In 2017, Bright Health raised $160 million from investors to scale its individual health plan and MA business operations. CLOVER HEALTH ANNOUNCES SIGNIFICANT MEDICARE ADVANTAGE EXPANSION FOR 2019 Clover Health announced an expansion into six Medicare Advantage markets for plan year 2019. Clover Health uses AI-driven technology to help risk stratify its 30,000 beneficiaries and identify opportunities to improve outcomes. The payer estimates that its platform is accurate 85 percent of the time when identifying patients at risk for a hospital readmission within 28 days. Leaders at Clover Health believe that the company’s AI solutions allow the payer to create optimal beneficiary experiences at scale. “Expanding into new cities and deploying our AI platform with international partners are both core to Clover's mission of improving the health of our customers by uniting cutting-edge technology with committed, personalized medical care,” said Vivek Garipalli, CEO of Clover Health. “We are already seeing the extremely positive results that our technology is having on the lives of our members and are optimistic about how we can begin to impact health on a global scale.” Clover Health has received $425 million in investor funding since 2015, the company said. OSCAR HEALTH EYES BIG MEDICARE ADVANTAGE MARKET FOR 2020 Oscar Health expanded into several new individual health plan markets and has for an even larger Medicare Advantage expansion in 2020. The payer offers personalized Medicare Advantage plans through which consumers can use mobile apps and web-based services to make health plan choices. MA beneficiaries can also access telemedicine and concierge services that help members receive care as needed, according to a recent press release about Oscar’s MA benefits. Oscar Health CEO Mario Schlosser explained that the company has developed claims administration technology, enrollment services, and communications services to streamline health plan operations. “Each new member and interaction with the healthcare system offers Oscar an opportunity to refine our member apps and make better recommendations for care; to enable our population health leads and concierge teams to drive more personalized interventions; to empower providers with easier tools that let them focus on delivering care,” Schlosser said. Oscar recently made national headlines after Alphabet, Google’s parent company, invested $374 million to help the payer expand MA operations for 2020. The investment is expected to help Oscar Health hire more engineers to build out concierge services and member engagement technologies. https://healthpayerintelligence.com/news/venture-funded-medicare-advantage-plans-launch-into-2019-market
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Tags: Medicare Advantage, Medicare, Medicare News, Part D

Sales Proposal Writing Tips

Posted by www.psmbrokerage.com Admin on Fri, Oct 26, 2018 @ 08:41 AM

Sales Proposal Writing Tips Applying the following 19 proposal writing tips will improve your next proposal and grow your business
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How Prior Authorization Can Impede Access to Care in Medicare Advantage

Posted by www.psmbrokerage.com Admin on Thu, Oct 25, 2018 @ 04:53 PM

How Prior Authorization Can Impede Access to Care in Medicare Advantage While Medicare Advantage (MA) plans are required to cover the same health services as Original Medicare, they are not required to offer the same level of provider access and can impose coverage restrictions—like prior authorization—that require enrollees to take additional steps before accessing prescribed care. If a service is covered “with prior authorization,” enrollees must get approval from the plan prior to receiving the service. If approval is not granted or sought, the plan generally will not cover it. A new analysis from the Kaiser Family Foundation looks at the prevalence of prior authorization in MA and found that many plans utilize this flexibility: 80% of MA enrollees are in plans that require prior authorization for at least one Medicare-covered service. Original Medicare, in contrast, does not require prior authorization for the vast majority of services, making this an important distinction between the two coverage options. In some instances, prior authorization may be an appropriate utilization management tool. In particular this is true when both beneficiaries and providers are likely to benefit from advance knowledge of Medicare coverage. However, MA’s broad application of prior authorization can impede access to care. On our National Helpline, we frequently hear from MA enrollees who are experiencing a range of denials for health-related services, and who are concerned and confused about their plan’s service denials and coverage requirements. While each MA plan has different rules, as the KFF report indicates, many require enrollees to obtain approval before receiving an array of critical services: At least 70% of enrollees are in plans that require prior authorization for Part B drugs and inpatient hospital stays. 60% of enrollees are in plans that require prior authorization for ambulance, home health, procedures, and laboratory tests. More than half of enrollees are in plans that require prior authorization for mental health services. In such situations, there is minimal value to beneficiaries or providers in procuring pre-service determinations. Instead, these requirements can often create barriers that may delay or prevent timely access to needed, affordable care. Additionally, coverage denials can have significant financial implications for the enrollee. Many face high out-of-pocket costs as a result, in particular those who miss the short 60-day window of time to appeal. Unlike Original Medicare, MA enrollees must appeal within 60 days of the date of service. If they miss this deadline, they are held responsible for the charges. While we support efforts to lower Medicare program costs and increase certainty about the scope of coverage, the potential consequences of such policies must be carefully considered, and any harms to to people with Medicare must be thoughtfully and thoroughly mitigated. We are pleased to see that many in Congress recognize the severity of these adverse impacts. Earlier this month, more than 100 lawmakers sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concern about the use of prior authorization in MA, and asking for agency guidance to ensure that these requirements do not create inappropriate barriers to care for people with Medicare. The effort was led by Rep. David P. Roe (R-TN-1) and Rep. Ami Bera (D-CA-7), and the Medicare Rights Center recently thanked them for their leadership. We look forward to working with Congress, the Administration, and our organizational partners to strengthen these and other beneficiary protections within Original Medicare and MA, with the goal of improving the health and economic security of people with Medicare. Read the KFF report. Read our letter to Reps. Roe and Bera. Read the Congressional Letter to CMS. Read more about the differences between MA and Original Medicare. Source
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Tags: Medicare Advantage, Medicare, Medicare News, Part D

Aetna Medicare: How to submit 2019 MA/MAPD and PDP enrollments

Posted by www.psmbrokerage.com Admin on Thu, Oct 25, 2018 @ 04:44 PM

Aetna Medicare:
How to submit 2019 MA/MAPD and PDP enrollments

Click here to veiw PDF

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna, AEP

New CMS Pay Model Targets Soaring Drug Prices

Posted by www.psmbrokerage.com Admin on Thu, Oct 25, 2018 @ 04:24 PM

New CMS pay model targets soaring drug prices The Trump administration on Thursday accelerated its efforts to bring prescription drug prices under control. Speaking at the Hubert Humphrey building, President Donald Trump announced a proposal that would shift Medicare Part B drugs to a level more closely aligned with prices in other countries. The CMS calls the program the International Pricing Index model. American taxpayers and patients are projected to save more than $17.2 billion over five years. "In an era where the pharmaceutical industry is pricing drugs at levels approaching a million dollars—and jeopardizing the future of our safety-net programs—the time has come to fix the perverse incentives in the Medicare program that are fueling price increases," CMS Administrator Seema Verma said in a statement. The move from current payment levels to ones based on international prices would be phased in over a five-year period, would apply to 50% of the country, and would cover most drugs in Medicare Part B, which includes physician-administered medicines such as infusions. Read the full article here
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Tags: Medicare Advantage, Medicare, Medicare News, Part D

Annuity Opportunities with Phoenix/Nassua Re

Posted by www.psmbrokerage.com Admin on Thu, Oct 25, 2018 @ 04:16 PM

*We wanted to make sure you saw our exciting news ……* Phoenix/Nassua Re has the highest lifetime income AND The highest fixed 5 & 7 year annuity rates *~ Personal Income Annuity* & Personal Protection Choice lifetime income went up, up, up!! Start income as early as 30 days after issue or spousal income on Qualified accounts – we allow both! The PPC Care benefit can cover both spouses on IRA rollovers which is a HUGE benefit to your clients. Click image to view larger version ~ Nassua Re MYAnnuity MYGA* fixed annuity rates 4.05% for 5-year term! This is a limited rate so act fast before it’s gone!!* (MYGA approved in all states except CA, ME & NY) Click image to view larger version Plan now for the income and protection needed for your clients’ retirement. Not appointed with Phoneix / Nassau Re? Request details here
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Mutual of Omaha to Offer Automated Underwriting for Living Promise Final Expense

Posted by www.psmbrokerage.com Admin on Thu, Oct 25, 2018 @ 03:28 PM

Mutual of Omaha to Offer Automated Underwriting for Living Promise Final Expense Mutual of Omaha will soon offer Automated Underwriting on e-Applications for their Living Promise® Final Expense product. Automated Underwriting delivers instant underwriting decisions for clients when using the iGO e-App platform. Simply complete the e-App for Living Promise and the new automated underwriting feature will work in the background. Key points about Automated Underwriting: Provides an instant underwriting decision — Possible outcomes include: Approved (with level benefit), Approved (with graded benefit), Referred to Underwriting (you or your client will be contacted for more information), or Declined Mobile friendly - It's available on mobile devices so it goes where you go Here is a flyer to check out. If you have any questions or would like to get contracted with Mutual of Omaha, please contact us at 800-998-7715 or go here
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Product Spotlight: Ameritas Dental and Vision Plans

Posted by www.psmbrokerage.com Admin on Thu, Oct 25, 2018 @ 01:28 PM

Ameritas Dental and Vision Plans

Need a product that can offer your clients coverage for themselves, as well as their spouse, for a LOWER combined monthly premium than most other carriers offer for an individual plan?

We are excited to offer Ameritas' suite of Individual Dental and Vision Plans to our agents. Ameritas offers you tremendous selling power with one of the nation's largest dental networks, an award-winning customer service team, and a quick and easy enrollment process for your clients.

PrimeStar Individual Dental Insurance can help keep your smile sparkling, while at the same time, protecting your overall wellness.

When you become appointed with Ameritas, you’ll receive a unique enrollment hyperlink. With this custom hyperlink you and your clients have 24/7 access to quote and purchase a PrimeStar Insurance Plan.

Your link has your agent number automatically embedded in it, so you will be credited for any online enrollments that originate from your hyperlink. You can place this link on your agency’s website, email, or text it to your clients for self-enrollment.

Not appointed with Ameritas? We encourage you to learn more and put this in-demand product in your portfolio, request details here

The Ameritas Difference:

With preventive dental services covered at 100% and coverage for major services included, preventive care visits are encouraged, such as an annual exam and cleaning (2 visits per year covered at 100%). This can help minimize the need for more costly procedures in the future.

You will receive the maximum plan benefits for using an Ameritas dental provider. If you visit a non-network dental provider, the plans reimburse at the 90th percentile of usual & customary prices.

This means that 9 out of 10 dentists in a given zip code do not charge more than Ameritas’ reimbursement amount, a very rare and generous benefit that minimizes or eliminates balance billing.

Ameritas Dental and Vision Highlights:

Next day coverage and no waiting periods for any service
Everyday effective dates.
Sell Dental and Vision Plans, together or individually.
Year 2 benefits start January 1st, regardless of when you got into the plan throughout the year.
NO policy fees, same premium for ages 18+.
Seamless E-Application process.
NO appointment fees.
Immediate coverage on preventive services, covering a free exam and cleaning per year.
Freedom to use any dentist with the opportunity to use the Ameritas dental network for greater savings.
Optional vision coverage Up to $2,000 calendar year maximum benefit.
Exciting commissions and advancing for the writing agent.
Available for all ages including seniors 65+.
Dental Rewards included in all plans – increase your annual maximum by submitting at least one dental claim per year and keeping your total paid claims for the year at or below the Threshold Amount: $250 for Plans 1 and 2; $500 for Plan 3. You will “earn” an Annual Reward – $125 for Plans 1 and 2; $250 for Plan 3 – to carry over toward your annual maximum benefit the next year.

Sell More Using the Ameritas PrimeStar Hyperlink:

A one-stop-shop hyperlink for clients to quote and purchase easily online.

Opportunity for sales 24/7. Agent is automatically credited on purchases made through their personalized hyperlink.

Why agents love selling Ameritas:

Year 2 benefits start January 1st, regardless of when you got into the plan throughout the year. Making this a great product to sell during AEP and offers a unique advantage over the competitors.

Ameritas PrimeStar Hyperlink giving you the opportunity for 24/7 sales.

Great commissions and support. Ameritas is one of the most agent friendly companies you will find in the market today.

Call now to talk to one of our stellar marketing staff for details on how you can start selling these plans today.

Not appointed with Ameritas? We encourage you to learn more and put this in-demand product in your portfolio, request details here

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Tags: dental hearing and vision insurance, ameritas, product spotlight, dental plans

U.S. News & World Report Announces the 2019 Best Insurance Companies for Medicare

Posted by www.psmbrokerage.com Admin on Thu, Oct 25, 2018 @ 09:08 AM

U.S. News & World Report Announces the 2019 Best Insurance Companies for Medicare U.S. News & World Report, the global authority in healthcare rankings, today released the 2019 Best Insurance Companies for Medicare Advantage and Prescription Drug Plans. The new ratings are a resource for Medicare beneficiaries and their families searching for the best coverage options during the annual open-enrollment period, which began October 15 and runs through December 7, 2018. The Best Insurance Companies for Medicare Advantage (a state-by-state list) and Medicare Prescription Drug Plans (same thing in this article) highlights insurance companies that consistently offer highly rated health coverage to Medicare beneficiaries, who are typically age 65 or older. "Medicare beneficiaries face many complex considerations when it comes to choosing the best health insurance plan, including monthly cost and in-network and out-of-network benefits," said Ben Harder, chief of health analysis for U.S. News. "Our easy-to-navigate online tools and straightforward ratings help consumers identify which plan is best for their specific needs." Insurance companies were recognized if either their Medicare Advantage or their Part D plans received an average rating of 4.5 stars or higher across all plans in a given state. Companies that consistently offer highly rated Medicare Advantage plans in multiple states include Anthem Blue Cross and Blue Shield, Cigna-HealthSpring, HealthPartners, Kaiser Permanente, Martin's Point Generations Advantage, Medical Associates Health Plan, Inc., MVP HEALTH CARE, Providence Health Assurance, and Senior Preferred. For Part D Prescription Drug plans, 12 states have one insurer that made the U.S. News list, with Blue Cross Blue Shield being the single insurer in 11 of those 12 states. U.S. News uses plan-ratings data from the Centers for Medicare & Medicaid Services (CMS) to populate its comparison tool and identify the Best Insurance Companies for Medicare Advantage and Prescription Drug Plans. CMS rates individual plans on a scale of 1 to 5 stars. The U.S. News methodology analyzes insurers in a given state with plans rated 3-stars or higher by CMS. The Best Insurance Companies for Medicare Advantage and Prescription Drug Plans serve the broader U.S. News mission to provide trusted information and rankings that help Americans navigate complex health care decisions, including their choices of insurance plans, doctors, hospitals and nursing homes. https://www.prnewswire.com/news-releases/us-news--world-report-announces-the-2019-best-insurance-companies-for-medicare-300736160.html
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Tags: Medicare Advantage, Medicare, Medicare News, Part D

Is Cold Calling Dead? 17 New Prospecting Strategies Salespeople Should Use

Posted by www.psmbrokerage.com Admin on Wed, Oct 24, 2018 @ 02:54 PM

Is Cold Calling Dead? 17 New Prospecting Strategies Salespeople Should Use Is cold calling dead? Let's be honest. That answer is "No." Cold calling used to be one of the best -- and only -- prospecting strategies salespeople could use. But in the past 40 years, a variety of more effective alternatives have emerged. While it's likely naive to say cold calling is never effective, useful, or necessary, it's crucial to elevate the rest of your prospecting strategy so it's never your go-to tactic. In this post, we'll compare warm calling and cold calling, and discuss how to make calls to prospects you aren't very familiar with more productive -- and less intrusive. In the words of Mark Twain, rumors of cold calling's death have been greatly exaggerated. Instead, you need to update and finesse your cold calling strategy so you're using all of the resources available to you to build rapport and make a connection. Let's run through the differences between warm calling and cold calling: Cold Calling vs. Warm Calling What is warm calling? "Warm calling" means you establish contact with a prospect before sending them an email. You might connect on LinkedIn, communicate over social media, or have a mutual acquaintance introduce you before you actually reach out to them with the intention of making a sale. A good prospecting strategy is: Consistent: It reliably generates new leads. High-return: It generates a high number of potential customers for the amount of energy and resources required. Targeted: It connects you with the right prospects, not just any prospects. What is cold calling? "Cold calling" refers to calling a prospect you haven't previously made a connection with before sending them an email or calling them on the phone to talk to them about your product or service. With over 200 million people on the national do not call list alone, T-Mobile releasing data-only mobile packages, and corporations not taking calls unless you have a named contact, it's clear that our desire to speak with people on the phone is dwindling -- especially if those calls are unsolicited. On top of that, prospects can now research company information, reviews, feedback, and all manner of information online. Cold calling is becoming an unnecessary nuisance -- prospects no longer need salespeople in the same ways they used to. In fact, it's fair to say that anyone interrupting your day with an uninvited three-minute script is going to have to do some seriously fast and impressive talking to keep you on the line. The odds aren't on the salesperson's side: Chances are the caller has already had to get creative about how they got through to your desk phone in the first place, and the call itself has probably begun with you being mildly irritated at best. So, while prospects are annoyed that their days are still being interrupted by cold calls, sellers aren't having a good time either. They most likely have managers who demand more than 20-30 calls a day and expect just as many meetings booked per week. But expectations and reality could not be farther apart. In sales organizations that rely on cold calling, lead flow is slowing down, the sales team is getting frustrated, and managers are getting increasingly angry. The Harvard Business Review reported cold calling is ineffective 90% of the time, and more recent research shows that less than 2% of cold calls actually result in a meeting. Assuming a 0.3% appointment-booking rate and a 20% win rate, it would take 6,264 cold calls to make just four sales. 17 Lead Generation Alternatives to Cold Calling What can the modern business do to protect its future and get new leads without cold calling? The good news is that it doesn't involve a circus act or shameless begging of any sort. The bad news is that it requires a completely different way of thinking and some serious energy and hard work. Here are 17 alternatives to cold calling salespeople can use to generate leads. See all 17 alternatives here
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New Gerber Senior Life Insurance Product Released

Posted by www.psmbrokerage.com Admin on Wed, Oct 24, 2018 @ 02:24 PM

At Gerber Life Insurance Company, they make it easy for you to grow your business by helping your clients obtain life insurance protection that can last a lifetime. Gerber Life’s new Simplified Senior Life Insurance Plan provides permanent life insurance coverage with these added benefits: Guaranteed premiums, cash value and death benefits¹ An easy application process for your clients Quick underwriting decisions² Gerber Life Simplified Senior Life Insurance Affordable whole life insurance for clients who are seniors and want to ensure their debt and final expenses are taken care of Offers up to $100,000 in permanent life insurance protection Issue ages 50 to 80 years old Simplified Issue (no medical exam for applicants age 70 and under)³ Almost instant underwriting decisions (within a minute) for most of the digital and telephone applications submitted from individuals age 70 and under⁴ Accelerated Death Benefit (ADB) Rider included at no additional cost⁵ Just as important, in addition to first-year commissions, you can earn renewal commissions in years 2 through 5. Be a hero to your clients by offering the convenience and simplicity of Gerber Life’s new Simplified Senior Life Insurance Plan. To learn more, click the links below for the new Gerber Life Simplified Senior Life materials: Simplified Senior Life Consumer Brochure - Click Here Simplified Senior Life Agent Sales Tip Flyer - Click Here Simplified Senior Life Agent Reference Guide - Click Here Questions? Contact us today at 800-998-7715. Request details here
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Aetna Announces Biggest Medicare Advantage Expansion in Its History

Posted by www.psmbrokerage.com Admin on Wed, Oct 24, 2018 @ 02:10 PM

Aetna Announces Biggest Medicare Advantage Expansion in Its History

Aetna’s 2019 Medicare plans offer enhanced benefits and greater value

Aetna announced its 2019 Medicare plans, featuring expanded plan options with low or $0 monthly plan premiums in many areas, enhanced benefits and a more personalized member experience.

“We are proud to be a leader in $0 premium plan offerings, with approximately 72 percent of our 2018 Individual Medicare Advantage members enrolled in $0 premium plans,”^* said Christopher Ciano, who was appointed head of Aetna Medicare earlier this year. “Our 2019 plan options will offer even more value to Medicare beneficiaries through a variety of expanded benefits, while still emphasizing affordability.”

Expanded plan options for greater access and choice

For 2019, Aetna is offering Medicare Advantage Prescription Drug (MAPD) plans in 45 states plus Washington, D.C. Aetna added 358 new counties and 6 new states — Idaho, Minnesota, New Hampshire, New Mexico, Oregon and Rhode Island. In Minnesota, Aetna and Allina Health will be launching a joint venture

Medicare Advantage plan in the greater Minneapolis/St. Paul area. In total, Aetna will offer MAPD plans in 1,416 counties in 2019.^**

This represents the biggest expansion of Medicare Advantage in Aetna’s history, providing about 7.4 million more Medicare beneficiaries (46 million in total^**) access to an Aetna plan.

Other 2019 plan options include:

Explorer Plan Portable PPO: Medicare eligibles who like to travel will have increased access to our expanded Explorer Plan Portable PPO offering with a multi-state network. This plan is now available in 17 new states for a total of 28 states.
Dual Eligible Special Needs Plan (DSNP): For those who qualify for both Medicare and Medicaid benefits, we expanded our DSNP offering to a total of 9 states: Existing DSNP markets include Florida, Pennsylvania and Virginia, with new DSNP markets in Georgia, Kansas, Louisiana, Missouri, Ohio and Texas.
Prescription Drug Plan (PDP): All three plans in our PDP portfolio are now available in all 50 states and DC. This includes the Aetna Medicare Rx^®Select (PDP) plan, which has an average monthly premium of $17; no deductible on Tier 1 and Tier 2 prescription drugs; $0 copay for Tier 1 prescription drugs at preferred pharmacies; and enhanced coverage in the doughnut hole.
Medicare Supplement: We offer standard Medicare Supplement plans in 49 states and ancillary products in all 50 states. This includes a combined dental, vision and hearing product launched earlier this year.
Group Medicare: Our Group Medicare business offers a suite of products for employers and retirees in all 50 states. This includes a new fall prevention program (also available for Individual Medicare Advantage members) and community-based support services.

Enhanced benefits for added convenience and improved overall wellness

To make it more convenient for our members to get the care they need, we expanded and enriched the following Medicare Advantage benefits for 2019:

Meal delivery after a hospital discharge is now available with 73 percent of our plans, up from 5 percent.
Over-the-counter (OTC) health and wellness products^***are available with 67 percent of our plans, up from 29 percent.
Transportation to plan-approved locations is available with 21 percent of our plans, up from 7 percent.

In addition, we’ll continue to offer Medicare Advantage members access to the following benefits and services at no additional cost:

Fitness memberships
Routine vision, dental and hearing coverage****
Resources For Living^®service, which connects members to community-based providers that offer social, wellness and behavioral services

“We recognize that good health goes beyond just physical care,“ added Ciano. “That’s why our Medicare Advantage plans take a total approach to health and wellness, so our members can age more actively.”

https://www.businesswire.com/news/home/20181022005492/en/Aetna-Announces-Biggest-Medicare-Advantage-Expansion-History

Not appointed with Aetna? Request details here

Additional Updates:

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Medicare Advantage / AEP Updates:

Your path to AEP success with Precision Senior Marketing - View
Enroll your MA and PDP clients online - at no cost to you - View
2019 Medicare Advantage / Part D Certifications now available - View
2019 Medicare Advantage First Looks now available - View
2019 AEP Road Map - Start your planning today - View
The DSNP Market continues to grow. Are you missing out? - View

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Tags: Medicare Advantage, aetna, medicare updates

Medicare Advantage Plans Proliferate in 2019, Raising Competition

Posted by www.psmbrokerage.com Admin on Wed, Oct 24, 2018 @ 02:06 PM

Medicare Advantage Plans Proliferate in 2019, Raising Competition

Medicare Advantage payer competition is likely to grow in 2019 as more payers offer plans and increase MA plan value for members.

Medicare Advantage (MA) payer competition is increasing significantly for plan year 2019 as more than 400 new options hit an already-crowded market, says a new report from the Kaiser Family Foundation (KFF).

More than 2700 different Medicare Advantage plans will be available nationwide in 2019, forcing payers to differentiate their offerings and include benefits that can attract and retain choosy consumers. The average Medicare Advantage beneficiary will be able to choose between health plans from seven different payers, and will be able to pick from multiple packages from each insurer, KFF said.

MA beneficiaries can access an average of 24 health plan options in 2019, or three more than in 2018. MA members also have greater access to special needs plans (SNPs) with customized benefits than in previous years. KFF estimates that MA members can access 717 MA SNPs in 2019 after having access to 630 SNP options in 2018.

Several MA health plans are offering more affordable health plan benefits for beneficiaries in 2019, the team found.

Nine out of ten beneficiaries have the option to enroll in a $0 premium Medicare Advantage prescription drug plan (MA-PD), while 45 percent of beneficiaries can choose MA plans with no premiums.

The average MA premium is expected to decrease by six percent in 2019, according to CMS.

However, MA access varies significantly by geographic region. While some counties have access to more than 50 MA plans, residents in 250 counties will only be able to choose between a maximum of two plans. Beneficiaries in 115 counties will not have any access to an MA plan.

New payers entering the 2019 Medicare Advantage market are providing a variety of options, while only a few payers will exit from MA entirely, KFF found. In 2019, 14 payers are entering the MA market for the first time. Seven payers are offering HMO plans, eight are offering at least one SNP, and one payer is offering a local PPO plan.

Five MA insurers are exiting the MA market in 2019, including payers offering small health plans sponsored by local community and religious groups.

KFF suggested that Medicare Advantage participation may not be as profitable for smaller insurers as for larger payers that can enroll more beneficiaries.

“The exits are evidence that not all plans in the Medicare Advantage market are profitable,” KFF said. “Together, the five insurers exiting the Medicare Advantage market had about 23,000 enrollees in 2018, far less than one percent of the 20 million beneficiaries enrolled in Medicare Advantage in 2018.”

Medicare Advantage presents significant financial opportunities for payers. Payers have expanded their Medicare Advantage business segments to stand out from competitors by improving health plan value and benefits packages.

The growth of the MA market may also require payers to incorporate new business strategies and data analytics in order to achieve high star ratings and encourage beneficiaries to choose their plans over competitor offerings.

“More Medicare Advantage plans will be offered in 2019 than any year since 2009,” KFF said.

“Fifteen insurers will be entering the market for the first time in 2019 – suggesting that the market remains very attractive to insurers. Some parts of the country (such as Florida) continue to be particularly attractive to insurers. As in prior years, some (mostly rural) counties are less attractive to insurers, with fewer firms and plans available…as Medicare Advantage enrollment continues to grow, insurers seem to be responding by offering more plans and choices to the people on Medicare.”

https://healthpayerintelligence.com/news/medicare-advantage-plans-proliferate-in-2019-raising-competition

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Tags: Medicare Advantage, medicare updates

2019 Medicare Costs at a Glance - Parts A & B

Posted by www.psmbrokerage.com Admin on Fri, Oct 19, 2018 @ 02:36 PM

Part A Premium	Most people do not pay a monthly premium for Part A (sometimes called "premium-free Part A". If you buy Part A, you will pay up to $437 each month. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $437. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $240.
Part A Hospital Inpatient Deductible and Coinsurance	$1,364 deductible for each benefit period Days 1-60: $0 coinsurance for each benefit period Days 61-90: $341 coinsurance per day of each benefit period Days 91 and beyond: $682 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) Beyond lifetime reserve days: All costs Inpatient mental health care in a psychiatric hospital limited to 190 days in a lifetime
Skilled Nursing Facility Care	0 for the first 20 days of each benefit period $170.50 per day for days 21-100 of each benefit period All costs for each day after day 100 in a benefit period
Home Health Care Services	$0 for home health care services 20% of the Medicare-approved amount for durable medical equipment
Part B Premium	Standard premium: $135.50 (or higher depending on your income) An estimated 2 million Medicare beneficiaries (about 3.5%) will pay less than the full Part B standard monthly premium amount in 2019 due to the statutory hold harmless provision, which limits certain beneficiaries' increase in their Part B premium to be no greater than the increase in their Social Security benefits.
Part B Deductibles and Coinsurance	$185 yearly deductible 20% coinsurance for most covered services, like doctor's services and some preventive services, if provider accepts assignment $0 for most preventive services 20% coinsurance for outpatient mental health services, copayments for hospital outpatient services and durable medical equipment (DME)

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Tags: medicare updates

PSM would like to wish you a great AEP. We are here to assist!

Posted by www.psmbrokerage.com Admin on Fri, Oct 19, 2018 @ 01:00 PM

WISHING YOU A GREAT

Useful AEP Links:

2019 Annual Enrollment Period (AEP) Checklist

2019 AHIP Training - $50 Discount for PSM Agents

2019 Carrier Specific Certification Instructions

2019 Medicare Advantage and PDP First Looks

Medicare Advantage Lead Incentive for PSM Agents

Online Submission Platform for MA and Part D Sales

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Tags: Medicare Advantage, Medicare Supplement, Part D, AEP, certification, Field Marketing Organization, IMO, dental plans, Connecture, DRX, Enrollment Tools, Medicare FMO

Get paid during AEP with Heartland National's New Hospital Indemnity Plan

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 05:19 PM

Help fill the gaps where Medicare Advantage leaves off!

Don't leave money on the table this AEP!... and save your clients thousands with Heartland's new Hospital Indemnity Plan!

Informing your clients of the benefits of having a hospital indemnity plan could save them thousands of dollars in out-of-pocket medical expenses that their Medicare Advantage plans does not cover.

GREAT BENEFITS FOR YOUR CLIENTS:

Guarantee Issue from ages 64 1/2 to 65 1/2
7% household discount
Dual applications
Issue ages 18 to 85
Choose from 3-31 days payable*

Customize the plan with additional riders**:

Lump Sum Cancer
Dental, Vision and Hearing
Skilled Nursing Facility Benefits
and Much More!

Available in 30 states! Additional states coming soon

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Not appointed with Heartland National. Request details here

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Medicare Advantage 2019 Spotlight: First Look

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 05:00 PM

Medicare Advantage 2019 Spotlight:
First Look

More than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This brief provides an overview of the Medicare Advantage plans that will be available in 2019, based on an analysis of data from the Centers for Medicare and Medicaid Services (CMS). Findings include:

Number of Plans.Nationwide, 2,734 Medicare Advantage plans will be available for individual enrollment in 2019 – an increase of 417 plans since 2018. The preponderance of the growth in plans will occur in Florida. The average beneficiary will be able to choose among 24 plans in 2019, up from 21 in 2018. The number of Special Needs Plans (SNPs) will also increase from 630 plans in 2018 to 717 plans in 2019.

Variation in Number of Plans Across Counties. The number of Medicare Advantage plans will vary greatly across counties in 2019, from more than 50 plans in 6 counties (1% of beneficiaries) to two or fewer plans in 246 counties (2% of beneficiaries), including 115 counties (with 1% of beneficiaries) in which no plans will be offered in 2019.
Number of Firms. The average beneficiary will be able to choose from plans offered by seven firms in 2019, with large variation across counties. Seven percent of all Medicare beneficiaries will have a choice of plans offered by two or fewer firms while 19 percent of beneficiaries will be able to choose from plans offered by 10 or more firms.
Market Entrants and Exits. Fourteen insurers will be entering the Medicare Advantage market for the first time in 2019, offering products in 26 states. Five insurers, together accounting for about 23,000 Medicare beneficiaries in 2018, will be exiting in 2019, four of which offered SNPs in 2018. These firms account for a small share of the insurers offering Medicare Advantage plans in 2019.

Read the full article here I Additional Information here

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Tags: Medicare Advantage, medicare updates

An Overview of Part D for 2019

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 04:35 PM

An Overview of Part D in 2019

This fact sheet provides an overview of the Part D program, plan availability, enrollment and spending and financing, based on data from the CMS, CBO and other sources. In 2019, 901 PDPs will be offered across the 34 PDP regions nationwide (excluding the territories). This represents an increase of 119 PDPs from 2018 and the second year in a row with an increase, after three years of plan reductions.

901 Part D Plans for 2019, a 15% Increase from 2018

Beneficiaries in each state will have a choice of multiple stand-alone PDPs in 2019, ranging from 22 PDPs in Alaska to 30 PD's in the Pennsylvania/West Virginia PDP region (see map graphic). In addition, beneficiaries will be able to choose among multiple MA-PDs offered at the local level for coverage of their Medicare benefits, including prescription drugs.

State-by-State Part D Plans for 2019

Catastrophic Coverage Begins at O-o-P of $5,100

Read the full article here

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Tags: Medicare Part D, medicare updates

Devoted Health, New Medicare Advantage Business, Raises $300 Million

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 04:14 PM

Devoted Health, New Medicare Advantage Business, Raises $300 Million

As open enrollment for Medicare began Monday, in one of the largest healthcare company fundraises of the year, Medicare Advantage business Devoted Health says it's raised $300 million in a Series B round led by Andreessen Horowitz.

“The problem is the fact that the system itself is fundamentally not designed in a patient-centric way,” wrote cofounder Ed Park in a post on Tuesday. “People are stuck ping-ponging among an assortment of well-meaning primary care doctors, specialists, hospitals, and other facilities, resulting in a patient experience that is highly uncoordinated, fragmented, and reactive, compounded by administrative hassles that seem to emerge from every corner.”

Devoted’s answer to that problem is to become what it's calling a “payvidor,” a service that combines being a provider and payer. According to Park's blog post, that means being responsible for the full cost of member care through Medicare Advantage, partnering with health providers and also offering care services like a medical group that will make house calls to patients.

Devoted was founded last year by brothers Todd and Ed Park and Venrock venture capitalists Bryan Roberts and Bob Kocher (as founding investor), a group with years of experience in both the public and private healthcare sectors. Todd Park is a cofounder of Athenahealth, a healthcare network services firm, and Castlight Health, a healthcare price transparency company, and was the U.S. chief technology officer under President Obama. Kocher served during the Obama administration on the National Economic Council and focuses on healthcare IT investments at Venrock.

So far the company, based in Waltham, Massachusetts, has launched in eight counties in southern and central Florida. The latest round also included new investors, Premji Invest and Uprising, and previous investors such as Venrock and F-Prime Capital Partners. The funds will be used to expand operations and build out the company's technology further. Devoted had previously raised almost $70 million in seed and Series A funding. According to venture funding database Pitchbook, the company was valued at $295 million following the Series A. The company has not commented on its valuation following this funding round.

Read the full article here

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Tags: Medicare Advantage, medicare updates, Devoted Health

CMS Proposes to Require Manufacturers to Disclose Drug Prices in Television Ads

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 02:56 PM

CMS Proposes to Require Manufacturers to Disclose Drug Prices in Television Ads

Proposed rule would further the Trump Administration’s commitment to lower prescription drug prices by requiring companies to list prices for prescription drugs covered in Medicare or Medicaid.

As part of the agency’s ongoing efforts to empower patients and lower prescription drug prices, the Centers for Medicare & Medicaid Services proposed today to require that prescription drug manufacturers post the Wholesale Acquisition Cost (WAC) for drugs covered in Medicare or Medicaid in direct-to-consumer television advertisements.

“This historic proposal is an important way to create new incentives for drug companies to start lowering their list prices, rather than raising them,” said HHS Secretary Alex Azar. “President Trump’s drug-pricing blueprint called for HHS to consider how to accomplish this goal, and now we are following through on this measure to better inform patients, help them lower their drug costs, and reduce unreasonable spending in Medicare and Medicaid.”

The proposed rule would work to inject greater transparency into the prices prescription drug manufacturers set and would give beneficiaries important information they need to make informed decisions based on cost, while concurrently providing a moderating force to counteract price increases.

“President Trump and Secretary Azar are working tirelessly to bring down prescription drug prices, and today CMS is continuing to execute on the President blueprint,” said CMS Administrator Seema Verma. “We are committed to price transparency across-the-board, and prescription drugs are no different. Patients often pay their cost-sharing or deductible off of a drug’s list price. Today’s proposed rule would ensure that those list prices are included in television advertisements, so patients have the information they need to make informed decisions.”

Under the proposed rule, the price required to be posted would be for a typical course of treatment for an acute medication like an antibiotic, or a thirty day supply of medication for a chronic condition that is taken every month, and the posting would take the form of a legible textual statement at the end of the ad. The HHS Secretary would maintain a public list of drugs that were advertised in violation of this rule. CMS would provide an exception to the requirement to post prices for prescription drugs with list prices of less than $35 per month.

Additionally, to advance the Administration’s goal to ensure drug price transparency and also account for the different ways Americans receive advertising and promotional messages, CMS is seeking comment on whether the regulation should apply to advertisements in other media forms such as radio, magazines, newspapers, websites, and social networking sites.

Today’s announcement further strengthens CMS’s commitment to pull back the curtain on the system of drug pricing. Earlier this year, CMS released a redesigned version of the Drug Spending Dashboards which include year-over-year information on drug prices and, for the first time, highlight which manufactures have been increasing their prices. This move was an important step to bringing transparency and accountability to a process largely hidden from patients.

The agency has also taken action to promote transparency in other areas of the healthcare system, such as by requiring hospitals to post their standard charges online in a machine-readable format. In addition, CMS recently launched the eMedicare initiative to empower beneficiaries with cost and quality information. This announcement included the launch of a mobile-optimized out-of-pocket cost calculator that will provide beneficiaries with information on both overall plan costs and prescription drug costs.

For a policy brief on the Drug Pricing Transparency CMS-4187 proposed rule, please visit: https://www.hhs.gov/about/news/2018/10/15/what-you-need-to-know-about-putting-drug-prices-in-tv-ads.html

The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/.

CMS looks forward to feedback on the proposal and will accept comments until December 17, 2018. Comments may be submitted electronically through our e-Regulation website https://www.cms.gov/Regulations-and-Guidance/Regulations-and-Policies/eRulemaking/index.html?redirect=/eRulemaking.

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Tags: Part D, medicare updates

Medicare Market Insights and Plan Competition for 2019

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 12:47 PM

Medicare Market Insights and
Plan Competition for 2019

Medicare Market Insights and Plan Competition for 2019 Medicare Advantage (MA) plans have been eagerly preparing their Medicare products in anticipation of the 2019 Annual Election Period (AEP) which is now upon us. The 2019 Medicare Advantage market is comprised of national health plans, Blue Cross Blue Shield organizations, prominent regional health plans and specialized Medicare companies. MA plans currently provide medical coverage for over 21.5 million beneficiaries. In the last three years, these plans have collectively increased enrollment by approximately 3.7 million members and currently cover over 34% of the nearly 63 million people eligible for Medicare benefits.

As Medicare companies finalize sales and marketing strategies, they analyze data from Medicare Plan Finder (MPF), an online tool that makes it easy for seniors to review options and shop for new Medicare plans. Medicare Benefits Analyzer™ , a Mark Farrah Associates’ database, helps simplify the analysis of the Medicare Plan Finder data for companies competing in this segment. This brief presents a snapshot of the 2019 Medicare Advantage market with insights from the Centers for Medicare and Medicaid Services (CMS) Medicare Landscape reports and discusses the plans that will be vying for business during the AEP.

The Competitive Medicare Landscape

MA plans, along with stand-alone PDPs (prescription drug plans), are immersed in competitive assessments as beneficiaries begin to choose plans during this Annual Election Period, which runs between October 15^th and December 7^th. Based on an aggregate analysis of CMS Landscape reports, a total of 3,810 distinct Medicare Advantage (MA) plan offerings are in the market lineup for the onset of the 2019 AEP. This includes MA plans, Medicare Advantage with prescription drug plans (MAPDs), Medicare/Medicaid plans (MMPs), and Special Needs Plans (SNPs). During the AEP, Medicare beneficiaries can choose to change MA plans or switch from Original Medicare to MA, and plan benefits will become effective on January 1, 2019.

MFA’s analysis of CMS landscape data found a total of 3,077 MA plans being offered for 2019, including MMPs, up from 2,619 in 2018. In addition, a total of 733 Special Needs Plans (SNPs) are available in 2019, up from 640 in 2018. Health Maintenance Organizations (HMOs) represent 68% of all MA plan types with over 2,600 offerings for the coming year. Stand-alone PDPs nationwide increased for 2019 with 910 plan offerings, as compared to 795 plans in 2018.

According to the CMS press release, Medicare Advantage premiums continue to decline while plan choices and benefits increase in 2019 ; Medicare Advantage average monthly premiums will decrease 6% from 2018, falling to $28. Enrollment is projected to experience 11.5% growth over 2018. In addition, over 91% of people with Medicare will have access to 10 or more Medicare Advantage plans, which is up from 86% for 2018.

Plan Competition for 2019

Based on the 2019 CMS Landscape reports, Humana continues to market more MA plans than any other company nationwide, with 548 distinct plans identified in MFA’s assessment. UnitedHealth continued to increase its MA plan offerings for the 2019 calendar year with 406 distinct plans identified, up 62 plans from last year. Aetna (including Coventry and other affiliates) is offering 355 plans for 2019. Anthem and the vast majority of other Blue Cross Blue Shield plans as well as WellCare and Centene also continue to have a notable plan offerings presence, respectively.

Read the full article here

Additional Updates:

PSM would like to wish you a great 2019 AEP. We are here to assist! - View
Medicare Advantage 2019 Spotlight: First Look - View
Record Medicare Advantage growth expected this AEP - View
Medicare Advantage riding high as new insurers flock to market - View
Average Medicare Advantage costs by state - View
Medicare Supplement enrollment by state - View
CMS releases Star Ratings for Medicare Advantage and Part D plans - View
Medicare Part D 2019 Spotlight: First Look - View
CMS announces 2019 Parts A & B Premiums and Deductibles - View
Humana received 5-Star Quality Ratings for two Medicare Contracts - View
Get paid this AEP with Heartland National's Hospital Indemnity Plan - View
Social Security benefits to increase in 2019 - View
Justice Department approves CVS Health / Aetna Merger with divestiture - View
Express: Mutual of Omaha weekly updates - View
VALUES Quote of the Week - View
Current agent incentive trips and contests - View

Medicare Advantage / AEP Updates:

Your path to AEP success with Precision Senior Marketing - View
Enroll your MA and PDP clients online - at no cost to you - View
2019 Medicare Advantage / Part D Certifications now available - View
2019 Medicare Advantage First Looks now available - View
2019 AEP Road Map - Start your planning today - View
The DSNP Market continues to grow. Are you missing out? - View

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Tags: Humana, Cigna, Medicare Advantage, aetna, mutual of omaha, medicare updates, star ratings

New Mutual of Omaha Medicare Advantage Plans Now Available for Cincinnati-Area Seniors

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 12:12 PM

New Mutual of Omaha Medicare Advantage Plans Now Available for Cincinnati-Area Seniors

Mutual of Omaha Care Advantage Complete and Mutual of Omaha Care Advantage Plus plans focus on wellness and high-quality care while offering benefits that include prescription and over-the-counter drug coverage, dental and vision care, and extras such as transportation to and from doctor appointments and fitness options through the SilverSneakers program.

“As a customer-focused company, we understand that Medicare Advantage is the right option for a significant number of seniors,” said Mutual of Omaha Senior Vice President Amber Rinehart. “We listened to what customers value in planning for their health care needs and are launching Medicare Advantage plans that address those needs with excellent local health care partners and backed by Mutual of Omaha.”

The plans will provide members in-network access to two local health care systems, TriHealth and St. Elizabeth Healthcare.

“Mutual of Omaha’s Medicare Advantage plans are committed to delivering top quality care for seniors. TriHealth and St. Elizabeth are two systems that share this vision and are dedicated to making a difference in patients’ lives,” Rinehart said.

Mutual of Omaha’s Care Advantage plans are offered through its Mutual of Omaha Medicare Advantage Company affiliate in collaboration with Lumeris, a leader in value-based care.

For more information, visit MutualofOmahaCareAdvantage.com.

About Mutual of Omaha

Founded in 1909, Mutual of Omaha is a Fortune 500 organization offering a variety of insurance, banking and financial products for individuals, businesses and groups throughout the United States. In the individual market, Mutual is a leader in the senior health, life, long-term care, disability and annuity lines. The company also offers a portfolio of employee benefit and retirement solutions. With $8 billion in assets, Mutual of Omaha Bank is a full-service bank providing financial solutions to individuals and businesses across the United States. For more information about Mutual of Omaha, visit www.mutualofomaha.com.

About Lumeris

Lumeris is a value-based care managed services operator for health systems and providers seeking extraordinary clinical and financial outcomes. Recognized nationally by KLAS in 2018 for Value-Based Care Managed Services, Lumeris aligns providers and payers across populations with technologies, processes, behaviors and information to achieve high-quality, cost-effective care with satisfied consumers — and engaged physicians. It was the third straight year Lumeris received the distinguished Best in KLAS award. For the past eight years, Lumeris with Essence Healthcare, its inaugural client and learning laboratory with more than 65,000 Medicare members in Missouri and Illinois, has received 4.5- to 5-Star Ratings from the CMS and produced the highest consumer and physician satisfaction scores in the industry along with significantly better clinical outcomes and lower costs. For more information, go to www.lumeris.com.

Navigating the MA Product Training Site
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Tags: Annual Enrollment Period, Medicare Advantage, Part D, AEP, mutual of omaha

The 2019 Medicare Star Ratings Program: Making the Cut

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 10:46 AM

The 2019 Medicare Star Ratings Program: Making the Cut

The Centers for Medicare & Medicaid Services (CMS) last week published its 2019 Part C and Part D Medicare Star Ratings data and, along with it, the Technical Notes describing the methodology for the Star Ratings. Here, Ashley McNairy, product director for Cotiviti’s Government Quality solutions, breaks down the changes to the cut points, which can have a significant impact on a health plan’s score.

Cut points are the ranges within which a measure’s score needs to fall in order to be assigned a certain star value. As an example, here is the cut point range for Breast Cancer Screening (C01), which measures the percentage of female plan members aged 52 to 74 who had a mammogram during the past two years:

1 Star	2 Stars	3 Stars	4 Stars	5 Stars
<47%	≥47% to <68%	≥ 68% to <76%	≥76% to <82%	≥82%

Every year, CMS adjusts these ranges slightly based on how the measures are trending. As the industry’s performance improves in a specific metric, in other words, you can expect the ranges to increase, so it becomes harder for a plan to hit the five-star mark.

Many health plans and analysts try to predict how these cut points may change year over year, as even a 1 percent change in a measure’s cut point range could drop the plan’s rating from five stars to four stars for that measure—or potentially even drop the plan’s overall rating.

Out of the 46 Part C and Part D measures that have carried over from 2018 to 2019, almost half have higher ranges in at least one of the thresholds. Some measures only moved one or two points in a couple thresholds; however, in general the two- and three-star ranges are higher, whereas the four- and five-star ranges were closer to last year’s cut points. This simply means it is harder to get even a two-star rating in several measures.

The most notable shift to higher cut points was the Medication Reconciliation Post-Discharge measure (C20), as each cut point threshold jumped at least 10 percent. As a measure that was only first introduced in 2018, this dramatic change could indicate that the cut points were simply too low in the first year, or that plans are exceeding expectations. These ranges will likely continue to grow, with plans’ measure scores averaging 56 percent for 2019 compared to 50 percent for 2018.

The other notable shift in cut points occurred in the three Care for Older Adult measures (C09-C11). These measures are required for Special Needs Plans (SNPs), which make up about 40 percent of all contracts. Both Medication Review and Functional Status Assessment had lower thresholds in the two- and three-star ranges, but stayed relatively the same in the four- and five-star ranges. For example, a plan only needs to achieve a 1 percent score to earn two stars for Medication Review, whereas last year plans needed to hit 59 percent. This seems like an odd starting point for a threshold in a measure where the average score improved from 90 percent to 92 percent this year. Alternatively, the Pain Assessment measure, which also saw average scores improved, shifted to higher cut points across each threshold.

Only one measure’s cut points stayed exactly the same: the Part C Customer Service measure, which is part of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Cut points for this measure stayed the same even as the other CAHPS measures all experienced slight changes. This could be due to overall health plan performance averaging the same for this measure for both 2018 and 2019.

With the quality of care in Medicare Advantage plans increasing each year and becoming more competitive for both market share and rebates, plans are understandably looking for more predictability in their Star Ratings. Out of the Cotiviti clients that had enough data for either an overall Summary Rating or a Part D score, 13 percent increased their rating, with several being either a four-and-a-half- or five-star plan. The majority of plans that worked with Cotiviti received the same rating as in 2018, which is a success to celebrate considering the many hurdles that plans have to overcome each year as the thresholds change.

Star Navigator is a quality improvement solution that enables Medicare Advantage plans to determine the most direct path to higher Star Ratings, then track and communicate their progress toward goals. Learn more from our fact sheet.

Source

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Tags: Humana, Cigna, Medicare Advantage, aetna, mutual of omaha, medicare updates, star ratings

Update on the prospective WellCare purchase of individual standalone Aetna Part D “PDP” plan

Posted by www.psmbrokerage.com Admin on Tue, Oct 16, 2018 @ 10:13 AM

Update on the prospective WellCare purchase of individual standalone Aetna Part D “PDP” plan

FOR AGENT USE ONLY

October 14, 2018

Dear Agents and Brokers,

The letter is to provide you additional information to keep you updated on the prospective WellCare Health Plans Inc. (WellCare) purchase of our individual standalone Aetna Part D “PDP” plans.

We understand and value your relationships with your Aetna standalone Part D clients. We want to make it easy for you to continue to serve them now, as well as during and after their transition to WellCare. As part of our commitment to help you support your clients’ PDP needs, you will receive periodic communications with updates and guidance.

We understand you may have some concerns about how these proposed transactions may impact you as an agent/broker or agency partner. Our number one priority is to make this transition completely transparent and as seamless as possible for both you and your members.

WellCare and Aetna have entered into an Administrative Services Agreement (ASA) during a transition period for all of 2019. Assuming the proposed transaction is consummated, WellCare will own Aetna’s individual standalone PDP plans in 2019. However, for the 2019 plan year, Aetna will continue to assume the same administrative services (e.g. enrollment, billing, claims & appeal processing, customer service, broker/sales) that we have historically provided for those PDP plans covered by the divesture, except that WellCare will become responsible for Compliance oversight.

To ensure transparency, below is some key information for you to consider:

Agent Appointment:

On January 1, 2019, WellCare will be the owner of the Aetna individual standalone Part D products. From a compliance perspective, agents must be appointed with WellCare as WellCare will be responsible for the agent commission program. WellCare will begin appointing agents for WellCare PDP via the states’ department of insurance. Appointments will be completed by December 31, 2018. At this time, no action from you is required.

Contracting and Certifications for 2019 AEP/Plan Year:

If you are currently contracted and certified with Aetna, you are eligible to market/sell 2019 Aetna individual standalone Part D products. Next year, agents will be required to complete contracting and certifications with WellCare for 2020 AEP. Please be on the lookout for communications from WellCare regarding contracting/certifying with WellCare for 2020 AEP.

Hierarchy Assignment:

For the 2019 plan year, WellCare will recognize the current hierarchal structure in place per your contract with Aetna. Please be on the lookout for future communications from WellCare regarding required hierarchy changes for plan year 2020.

Initial Commission Payments:

For new Aetna individual standalone Part D business written in 2019, Aetna will administer payments per the rates and timing aligned with your current Aetna contract. Beginning plan year 2020, agents will be paid per the WellCare commission program. All cycle year one, individual standalone PDP enrollments are paid the maximum fair market value per CMS guidelines.

Renewal Commission Payments:

For 2019, in accordance with your current contract terms, Aetna will continue to pay renewals for members who remain active with the Plan in an individual standalone Aetna Medicare Part D Plan. Beginning 2020, WellCare renewal commissions will be paid per the WellCare contractual process:

Writing agents/Agents of Record (AOR) renewal payments are considered, “as earned” on a per member per month basis. As long as the member is active and you are the AOR, you will continue to receive renewal commissions.
WellCare is committed to an override renewal structure into 2020. Be on the lookout for future communications from WellCare regarding additional details and information in this regard.

We want to ensure a smooth and positive transition for our partners. If you have any further questions, please call Aetna support:

Phone: 866-714-9301 from
Hours of Operation: Monday – Friday, 8:00am – 8:00pm EST.

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna, AEP

Americo Medicare Supplement Now Available in Wisconsin

Posted by www.psmbrokerage.com Admin on Mon, Oct 15, 2018 @ 01:21 PM

We are excited to announce that Americo Medicare Supplement is now available for sale in Wisconsin.

"A" (Excellent) by A.M. Best*
Great rates
10% Household Discount
No policy fee
Competitive Commissions
UFirst Rewards Bonus

Americo offers everything you need to be successful in the Medicare Supplement Market:

Instant decision eApplication now available; policy eDelivery available
Great rates on Plans F, G, and N
Rated "A" (Excellent) by A.M. Best*
10% Household Discount available in most states**
Voice, Tablet, and Electronic Signature options available to make it easy
UFirst Rewards Bonus
Sales tools and pre-approved client advertising available.

Not appointed to sell Americo's Medicare Supplements? Request Info here

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CMS announces 2019 Medicare Parts A & B premiums and deductibles

Posted by www.psmbrokerage.com Admin on Mon, Oct 15, 2018 @ 11:48 AM

CMS Announces 2019 Medicare Parts A&B Premiums and Deductibles The Centers for Medicare & Medicaid Services (CMS) announced the 2019 premiums, deductibles, and coinsurance amounts for Medicare Parts A and B. “CMS is committed to empowering beneficiaries with the information they need to make informed decisions about their healthcare,” said CMS Administrator Seema Verma. “In addition to the information we recently released for Medicare Advantage, the program through which private plans provide Medicare benefits, today we are releasing information for fee-for-service Medicare, so enrollees understand their options for receiving Medicare benefits.” As announced earlier this month, CMS launched the eMedicare Initiative that aims to modernize the way beneficiaries get information about Medicare and create new ways to help them make the best decisions for themselves and their families. Ahead of Medicare Open Enrollment – which begins on October 15, 2018 and ends December 7, 2018 – CMS is making improvements the Medicare.gov website to help beneficiaries compare options and decide if Original Medicare or Medicare Advantage is right for them. Among the tools released as part of the eMedicare Initiative is a stand-alone, mobile optimized out of pocket cost calculator that will provide information on both overall costs and prescription drug costs. Medicare Part B Premiums/Deductibles Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. The standard monthly premium for Medicare Part B enrollees will be $135.50 for 2019, a slight increase from $134 in 2018. An estimated 2 million Medicare beneficiaries (about 3.5 percent) will pay less than the full Part B standard monthly premium amount in 2019 due to the statutory hold harmless provision, which limits certain beneficiaries’ increase in their Part B premium to be no greater than the increase in their Social Security benefits. CMS also announced that the annual deductible for Medicare Part B beneficiaries is $185 in 2019, an increase from $183 in 2018. Medicare Part A Premiums/Deductibles Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment. The Medicare Part A inpatient deductible that beneficiaries will pay when admitted to the hospital is $1,364 in 2019, an increase of $24 from $1,340 in 2018. Medicare Advantage Premiums Medicare beneficiaries can choose to enroll in fee-for-service Medicare (Parts A and B) or can select a private Medicare Advantage plan to receive their Medicare benefits. Premiums and deductibles for Medicare Advantage and Medicare Prescription Drug plans are already finalized and are unaffected by this announcement. Last month, CMS released the benefit, premium, and cost sharing information for Medicare Advantage plans in 2019. On average, Medicare Advantage premiums will decline while plan choices and new benefits increase. On average, Medicare Advantage premiums in 2019 are estimated to decrease by six percent to $28, from an average of $29.81 in 2018. For a fact sheet on the 2019 Medicare Parts A & B premiums and deductibles, please visit: https://www.cms.gov/newsroom/fact-sheets/2019-medicare-parts-b-premiums-and-deductibles. For more information on the 2019 Medicare Parts A and B premiums and deductibles (CMS-8068-N, CMS-8069-N, CMS-8070-N), please visit https://www.federalregister.gov/public-inspection.
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Medicare Posts 2019 Rates, Pinches High Earners

Posted by www.psmbrokerage.com Admin on Mon, Oct 15, 2018 @ 11:34 AM

Medicare Posts 2019 Rates, Pinches High Earners Medicare managers announced today that they will hold increases in Medicare Part B premiums to about 1.1% for most enrollees in 2019. For some high-income enrollees, however, premiums will rise 7.4%. Medicare Part B is the component of the traditional Medicare program that covers physician services and hospital outpatient care. Here’s a look at how the monthly Part B premiums will change, by annual income level: Individuals earning less than $85,000, and couples earning less than $170,000: $135.50 in 2019, from $134 this year. Individuals earnings $160,000 to $500,000, and couples earning $320,000 to $750,000: $433.40 in 2019, from $428.60 this year. Individuals earning $500,000 or more, and couples earning $750,000 or more: $460.50 in 2019, from $428.60 this year. The annual Medicare Part B deductible will increase 1.1%, to $185. Another component of the traditional the Medicare program, Medicare Part A, covers inpatient hospital bills. Medicare managers use payroll taxes to cover most of the cost of running the Medicare Part A program. Few Medicare Part A enrollees pay premiums for that coverage. But, for the enrollees who do have to pay premiums for Medicare Part A coverage, the full premium will increase 3.6%, to $437 per month. The Medicare Part A deductible for inpatient hospital care will increase 1.8%, to $1,340. Why are high earners paying so much more for Medicare Part B? Congress has been increasing the share of Medicare costs that high earners pay in recent years. For 2018, the top annual income category for Medicare Part B rate-setting purposes was for $160,000 and over for individuals, and for $320,000 and over for couples. Premiums from those Medicare Part B enrollees are supposed to cover 80% of their Part B claims. In the Balanced Budget Act of 2018, Congress added a new annual income category: for individuals earning $500,000 or more and couples earning $750,000 or more. Premiums from Part B enrollees in that income category are supposed to cover 85% of those enrollees’ Part B claims. Who do these rate increases actually affect? Medicare now has about 60 million enrollees of all kinds, according to the CMS Medicare Enrollment Dashboard. About 21 million are in Medicare Advantage plans and other plans with separate premium-setting processes. About 38 million are in the traditional Medicare Part A, the Medicare Part B program, or both the Medicare Part A and the Medicare Part B programs. CMS refers to the traditional Medicare Part A-Medicare Part B program as Original Medicare. The rate increases have a direct effect on the Original Medicare enrollees’ costs. How do the Medicare increases compare with the Social Security cost-of-living adjustment (COLA)? The Social Security Administration recently announced that the 2019 Social Security COLA will be 2.8%. *(Related:* *Social Security COLA for 2019: 2.8%)* That means the size of the COLA will be greater than the increase in Medicare premiums for all Medicare enrollees other than the highest-income Medicare Part B enrollees and the enrollees who pay the full cost of the Medicare Part A premiums. Why should financial professionals care about Original Medicare premiums? For consumers who already have traditional Medicare coverage, the Part A and Part B premiums may affect how much they have to spend on other insurance products and related products, such as Medicare supplement insurance coverage. For retirement income planning clients, Medicare costs are something to factor into income needs calculations. Because access to Medicare coverage is critical to all but the very wealthiest retirees, knowledge about how to get and keep eligibility for Medicare coverage on the most favorable possible terms is of keen interest to many consumers ages 50 and older. Some consumers may like to get information about that topic from their insurance agents, financial planners and other advisors. Source
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Humana Received 5-Star Quality Ratings for Two Medicare Contracts

Posted by www.psmbrokerage.com Admin on Thu, Oct 11, 2018 @ 04:04 PM

Humana Received 5-Star Quality Ratings for Two Medicare Contracts Reflecting the Company’s Focus on Quality in both Member Experience and Clinical Outcomes.

October 10, 2018

Humana received a 5-star rating for its Medicare Advantage HMO contract in Tennessee and its CarePlus Health Plans, Inc.Medicare Advantage HMO contract in Florida for 2019
3 million, or approximately 84%, of Humana Medicare Advantage members are currently enrolled under contracts with 4-plus stars for 2019, including approximately 225,000 members in 5-star contracts
Humana received a 4.5-star rating for two Medicare Advantage contracts offered in 6 states, covering approximately 550,000 members
All Humana Medicare Advantage HMO membership in Florida is in 4.5 or 5-star rated contracts
12 Humana Medicare Advantage contracts received a 4-star rating or above
Over 99% of retirees in Humana’s Group Medicare Advantage plans are in 4-plus star contracts

LOUISVILLE, Ky.--(BUSINESS WIRE)--Oct. 10, 2018-- Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today the Medicare star ratings for its Medicare Advantage (MA) plans, effective January 1, 2019, from the Centers for Medicare and Medicaid Services (CMS).

Humana currently serves more than 8.5 million Medicare members in all 50 states, Washington D.C. and Puerto Rico, 3.5 million of which are Medicare Advantage members and 5 million are stand-alone PDP members. The star ratings were posted at www.medicare.gov.

Humana received a 5-star rating on CMS’s 5-star rating system for two MA contracts offered in Florida and Tennessee. In addition, Humana received a 4.5-star rating for two MA contracts offered in Florida, Illinois, Kentucky, Mississippi, North Carolina, and Oregon. Humana has 12 contracts rated 4-star or above and 3 million members in 4-star or above rated contracts to be offered in 2019, representing 84% of our MA membership as of July 2018. The achievement of a 5-star rating for two MA contracts in Florida and Tennessee provides Humana the ability to market for these contracts
throughout the year, creating an opportunity for increased penetration in these important geographies.

“The continued improvement in Humana’s star quality ratings and the achievement of two 5-star contracts is a reflection of Humana’s unwavering commitment to drive quality and improved clinical outcomes for those we serve.” said Alan Wheatley, President, Retail Segment at Humana “Quality is at the forefront of everything we do and we are pleased that this steadfast commitment throughout the organization is reflected in our star ratings.”

The Medicare 5-star rating system rates the excellence of Medicare plans nationally. A plan may receive a rating between one and five stars, with five
stars representing the highest rating. Star ratings are calculated each year and may change from one year to the next.

CMS uses information from member-satisfaction surveys, health plans, and health care providers to assign overall Star Ratings to plans. The rating system uses more than 40 different quality measures in five categories, including:

Staying healthy: screening tests and vaccines
Managing chronic (long-term) conditions
Member experience with the health plan
Member complaints and changes in the health plan’s performance
Health plan customer service

Listed below is a breakdown of Humana’s contracts that achieved a rating of 5.0, 4.5 and 4.0-stars:

Humana 5.0-Star Rated Contracts

H1019 CarePlus Health Plans, Inc. (FL HMO)
H4461 Cariten Health Plan, Inc. (TN HMO)

Humana 4.5-Star Rated Contracts

H1036 Humana Medical Plan, Inc. (FL, KY, MS, NC, OR HMOs)
H1468 Humana Benefit Plan of Illinois, Inc. (IL HMO)

Humana 4.0-Star Rated Contracts

H0028 CHA HMO, Inc. (AZ, CO, HI, IA, IL, KS, MO, NE, NM, SD, TX HMOs)
H1951 Humana Health Benefit Plan of Louisiana, Inc. (LA HMO)
H4007 Humana Health Plans of Puerto Rico (PR HMO)
H5216 Humana Insurance Company (AL, AZ, AR, CO, DE, FL, GA, HI, IA, ID, IL, IN, KY, KS, LA, MD, ME, MI, MN, MS,
MO, MT, NE, NJ, NV, NH, NM, NC, ND, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WA, WV, WI LPPOs)
H5525 Humana Benefit Plan of Illinois, Inc. (AL, GA, IL, IN, KY, LA, MT, NC, OH, PA, SC, WV LPPOs)
H5619 Arcadian Health Plan, Inc. (AL, AR, CA, ID, IN, KY, ME, NH SC, VA, WA, WV HMOs)
H5970 Humana Insurance Company of New York (NY PPO)
H6622 Humana WI Health Organization Insurance Corp (DE, KY, MS, MT, NV, NC, OH, OK, PA, VA, WI HMOs)

Additional Helpful Resources:

Click here to download the 10 Step Selling Process guide

Compliant Sales Videos: 2019 Medicare Plan Presentation Videos

Link to order supplies: 2019 Materials Order Link

FOR AGENT USE ONLY

Humana MAPD, PDP and Medigap Presentation Process

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

Mutual of Omaha: It’s Showtime! Want to know what you can earn?

Posted by www.psmbrokerage.com Admin on Thu, Oct 11, 2018 @ 03:50 PM

Sure, your audience will cheer when you help them find a Medicare supplement plan that's right for them. But with Mutual of Omaha, you also have the opportunity to earn some pretty cool perks.

Broker Bonus — For a limited time during Fall Surge, you'll receive a cash bonus when you sell our Medicare supplement and SELECT products in most states.
Get Details →

Marketing Credits — Earn credits to help pay for all kinds of business-building activities - from leads to Mutual of Omaha branded merchandise.
Get Details →

Mutual Sales Leaders — The Medicare supplement policies you sell during Fall Surge can help you qualify for one of the best incentive programs in the industry with a trip to the Dominican Republic in 2019.
Get Details →

Coming Attractions!

Up next week: We'll show you how you can help your clients save on their Medicare supplement premium.

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Tags: Annual Enrollment Period, Medicare Supplement, AEP, mutual of omaha

SilverScript News: U.S. Department of Justice Clears Aetna Acquisition

Posted by www.psmbrokerage.com Admin on Thu, Oct 11, 2018 @ 03:31 PM

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SilverScript News: U.S. Department of Justice Clears Aetna Acquisition

SilverScript is pleased the U.S. Department of Justice (DOJ) has approved the planned acquisition of Aetna by CVS Health. DOJ’s approval of the transaction is an important milestone, and we remain on track to complete the transaction in the fourth quarter of 2018.

We will keep you informed of developments and look forward to providing more detail following the close of the transaction.

The SilverScript team remains focused on the Annual Enrollment Period, and in serving new and existing members with a commitment to great service, care and value.

Not appointed to represent SilverScript Part D Plans? Request Details

FOR AGENT USE ONLY and not intended for public or general use.

CONFIDENTIALITY NOTICE: This communication and any attachments may contain confidential and/or proprietary information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender immediately by telephone and destroy all copies of this communication and any attachments.

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Average Medicare Advantage Costs Per State

Posted by www.psmbrokerage.com Admin on Wed, Oct 10, 2018 @ 03:40 PM

Medicare Advantage Costs Per State An analysis of CMS data shows average Medicare Advantage plan premiums next year will vary, ranging from $13.80 in Florida and $16.91 in Iowa to $94.92 in Oregon and $115.90 in Minnesota. The overall average monthly premium will be $46.91. Here’s a look at average Medicare Advantage plan amounts, by state, for 2019. To create these averages, we started with the big file of 2019 Medicare Advantage plan information that the CMS posted last week. The file, the 2019 Medicare Advantage Landscape Source Files spreadsheet, is available here. The spreadsheet gives plan price information on a county-by-county basis. In an effort to try to create apples-to-apples comparisons, we used only information for local HMO plans, local PPO plans and regional PPO plans. All plans included in the state averages offer Part D coverage, and all plans included offer “enhanced alternative” drug benefits. Alaska is missing from this data, because Medicare Advantage plans are not available in Alaska. ARTICLE
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Record Medicare Advantage Growth Expected This AEP

Posted by www.psmbrokerage.com Admin on Wed, Oct 10, 2018 @ 03:33 PM

Record Medicare Advantage Growth Expected This AEP A flood of new Medicare Advantage health plans are expected to divvy up a larger pool of seniors flocking to lower premiums, expanded benefits and additional choices for 2019. UnitedHealth, Aetna, Cigna, Humana and Anthem are selling in new markets and additional counties when AEP starts Monday; this is expected to increase the total number of seniors enrolled in M/A for 2019 to more than 22 million. The number of Medicare Advantage choices will increase nearly 20% to 3,700 in 2019 from about 3,100 in 2018, according to the CMS. “More than 91% of people with Medicare will have access to 10 or more M/A plans in 2019, compared to nearly 86% in 2018,” CMS said. The nation’s largest health insurer, UnitedHealth Group, is expanding its individual Medicare plan offerings to 130 more counties in 2019 and entering Minnesota this year. In all, UnitedHealth will offer Medicare Advantage plans in 47 states and Washington D.C. for 2019. And Humana will expand HMO offerings into 97 new counties and PPO plans in 352 new counties for 2019 , and Anthem is launching MA plans in 150 new counties , the insurers said. Aetna, too, has a major expansion underway plans even as it works to complete its merger with CVS Health. Aetna is offering Medicare Advantage Prescription Drug plans in 358 new counties and six new states including a joint venture Medicare Advantage plan in the Minneapolis market with Allina Health, a large provider of medical care in that region. “This represents the biggest expansion of Medicare Advantage in Aetna’s history, giving about 7.4 million more Medicare beneficiaries access to an Aetna plan,” Aetna spokesman T.J. Crawford said of the insurer’s 2019 Medicare Advantage offerings in 45 states and Washington D.C. Meanwhile, Cigna said it’s expanding into Florida, a market rich with seniors, offering two Medicare Advantage plans in the state. Florida has also been a target of Anthem, Centene and Humana, which have purchased doctor practices, clinics, other outpatient operations or regional health plans in the market as a way to complement their Medicare Advantage businesses. Several smaller and startup plans like Bright Health and Devoted Health are also entering the Medicare Advantage business in certain regions of the country, taking advantage of a market of more than 10,000 baby boomers aging into the Medicare population every day. “In most cases, MA plans both entered new counties through acquisition or de novo geographic expansion, as well as offered additional plan benefit packaged options in existing counties,” L.E.K. Consulting’s Kadar said. The open enrollment period runs Oct. 15 to Dec. 7 for seniors signing up for Medicare Advantage or renewing their coverage from this year. Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines, with some even providing vision and dental care and wellness programs. Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025, according to a report last year from L.E.K. Consulting. Currently, just under 35% of Medicare beneficiaries, or about 20 million Americans, are enrolled in MA plans. “We remain bullish on MA and believe that increased availability of plan options at the county level will continue to increase MA penetration going forward,” Kadar said. ARTICLE
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Mutual of Omaha: Medicare Advantage and Part D Enrollment Process

Posted by www.psmbrokerage.com Admin on Wed, Oct 10, 2018 @ 12:09 PM

Mutual of Omaha: Medicare Advantage and Part D Enrollment Process

All Ready to Sell (RTS) agents may begin taking applications for our Mutual of Omaha Rx (PDP) and Mutual of Omaha CareAdvantage (MA) plans effective October 15, 2018. The following provides information on the various application processes for each product.

Please note: Applications must be submitted with 48 hours of the application sign date therefore it is recommended that application be taken electronically whenever possible.

PRESCRIPTION DRUG PLANS (PDP)

PDP Electronic Application
Access to the PDP electronic application can be found on Sales Professional Access (SPA- www.mutualofomaha.com/broker). On the left navigation bar under Sales Tools, click:

Electronic Applications – Prescription Drug Plans e-Application – Start or Continue e-App.

The link allows access to the application platform where you can create a client profile and provide a quote at this time. However, you will not have access to the enrollment application until October 15.

Click to view the PDP Electronic Application Process

PDP Paper Application
A PDP enrollment packets can be order through regular channels – Fax the Order Form or call Sales Support @ 800-693-6083.

Completed paper enrollment forms can be submitted to Mutual of Omaha via fax or mail. The Scope of Appointment (SOA) should be retained by the agent and a copy must be submitted to Mutual either via Fax or email.

Form	FAX	Email	Mail
Application Enrollment	855-867-6711 (Preferred method of submission)	N/A	Mutual of Omaha Rx PO Box 3625 Scranton, PA 18505-9811
Scope of Appointment	402-599-5822	scope@omahapdp.com (Preferred method of submission)	N/A

All paper enrollment forms MUST be submitted to Mutual of Omaha Rx’s enrollment processor within 48 hours after the signed application date.

MEDICARE ADVANTAGE (MA)

MA Electronic Application
The MA electronic application can be found on the MA producer portal, which is accessible on Sales Professional Access (SPA- www.mutualofomaha.com/broker). On the left navigation bar under Sales Tools, click:

Electronic Applications – Medicare Advantage e-Application – Start or Continue e-App

You may begin taking applications 10/15/18.

Click to view the MA Electronic Application Process

MA Paper Application
MA paper enrollment applications can be ordered through the MA producer portal via the Store Front.

There are two options for submitting completed paper enrollment applications.

Producer Online Quick Entry
- Log in to the MA Producer Portal on Sales Professional Access (SPA- www.mutualofomaha.com/broker).
- Select the Start New Application icon
- Complete the form online and upload your paper documents
- Mail the paper documents to our enrollment processing center within 48 hours of application signature.

Producer Phone Enrollment
- Once the application has been completed, the producer MUST leave the beneficiary’s house
- Call Producer Support at 877-259-8657 during business hours (Monday through Friday, 8 a.m. – 5 p.m. CST) and provide details of the application
- If the application is completed after hours, please call by 11 a.m. on the next business day
- Producer is limited to three (3) applications per call
- Be sure to enter the confirmation number in the ‘For Office Use only” section on the last page of the application
- Mail the application, SOA and Agent Checklist to our enrollment processing center within 48 hours of application signature

A pre-addressed, postage paid envelope is included in every sales kit. Mailing address for paper enrollment applications following submission of paper application via either Producer Online Quick Entry or Phone Enrollment:

Mutual of Omaha Medicare Advantage Company
PO Box 12487
St. Louis, MO 63132-9922

Navigating the PDP Product Training Site
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Tags: Annual Enrollment Period, Medicare Advantage, Part D, AEP, mutual of omaha

CMS releases Star Ratings for 2019 Medicare Advantage and Part D prescription drug plans ahead of Medicare Open Enrollment

Posted by www.psmbrokerage.com Admin on Wed, Oct 10, 2018 @ 12:03 PM

CMS releases Star Ratings for 2019 Medicare Advantage and Part D prescription drug plans ahead of Medicare Open Enrollment

Today, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare beneficiaries continue to have access to high-quality health choices for their Medicare coverage as the agency releases the Star Ratings for the 2019 Medicare Advantage and Part D prescription drug plans.

“Medicare Advantage enrollees will continue to have access to high quality plans while plan choices are increasing and premiums are declining,” said CMS Administrator Seema Verma. “Along with the steps the Trump Administration has taken to maximize competition and lower out-of-pocket prices, we are committed to empowering Medicare beneficiaries to make informed choices in choosing high-quality plans that best fit their health needs.”

As announced last month, Medicare Advantage premiums continue to decline while plan choices and benefits increase. In 2019, Medicare Advantage will be offering approximately 600 more plans with the number of plans available to individuals to choose from across the country is increasing from about 3,100 to about 3,700 – and more than 91 percent of people with Medicare will have access to 10 or more Medicare Advantage plans. On average, Medicare Advantage premiums in 2019 are estimated to decrease by six percent to $28.00, from an average of $29.81 in 2018.

As part of CMS’s recently launched eMedicare initiative, Medicare.gov will feature an improved “coverage wizard” to help users compare options at a deeper level to decide if Original Medicare or Medicare Advantage is right for them. CMS will also provide a stand-alone, mobile optimized out-of-pocket cost calculator that will provide information on both overall costs and prescription drug costs.

Each year, CMS publishes the Part C and Part D Star Ratings to measure the quality of, and reflect the experiences of beneficiaries in, Medicare Advantage and Part D prescription drug plans. In 2019, most areas across the country will have Medicare Advantage and Part D plans with four or more stars. Based on current enrollment, approximately 74 percent of Medicare Advantage enrollees with prescription drug coverage are projected to be in plans with four and five stars in 2019 as compared to 73 percent in 2018. Approximately 45 percent of Medicare Advantage plans that offer prescription drug coverage will have an overall rating of four stars or higher in 2019.

Enrollees in stand-alone Medicare Part D prescription drug plans will also have access to high-quality plans. In 2019, approximately 31 percent of stand-alone prescription drug plans will have a rating of four stars or higher in 2019. The majority of enrollees are in stand-alone prescription drug plans with 3.5 stars or higher.

CMS updates the Star Ratings for Medicare Advantage and Part D prescription drug plans every year to help beneficiaries distinguish between plans. In an effort to continually enhance the Star Ratings, CMS made changes to the measures used for the 2019 ratings for health and drug plans based on industry feedback.

The Star Ratings system helps people with Medicare, their families, and their caregivers compare the quality of health and drug plans being offered. Medicare health and drug plans are given a rating on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance. Medicare beneficiaries can compare health coverage choices and the Star Ratings through the online Medicare Plan Finder tool available at Medicare.gov (http://www.medicare.gov).

CMS recently launched the eMedicare Initiative that aims to modernize the way beneficiaries get information about Medicare and create new ways to help them make the best decisions for themselves and their families. Medicare Open Enrollment for 2019 Medicare health and drug plans begins on October 15, 2018, and ends December 7, 2018. Plan costs and covered benefits can change from year to year. People with Medicare should look at their coverage choices and decide the option that best fits their health needs. They can visit Medicare.gov (http://www.medicare.gov), call 1-800-MEDICARE, or contact their State Health Insurance Assistance Program (SHIP). Those people with Medicare who do not wish to change their current coverage do not need to re-enroll in order to keep their current coverage.

For more information on the 2019 Medicare Advantage and Part D Star Ratings, including a fact sheet, please visit: http://go.cms.gov/partcanddstarratings.

To view the premiums and costs of 2019 Medicare health and drug plans, please visit: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/index.html.

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Justice Department approves CVS-Aetna merger with divestiture

Posted by www.psmbrokerage.com Admin on Wed, Oct 10, 2018 @ 11:51 AM

Justice Department approves CVS-Aetna merger with divestiture

On October 10 we learned that the Department of Justice (DOJ) will allow CVS Health’s acquisition of Aetna to proceed.

Under the DOJ consent decree, closing of the CVS Health-Aetna transaction may proceed prior to the effective date of Aetna’s previously announced divestiture of its entire standalone Medicare Part D business to a subsidiary of WellCare Health Plans, Inc. Aetna and CVS Health will continue to operate as separate companies until the CVS Health transaction is complete.

While the DOJ decision is an important step toward finalizing the CVS Health transaction, closing remains subject to certain state regulatory approvals and satisfaction of other closing conditions. We continue to expect the CVS Health transaction to close this year.

We value our relationship, and will keep you informed every step of the way in accordance with the terms of our current agreements.

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna, AEP

Product Spotlight: SilverScript Part D Plans

Posted by www.psmbrokerage.com Admin on Tue, Oct 09, 2018 @ 04:09 PM

SilverScript Part D Drug Plans

Silverscript_logo

“In an era of rising drugs costs, our goal is to help keep out-of-pocket costs lower for America’s seniors. That is why we want to ensure consumers know they have options, and we are providing enhanced choices to meet their individual needs from both a prescription and financial standpoint.”

-Todd Meek, President, SilverScript Insurance Company, CVS Health

Indeed SilverScript has both expanded and enhanced their product options for 2019. Already the #1 Prescription Drug Plan of choice among seniors for three years running with their zero deductible Choice and Plus plans, SilverScript will begin offering a third plan option in 2019 - SilverScript Allure.

SilverScript Allure:

New for 2019, SilverScript Allure offers an enhanced plan design for people taking brand name medications in higher drug tiers, and offers low out-of-pocket costs on many generic and brand name drugs through point-of-sale (POS) rebates. Listed below are some of the highlights:

$0-deductible on all covered drugs, $0-copays for 90-day supplies of Tier 1 drugs when filled by CVS Caremark Mail Service Pharmacy and the same large national pharmacy network as the SilverScript Plus plan.

Immediate access to your copay and coinsurance benefits and up to $415 in savings on deductible costs.

While SilverScript Allure features a higher premium than the other SilverScript plans, it offers beneficiaries lower out-of-pocket costs for their prescription drugs, including copays as low as $1 on a 30-day supply of a Tier 1 drug when filled at a preferred retail pharmacy.

The plan also offers reduced costs on many brand name drugs through the application of point-of-sale rebates where a portion of pharmaceutical manufacturer rebates on certain Tier 3, Tier 4, and Tier 5 brand drugs is applied directly to the drug’s price when the member purchases the prescription at any retail pharmacy or by mail.

As captivating as the new Allure plan is, rest assured SilverScript is not giving up on their two staple products, Silverscript Choice and Silverscript Plus.

With over 6 million enrolled in 2018, these two plans have made Silverscript the #1 product of choice based on membership enrollment. Below are just of few of the highlights of these two hot-selling plans:

SilverScript Choice:

The most popular plan that offers:

Offers a $0-deductible on all covered drugs in most states.

$0-copays for 90-day supplies of Tier 1 drugs nationwide when filled through the CVS Caremark Mail Service Pharmacy.

Immediate access to your copay and coinsurance benefits and up to $415 in savings on deductible costs.

Up to 50% savings on copays at preferred network pharmacies.

16% Savings on 90-day prescriptions through CVS Caremark Mail Service Pharmacy.

SilverScript Plus:

An enhanced plan that provides additional coverage in the Coverage Gap (or Donut Hole). The Plus plan is designed for people who take several medications on a regular basis and are likely to reach the Coverage Gap during the 2019 plan year:

Offers a $0-deductible on all covered drugs in most states.

Additional copay coverage benefits for those that enter the Medicare Coverage Gap.

Save up to 90% with preferred copays at thousands of preferred pharmacies.

16% Savings on 90-day prescriptions through CVS Caremark Mail Service Pharmacy.

Additional savings with delivery by mail, including $0 copays on 90-day supplies of Tier 1 and 2 drugs.

Why agents love selling SilverScript:

5 Different Enrollment Options – streamlined for an efficient and easy selling process, whether Face-to-Face or Over The Phone.

Electronic SOA Capability – with a repository of completed SOAs to print and use whenever need be.

Superior Agent Portal – enhanced with new reporting features and a great Drug Pricing Tool for comprehensive comparisons on their 3 Part D Plans.

This year’s AEP is expected to be record setting and it’s obvious that SilverScript is poised to continue their dominance in the PDP marketplace.

These new plan designs and enhancements will being added value to the SilverScript product in your portfolio by giving you more options to meet your clients’ ever changing drug needs.

Call now to talk to one of our stellar marketing staff for details on how you can start selling these plans today.

Not appointed with SilverScript? I encourage you to learn more and put this in-demand product in your portfolio, request details here

Additional Updates:

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Tags: Part D, silverscript, product spotlight

Medicare Supplement Enrollment Percentage by State

Posted by www.psmbrokerage.com Admin on Tue, Oct 09, 2018 @ 01:17 PM

Medicare Supplement Enrollment
Across America

If you sell Medicare Supplement plans, this might help you better focus your marketing efforts on where you will have the most success. In 20 states (as of 2016), at least 25% of Medicare beneficiaries have a Medicare Supplement, largely highest in the Midwest and Plains states.

Additional Updates:

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Tags: Medicare Supplement

Increase Your AEP Sales with the Connecture Quote & Enrollment Platform

Posted by www.psmbrokerage.com Admin on Tue, Oct 09, 2018 @ 09:17 AM

Increase Your AEP Sales with the Connecture Quote & Enrollment Platform

Untitled-1-18Increase Your AEP Sales with the Connecture Quote & Enrollment Platform

We have partnered with Connecture, the leading provider of web-based Medicare plan comparison and enrollment services to assist you with your Medicare Advantage & PDP sales. This is a great time to have access to this platform as we head into AEP.

Independent agents play a vital role in helping seniors secure the most cost-effective Medicare plans for their individual needs. This comprehensive tool simplifies the sales process with multi-carrier shopping and enrollment platforms wrapped into a single online experience. And best of all, this platform is available at no cost to PSM agents.

Connecture’s industry-leading Medicare solution powers dynamic, personalized shopping experiences and electronic enrollment capabilities across a variety of distribution channels. In addition, their technology powers the Medicare.gov Plan Finder and online enrollment center.

"66% of Medicare Advantage & Part D electronic enrollments are facilitated on the Connecture platform, making it the most widely used Medicare decision support tool available."

Why is Connecture's Medicare solution so trusted?
Connecture's platform provides beneficiaries with plan options based on their individual needs, and help them find alternative medications that save money. Connecture’s solution helps you guide Medicare customers with meaningful decision-support tools and personal engagement experiences that strengthen relationships.

So how do I get access?
For more details, and to have access to this free tool, please request access here.
You can also contact your marketing representative at 800-998-7715.

Get to know Connecture's Medicare solution

Additional Updates:

Humana: 10 Step Selling Process Guide for Med Supp, MA and PDP - View
LTC Benefits creep into 2019 Medicare Advantage plans - View
Dental coverage and the Medicare eligible. Opportunity for agents - View
Will CMS policy changes have an impact on the healthy age-in market? - View
Mutual of Omaha Part D and Medicare Advantage materials available
Express: Mutual of Omaha weekly updates - View
VALUES Quote of the Week - View
Current agent incentive trips and contests - View

Medicare Advantage / AEP Updates:

Your path to AEP success with Precision Senior Marketing - View
Enroll your MA and PDP clients online - at no cost to you - View
2019 Medicare Advantage / Part D Certifications now available - View
2019 Medicare Advantage First Looks now available - View
2019 AEP Road Map - Start your planning today - View
The DSNP Market continues to grow. Are you missing out? - View

0 Comments Click here to read/write comments

Tags: Medicare Advantage, Part D, Connecture, DRX, Enrollment Tools

LTC Benefits Tiptoe Into 2019 Medicare Advantage Plans

Posted by www.psmbrokerage.com Admin on Mon, Oct 08, 2018 @ 04:37 PM

LTC Benefits Tiptoe Into 2019
Medicare Advantage Plans

medicare card

Medicare Advantage plan issuers seem to be taking a quiet, careful approach to adding home- and community-based long-term care (LTC) benefits for 2019.

About 1.5 million of the 2019 enrollees, or 7.5% of Medicare Advantage plan enrollees, may have access either to support services in the home or community, or to extra benefits designed to help enrollees cope with the burden of diabetes or other chronic conditions, according to officials at the Centers for Medicare and Medicaid Services (CMS).

But CMS officials have not given an estimate of how many enrollees might have access solely to the new home- or community-based services.

It’s not easy to tell, for someone looking at CMS 2019 plan information or the plan issuers’ own benefits summary sheets, which plans will take advantage of the new CMS chronic care and “social determinants of health” benefits flexibility.

In Arizona and California, for example, units of Anthem Inc. are openly stating that they will use the new flexibility to beef up the benefits offered by some plans.

Enrollees in certain Anthem plans will have access to what amount to LTC benefits provided for a short period of time:

Three meals delivered per day for up to 42 days.
Four four-hour shifts of in-home assistance with daily living activities, such as laundry.
40 hours of respite care for caregivers per year.
One visit per week for adult day care center services, for older adults who need supervision.
Health care appointment transportation services.

Traditionally, commercial insurers have referred to benefits for small amounts of LTC-type services with terms such as “convalescent care benefits,” or “short-term care benefits.”

SCAN Health Plans of Long Beach, California, says it will offer new in-home benefits through most plans in Southern California, but it’s not easy to tell which new benefits will be related to the new rules.

UnitedHealth Group Inc.’s UnitedHealthcare unit says it will make telemedicine services available to 1.7 million enrollees through phones and computers, and health-related transportation services available to 1.7 million enrollees. The company is also offering a care management and care planning service for caregivers to most of its Medicare Advantage plans. It’s not clear from the company’s 2019 plan announcement whether those benefits are related to the new CMS rules.

Medicare Advantage Basics

Medicare is a federally funded and federally run program that serves Americans ages 65 and older, people who qualify for Social Security Disability Insurance benefits, and Americans who need kidney dialysis.

The Medicare Advantage plan program gives private health coverage providers a mechanism for providing an alternative to traditional Medicare program coverage.

The annual enrollment period for 2019 is set to start Oct. 15 and run until Dec. 7.

CMS has succeeded at keeping the Medicare Advantage market rules a lot more stable than the rules in the individual major medical market. CMS officials are predicting enrollment to increase more than 11% in the coming year, to 23 million, or 36% of the 63 million people who have Medicare benefits next year.

Another program, Medicaid, serves poor people and people who meet state Medicaid nursing home benefits eligibility requirements.

Medicaid is a program made up of state-administered plans that are funded with a combination of state and federal money.

Medicare, Medicaid and Long-Term Care

Traditionally, Medicaid has been the government health program that pays for nursing home care.

Federal rules have blocked Medicare from paying for long-term care.

Medicare has paid for skilled nursing care for people recovering from serious acute health care problems,

Medicare also paid for home health care services.

But Medicare has not paid for nursing home care for people who are in a nursing home simply because they are frail or have trouble with the activities of daily living, such as bathing or eating.

Medicare has also avoided paying for other types of in-home services, such as help with cleaning or laundry, that might help keep older people in their homes.

In May, CMS said it would change Medicare Advantage benefits rules, to give issuers ways to offer new benefits for the “social determinants of care” that might help reduce overall medical spending.

Officials suggested, for example, that, in some cases, spending a little money on transportation services or meal delivery for someone with serious health problems might be a good way to avoid spending a lot of money on hospital care.

Read the full article

Additional Updates:

0 Comments Click here to read/write comments

Tags: Medicare Advantage, Part D

Humana MAPD, PDP and Medigap 10 Step Selling Process

Posted by www.psmbrokerage.com Admin on Fri, Oct 05, 2018 @ 02:07 PM

Humana MAPD, PDP and Medigap
10 Step Selling Process

Click here to download the 10 Step Selling Process guide

Additional Helpful Resources:

Compliant Sales Videos: 2019 Medicare Plan Presentation Videos

Link to order supplies: 2019 Materials Order Link

FOR AGENT USE ONLY

Additional Updates:

0 Comments Click here to read/write comments

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

Sell more this AEP with Aetna: Enhanced provider search tools

Posted by www.psmbrokerage.com Admin on Fri, Oct 05, 2018 @ 10:02 AM

Aetna Medicare Advantage:
Enhanced provider search tools for AEP success

Aetna has made BIG improvements to their Medicare provider search tools, aetnamedicare.com/findprovider and coventry-medicare.com/findprovider. The updated tools make it easier and faster for you to assist your clients this AEP season. Some recent enhancements include:

New responsive design allows you to search on tablets and smart phones, too
New easy-to-use features
Enhanced search functionality
New guided search makes the most commonly-searched terms easy to find

Quick tips and tools

Provider network tools flyer – This quick reference guide covers online tools, provider directory PDFs, and more
Provider lookup tools training – Provides step-by-step instructions

If you have any questions, just contact your local Aetna Medicare Broker Manager.

We wish you a successful AEP! Let us know how we can help you grow your Medicare business in 2019.

Not appointed with Aetna? Request details here

Additional Updates:

0 Comments Click here to read/write comments

Tags: Medicare Advantage, aetna, AEP

Will CMS Policy Changes Have an Impact on the Healthy Age-in Market?

Posted by www.psmbrokerage.com Admin on Thu, Oct 04, 2018 @ 04:40 PM

Will CMS Policy Changes Have an Impact on the Healthy Age-in Market?

For many years Deft Research studies have shown that persons who are aging into Medicare coverage are equally likely to gravitate toward Supplemental Medicare (aka, Med supp) products and Medicare Advantage (MA) products. The primary reasons for Medsupp remaining attractive despite its price disadvantage are its unrestricted access to doctors and hospitals, and the simplicity of coverage terms leading consumers to feel more certain about what they are buying. Suspicion and lack of trust in Medicare Advantage’s detailed list of provisions and restrictions drives many away.

But in coming years, Medicare Advantage product designers will have opportunities to restore trust among consumers. And if they do, they will steer more market share toward these plans. For the MA 2019 contract year, the Centers for Medicare and Medicaid Services (CMS) has promulgated new policies allowing MA plans to offer more supplemental benefits and allow more flexibility in how benefits are offered. The new policies create opportunities for MA plans to meet a wider set of consumer needs. However, getting consumers to react to the term “coordinated care” and communicating health care value to consumers is difficult. It remains to be seen whether those new to Medicare – the age-ins – will recognize the value and be more likely to select MA over Medsupp.

From a high altitude, the new policies enable MA plans to include supplemental benefits in their health plan designs. This conjures visions of greater care coordination, more differentiated products, stronger relationships with providers, and increased opportunities to promote wellness and reduce costs.

CMS outlines two sets of criteria for supplemental benefits to be accepted as health-related and appropriate for inclusion in an MA package. A supplemental benefit must be “used to diagnose, prevent or treat an illness or injury, compensate for physical impairments, act to ameliorate the functional/psychological impact of injuries or health conditions, or reduce avoidable emergency and health care utilization.” Secondly, the benefit must be “medically appropriate, focus directly on the enrollee’s health care needs and be recommended by a physician or licensed medical professional as part of a care plan.”

In advance of the June bids, there were several areas of supplemental benefits that CMS stressed (and no doubt these were subsequently emphasized in the health plan bids submitted).

Adult Day Care Services– these are services for adults who need a safe place to be during the day when other caregivers may not be available. The health status of the consumers using ADCS varies, but the service tends to be used by persons with some health problem that requires at least monitoring or assistance.
In Home Support Services and Home-based palliative care– are services performed by personal care attendants to help persons with activities of daily living, and/or provided by health professionals to diminish pain and other symptoms in very ill persons, and/or enhance bathrooms and other areas of the home to reduce the risk of injury.
Transportation– must be used to accommodate an enrollee’s heath care needs and, for this discussion, is not an emergency service. Missing appointments and failure to fill prescriptions are common signals that health problems are not managed, prevented, or addressed as well as could be. By making travel more convenient, a transportation service can contribute to better health.

MA companies are excited about the CMS allowance of greater flexibility on offering benefits.

For health plans, this means benefits can be offered to targeted populations, and generate a greater return on investment. This prompts greater sustainability of programs. Health plans will be able to reduce cost sharing for certain covered benefits, offer tailored supplemental packages targeted for specific populations, and reduce deductibles for beneficiaries that meet specific medical criteria.

Other supplemental benefits exist beyond what is outlined here. Many of the supplementals and new flexibility CMS address the needs of consumers who are quite ill. So how could these changes affect the broader Medicare market? There are three ways that new age-ins’ can be made more likely to consider a Medicare Advantage plan.

By being different. The changes are enough to signal to age-ins that MA is no longer the same old deal. The new offerings change the old value proposition.
By presenting higher value. Studies show that presenting a “Cadillac” plan containing extended benefits generates more attractiveness even though consumers may not need the benefits at the time of purchase.
By generating more trustworthiness. Extended supplemental benefits can be positioned to support the promise that, “we will take care of you if the worst happens.” They help reduce the worry that a managed care plan limits services and won’t deliver in a time of greatest need. They show that the health plan is organized to provide a complete package to meet every need, thereby offering a proof of trustworthiness.

Additional Updates:

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Tags: Medicare Advantage, Medicare, Medicare Supplement, med supp

CMS Extends Important Relief Opportunity, Creates Permanent Fix for those Affected

Posted by www.psmbrokerage.com Admin on Thu, Oct 04, 2018 @ 04:13 PM

CMS Extends Important Relief Opportunity, Creates Permanent Fix for those Affected

The Centers for Medicare & Medicaid Services (CMS) recently announced a year-long extension, through September 30, 2019, of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed Medicare enrollment. The agency also agreed to develop a more permanent solution for people who are affected.

Under this policy, people who are eligible for Medicare and have Marketplace coverage can apply to enroll in Medicare Part B without penalty. Those who have already transitioned to Medicare can request that any Part B late enrollment penalties they may have received be reduced or eliminated.

Additional Updates:

0 Comments Click here to read/write comments

Tags: dental hearing and vision insurance, dental plans

Dental Coverage and the Medicare-Eligible

Posted by www.psmbrokerage.com Admin on Thu, Oct 04, 2018 @ 11:40 AM

Dental Coverage and the Medicare-Eligible

There are 51 million Americans 65+, a number that will increase to more than 68 million in the next decade. One of Medicare’s limitations is dental care, and since only 40% of seniors have their own dental insurance coverage, there’s a sizeable opportunity for insurance agents during AEP:

Just 40% of Medicare beneficiaries have dental coverage, so the majority of them must pay for dental services out of their own pocket;
Many seniors are unaware of the lack of Medicare’s dental coverage and of specific dental insurance available to seniors;
Estimates suggest more than 13 million beneficiaries might purchase new dental insurance, a number that will grow to 17 million by 2027.

View Dental Plans PSM represents

Senior Population and Dental Coverage Forecast

Article

Additional Updates:

0 Comments Click here to read/write comments

Tags: dental hearing and vision insurance, dental plans

Mutual of Omaha: It’s Showtime! Check out these enhancements

Posted by www.psmbrokerage.com Admin on Thu, Oct 04, 2018 @ 10:14 AM

Get into the Act with Medicare Solutions!

Even though Medicare supplements are the main attraction, you can wow your audience with a full suite of Medicare Solutions products.

We've expanded our Medicare Solutions portfolio to include all the coverage your Medicare-age clients may need:

Medicare Supplements
Prescription Drug Plans
Dental & Vision Coverage

You've got the audience in the palm of your hand. So, show them how convenient it is to be able to purchase everything they need from you...with plans backed by a company they know and trust. Then, take a bow!

Ready to Learn More?

Download these helpful materials to get started:

Don't forget to check out the Medicare Solutions page of Sales Professional Access for everything else you need — including training and certification to sell prescription drug plans.

Not appointed to sell Mutual of Omaha Medicare Supplement plans? Request details here

Additional Updates:

0 Comments Click here to read/write comments

Tags: Annual Enrollment Period, Medicare Supplement, AEP, mutual of omaha

Mutual of Omaha: Prescription Drug Plan Materials Available to Order

Posted by www.psmbrokerage.com Admin on Wed, Oct 03, 2018 @ 04:23 PM

Mutual of Omaha
Prescription Drug Plan Materials
Available to Order

Great News!
Marketing materials for Mutual's new Prescription Drug Plans (PDP) are now available to order.

Prescription Drug Plans (PDP)
All available marketing materials for the PDP products can be viewed and downloaded on Sales Professional Access (SPA- www.mutualofomaha.com/broker) under Forms and Materials. Search by using Omaha Health Insurance Company as the underwriting company.

Orders for the PDP Enrollment Packet may be placed using the Materials Order Form or by calling our Sales Support team at 800-693-6083.

The enrollment packet is not state specific – it is a national version. When using the order form or requesting an order simply request the total desired quantity of PDP Enrollment Packets. Due to system limitation we must select a state to place the order. At this time we are defaulting to Nebraska, which will show on your order confirmation email.

In addition, prospecting materials can be ordered using the PDP Prospecting Materials Order Form.

Navigating the PDP Product Training Site
Ready to sell Guidelines

Not appointed to sell Mutual of Omaha Part D plans? Request details here

Additional Updates:

0 Comments Click here to read/write comments

Tags: Annual Enrollment Period, Medicare Advantage, Part D, AEP, mutual of omaha

Mutual of Omaha: Medicare Advantage Marketing Materials Available to Order

Posted by www.psmbrokerage.com Admin on Wed, Oct 03, 2018 @ 04:10 PM

Mutual of Omaha
Medicare Advantage Marketing Materials Available to Order

It's Here!
Marketing materials for Mutual's new Medicare Advantage product are now available to order.

All marketing materials for the MA product can be viewed and ordered through the Medicare Advantage producer portal.

MA marketing materials are not available to view on the SPA Forms and Materials site; however, the link to the MA producer portal can be found on the Forms and Materials landing page. (The link is only viewable to those producers who are contracted to sell Medicare Advantage)
Once in the MA producer portal the login screen can be found under the Documents - Resources - Store Front for Supply Orders
Login User Name: Your National Production Number (NPN)
Password: mutual
Access to the ordering in the Store Front will be limited to NPNs that are Ready to Sell for Mutual of Omaha Medicare Advantage
Ordering process is similar to most on-line shopping experiences
Any shipping information you provide can be given an "Address Label' (or name) that is saved and can be retrieved for future orders
There is no charge for materials. When reviewing your order the total billed amount will show $0.00. The billing information you see is for internal use only

For more details and to view screenshots of the site, click here.

Navigating the MA Product Training Site
Ready to Sell Guidelines

Not appointed to sell Mutual of Omaha Medicare Advantage plans? Request details here

Additional Updates:

0 Comments Click here to read/write comments

Tags: Annual Enrollment Period, Medicare Advantage, AEP, mutual of omaha

Medicare Advantage Now the "Choice"

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 04:25 PM

Medicare Advantage Now the "Choice"

Medicare advantage is now the product of choice

As of March 2018, Medicare Advantage plans served 21.1 million people of the 61.2 million eligible. The proportion of eligible Medicare members selecting M/A increased to 34.5% in March 2018 from 33.8% in 2017. M/A membership increased by 7.5% from 19.6 million in March 2017.

M/A participation increased from 12.9% of total beneficiaries in 2005 to 34.5% in 2018. In every year since 2007 – except for 2016 and 2018 – the net number of people joining M/A plans exceeded those joining traditional Medicare. While there are 13.4 million more people eligible for Medicare, the number of people served by traditional Medicare is now 2.4 million higher than it was in 2005. In other words, 74% of the additional Medicare beneficiaries since 2005 are in Medicare Advantage, as opposed to 26% in traditional.

Medicare Advantage Share

Capture-48

Read the full report here

Additional Updates:

CMS promotes Medicare Advantage plans ahead of Oct 15 enrollment - View
Medicare Advantage premiums to decrease by 6% in 2019 - View
The AEP is almost here. Are you ready? - View
Aetna signs an agreement to divest all Part D business to Wellcare - View
2019 Medicare and You Handbook updates - View
Be the hero this AEP with Ameritas dental plans - View
Americo releases High Deductible Plan F plans - View
15 of Jim Rohn's most memorable quotes - View
Express: Mutual of Omaha weekly updates - View
VALUES Quote of the Week - View
Current agent incentive trips and contests - View

Medicare Advantage / AEP Updates:

Your path to AEP success with Precision Senior Marketing - View
Enroll your MA and PDP clients online - at no cost to you - View
2019 Medicare Advantage / Part D Certifications now available - View
2019 Medicare Advantage First Looks now available - View
2019 AEP Road Map - Start your planning today - View
The DSNP Market continues to grow. Are you missing out? - View

0 Comments Click here to read/write comments

Tags: Medicare Advantage

Aetna: 2019 sales presentations | How to submit enrollments | Provider look up tools

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 02:44 PM

2019 sales presentations | How to submit enrollments | Provider look up tools

Medicare Producer News

Individual MA/MAPD, PDP: October 02, 2018

Start marketing 2019 plans as of October 1
Download 2019 MA/MAPD sales presentations
How to submit 2019 enrollments: NEW addresses & fax numbers
Fresh look for AetnaMedicare.com
Provider look up: Are your clients' doctors in-network?
Order/download 2019 AEP marketing materials on Studio

Ready, set, go — 2019 AEP marketing is here!

If you’re ready to sell, you can begin marketing 2019 plans as of October 1, for the Annual Election Period (AEP). In 2019, we’ve got more MA/MAPD plans in more counties than ever before! Remember, you’re allowed to hand out enrollment applications for CY2019 products starting October 1, but you may NOT accept, collect or take possession of a completed AEP enrollment application prior to October 15, unless the beneficiary is entitled to another valid enrollment period. Learn more.

Download 2019 MA/MAPD sales presentations

The 2019 MA/MAPD sales presentations are now available to download from Producer World. As of October 1, you're required to use these CMS-approved presentations at all MA/MAPD sales events. Talking points are also provided to assist you, but please remember they are for agent-use only and can't be shared with beneficiaries.

Coming soon:

Spanish versions of MA/MAPD sales presentations
English/Spanish versions PDP sales presentations
Sales presentation videos

How to submit 2019 MA/MAPD and PDP enrollments

Starting October 15, you'll have several options to submit 2019 MA/MAPD or PDP enrollment applications. There are a few important changes this year. Please note that mailing addresses and fax numbers vary by plan and some have changed for 2019. Make sure you send paper applications to the specific address or fax number listed on the enrollment form.

Don’t forget, when assisting clients, you’re responsible for answering all their questions, and submitting a complete enrollment application within two calendar days after they sign the application.

REMINDER: You may NOT accept, collect or take possession of a completed AEP enrollment application prior to October 15, unless the beneficiary is entitled to another enrollment period.

New and improved AetnaMedicare.com

We recently launched a enhanced Medicare website that delivers our brand promise. Published in English and Spanish, it’s an incredible resource that provides educational content and online tools that empower consumers to effectively choose the right Aetna Medicare plan to help them age actively. As part of the revamped site, we launched a new needs-based recommendation engine, which helps match consumers with a product that can best meet their needs. We invite you to visit the site and explore what it has to offer at AetnaMedicare.com.

How to find network providers for MA/MAPD plans

It's easy to search for in-network providers. Just use our online directory tools, AetnaMedicare.com/findprovider and Coventry-Medicare.com/findprovider. They're updated 6 days a week.

New 2019 AEP materials added on the Studio— Order or download today!

You can now order and download 2019 AEP marketing materials on the Medicare Marketing Studio (the Studio). We've added tons of new materials. And we’ll keep adding materials until 2019 AEP starts! You’ll find:

NEW lead gen ads (black/white and color)
NEW expansion flyers and postcards
NEW Aetna branded signs

Don’t forget to update your user profile on the Studio

We base all of the customized materials on Studio off the information in your user profile. To ensure you’re able to see all the correct materials, and that your contact information appears correctly on personalized materials, please verify your user profile is up-to-date. Incomplete profiles may cause issues or delays with processing your orders. To review and update your user profile, just select “My Profile” in the top menu bar in the Studio.

Not appointed with Aetna? Request details here

Additional Updates:

0 Comments Click here to read/write comments

Tags: Medicare Advantage, aetna, AEP

Bankers Fidelity: Underwriting and Compliance Updates for AEP

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 11:02 AM

Bankers Fidelity: Underwriting and Compliance Updates for AEP

As Medicare's busy season approaches, it is important to refresh yourself with the different requirements between carriers so you can be prepared when submitting business during AEP. Marketing with branded collateral to advertise a carrier to your clients can be tricky for compliance reasons. To stay compliant and submit business seamlessly this AEP, we have shared a few tips and tricks from our Compliance and Underwriting departments below.

UNDERWRITING

Submit your applications at least 30 days prior to the effective date. This allows underwriting adequate time to review your application. Bankers has begun accepting applications 90 days prior to the effective date starting October 1, 2018.
The most common reason for a delayed application is due to the underwriter's need to complete counter offers because of an incorrect rate assumption. Review the Underwriting Guidelines and product-specific guidelines before submitting applications. This will help you determine if a product should be offered at a standard or preferred rate.

To check the status of a pending application or any actions needed, be sure to utilize the reporting, such as the Underwriting Application Tracker, available in your agent portal.
Submitting business electronically cuts processing time 1 to 2 days. Utilize our eApp to submit your applications through your agent portal.

COMPLIANCE

Review each bulletin emailed to your inbox. Field bulletins include important Home Office announcements and product information regarding rate changes, updated applications, product withdrawals, and office closures. By becoming familiar with changes to our products, it is likely that your applications will process more smoothly.
Don't use scare tactics and make promises to your clients that you can't keep. It's easy to tie an intangible product like insurance to an emotional need, as long as that emotion isn't based on fear.
Always request to use the Bankers Fidelity logo, whether in print or digitally. We'll be happy to work with you on approving the use of our logo and delivering an image that will be the correct fit for your needs.
Have a need for branded marketing collateral? Log in to BOLT^® Marketplace, powered by Vistaprint^®Corporate, to customize Bankers Fidelity branded marketing pieces with your contact in formation. It's as simple as logging in, customizing, and ordering!
Staying compliant on social media during AEP can be tricky. Don't be afraid to simply share posts from gov, CMS, and other carriers instead.

Additional Updates:

0 Comments Click here to read/write comments

Tags: Annual Enrollment Period, Medicare Supplement, AEP, bankers fidelity

Mutual of Omaha: It’s Showtime! Prepare to be amazed by our Medicare supplement rates

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 10:52 AM

Our Rates Will Have You Flying High!

Nothing could be better than helping your clients find the right Medicare supplement plan at an incredible price. At Mutual of Omaha, they take pride in providing you some of the most affordable Medicare supplements in the industry.

Contact one of our marketing representatives today at 800-998-7715 and make sure you have the most current Med Supp rates Mutual of Omaha has to offer in your state.

Not appointed to sell Mutual of Omaha Medicare Supplement plans? Request details here

Additional Updates:

0 Comments Click here to read/write comments

Tags: Annual Enrollment Period, Medicare Supplement, AEP, mutual of omaha

18 No-Brainer Ways to Connect with More Prospects More Easily

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 10:45 AM

18 No-Brainer Ways to Connect with More Prospects More Easily

Looking for a few easy, virtually-free ways to immediately connect with more prospects? I’m willing to bet you just said, "That’s a no-brainer."

Below, are 18 methods for reaching prospects. Some of them take seconds to deploy, and all of them will save you time throughout your workday. To help prioritize first steps, they are in sequential order -- starting with those that offer value the fastest and ending with those that require more time.

However, don’t stop after the first few. They provide the groundwork for the tips at the bottom -- which are well worth the extra effort.

Here is a link to the Hubspot article with all the details. Hope this helps in your prospecting and follow-up efforts.

Additional Updates:

0 Comments Click here to read/write comments

Tags: following up after the sale, prospecting

Medicare Tweaks Its 2019 Medicare and You Handbook

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 10:31 AM

2019 Medicare and You Handbook

Medicare’s AEP begins in less than two weeks, and the CMS released its final handbook that serves as a central guide for seniors and disabled people signing up for coverage. There are changes, omissions and new information.

CMS has also made it more accessible by providing a website to review the handbook online as well as download in numerous formats.

Here is a link to the website: https://www.medicare.gov/medicare-and-you

You can also click on the image below to download the handbook in PDF

Additional Updates:

0 Comments Click here to read/write comments

Tags: medicare updates

CMS announces new streamlined user experience for Medicare beneficiaries

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 08:56 AM

Today, the Centers for Medicare & Medicaid Services (CMS) announced a multi-year initiative that will empower patients and update Medicare resources to meet beneficiaries’ expectation of a more personalized customer experience. The eMedicare initiative will modernize the way beneficiaries get information about Medicare and create new ways to help them make the best decisions for themselves and their families.

The eMedicare initiative’s goal is to provide a seamless online health care experience to meet the growing expectations for this generation of Medicare beneficiaries. CMS has a cohesive, multi-year strategy of consumer data integration and web product development to modernize Medicare.gov and improve access to personal health care data. The road map for this program will enhance opportunities to go digital, offer additional self-serve options, and create a seamless multi-channel customer service experience.

“Since day one, President Trump has been committed to strengthening the Medicare program—eMedicare puts his leadership into action by giving Medicare beneficiaries a simpler, more intuitive customer experience,” CMS Administrator Seema Verma said. “Our intent is not to replace traditional channels that beneficiaries trust and depend on, but to improve and enhance them with the emerging digital options to create a user-centered, seamless consumer experience.”

Some of the new eMedicare initiatives that CMS is launching ahead of Medicare Open Enrollment are:

An improved coverage wizard to help beneficiaries compare options at a deeper level as a way to decide if Original Medicare or Medicare Advantage is right for them;
A stand alone, mobile optimized out of pocket cost calculator that will provide information on both overall costs and prescription drug costs;
A simplified log in for the Medicare Plan Finder (https://www.medicare.gov/find-a-plan/questions/home.aspx) tool using their online account (instead of the current process of entering 5 pieces of information to authenticate);
A webchat option, which will be available within the Medicare Plan Finder for some beneficiaries; and
New easy to use surveys available across Medicare.gov so beneficiaries can continue to tell us what they want.

These changes are building on previous improvements including:

Giving beneficiaries the ability to print their Medicare card online;
Re-designing the Mymedicare.gov homepage for easier navigation;
Launching consumer-facing Blue Button features in Mymedicare.gov;
Providing an online version of the Medicare & You Handbook in a mobile-friendly format. We’ve also added simple, graphical explanations at the beginning of the Medicare & You handbook;
Improving email communications. Medicare emails more than 8 million beneficiaries with information about Open Enrollment, preventive benefits, money saving tips, and fraud prevention.
Enhancing social media presence—Medicare’s Facebook page has grown to almost a half-million followers;
Distributing the electronic version of the Medicare Summary Notice, allowing people with Medicare to view their explanation of benefits in a more timely manner online at Mymedicare.gov ; and
The eMedicare initiative will expand and improve upon current consumer service options. People with Medicare will continue to have access to paper copies of the Medicare & You handbook and the Medicare Summary Notice.

CMS launched the initiative with a new video that includes insights from Medicare beneficiaries on what they expect from Medicare and remarks from Administrator Verma outlining her vision for modernized program. Approximately 10,000 people join Medicare each day. The Medicare population is expected to increase to more than 80 million beneficiaries in 2030, up from 54 million in 2015. As of 2016, about two-thirds of Medicare beneficiaries indicate they use the Internet daily or almost daily (65%).

Read a Medicare.gov blog about eMedicare: https://www.medicare.gov/blog/emedicare-another-step-to-strengthening-medicare.

Additional Updates:

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Tags: medicare updates

SilverScript Insurance Company Agent Update – October 1, 2018

Posted by www.psmbrokerage.com Admin on Tue, Oct 02, 2018 @ 08:43 AM

SilverScript_Logo_No_Border

SilverScript Insurance Company Agent Update – October 1, 2018

As we enter October and the Annual Enrollment season, we want to provide you with helpful information to enhance your SilverScript knowledge and assist your efforts for a rewarding and efficient AEP.

Keep this in mind: when you are on the SilverScript Agent Portal, be certain you have selected the appropriate 2018 or 2019 plan year to access/view the appropriate plan year’s functionality.

2019 SilverScript Plan Designs – Keep These Things in Mind!

SilverScript Choice PDP: In most regions, the SilverScript Choice PDP has a $0 deductible while lower premium plans from other plan sponsors include deductibles that are as high as $415. Our SilverScript Choice PDP will likely be very competitive when total cost analysis is considered and beneficiary’s decide to insure themselves from the costs associated with potential Tier 3 through Tier 5 prescriptions.

NEW! SilverScript Allure PDP: This innovative new plan applies a portion of pharmaceutical manufacturer rebates earned on certain brand drugs directly to the drug’s price when the prescription is purchased. This passes savings on to members by reducing the price for these select drugs, thereby lowering the member’s out-of-pocket cost for these medications. For this reason, you may see a different price for the same drug when comparing SilverScript Allure to other SilverScript plans using drug pricing tools on Medicare.gov, SilverScriptAgentPortal.com, and other price comparison tools. The SilverScript Allure PDP has copays as low as $1 on Tier 1 drugs at preferred pharmacies and a $0 deductible on all tiers. The SilverScript Allure plan is not available in AK.

Additional information: The SilverScript 2019 plan designs are posted on the SilverScript Agent Portal’s Resources/Plan Offerings page.

2019 Enrollment Kits - Supplies

An order for a 10-pack of SilverScript enrollment kits are automatically triggered when agents complete their SilverScript annual certification. Please log into the SilverScript Agent Portal, select the 2019 plan year, and go to the “I Want To…” tab then click on Order Enrollment Kits to order more kits. Kits typically ship the next business day via UPS ground from the Philadelphia, PA, area. UPS shipment tracking information is also posted on the Agent Portal. Feel free to place as many kit orders as you deem appropriate to ensure you have enough materials for a productive AEP…and beyond.

2019 Annual Certification Tips & Tricks

You must complete the 2019 annual certification requirements before you can market SilverScript plans this AEP and you must complete the requirements prior to December 7, 2018 (the last day of AEP), in order to be eligible for 2019 renewal commission.

SilverScript has a direct relationship with AHIP and Pinpoint training websites. Agents who have completed 2019 initial training and/or annual re-training certifications through AHIP or Pinpoint can have their results automatically submitted to SilverScript. Instructions are on the SilverScript Agent Portal’s Training & Certification page. Keep in mind that after the external training courses are applied to your SilverScript profile you still need to complete the SilverScript curriculum attestation on the SilverScript Agent Portal.

If you can’t Launch our training course, clear your browser history cache, enable popups (disable blockers), and enable tracking cookies. Remember, the SilverScript course material is available as PDF files in the SilverScript Agent Portal’s Reference Materials section. Download the PDF and toggle between the PDF and the quiz.

Download the Updated SilverScript iPad App for Agents from the Apple App Store

The SilverScript iPad App for Agents was updated on 10/1 to include 2019 plan year information; however, the AEP enrollment functionality is disabled since it’s too soon to submit applications with this election type. You should download the SilverScript iPad App for Agents now and AGAIN on or after 10/15. The AEP application functionality will be activated with downloads starting on October 15^th.

Forgot your SilverScript Agent Portal Password

The SilverScript Agent Portal was relaunched in mid-June. If you have not logged in since June 15, 2018, you will need to click on "Forgot Password" on our Login page to reset your password. Keep in mind that the new password now needs to include at least one $p3ci@l Ch@r!ct3r. Your login ID is the same as your SilverScript agent/writing number.

SilverScript Agent Portal Supported Web Browsers

To ensure you get the best out of the enrollment portal, make sure you are running one of the following supported browsers: Google Chrome version 60 or above, Internet Explorer version 11, Mozilla Firefox version 60 or above. At this time, Safari, and Microsoft Edge are not compatible.

Protect your Medicare Supplement clients and give them the coverage they need. Request details today and make sure you have this competitive PDP product available this AEP.

FOR AGENT USE ONLY and not intended for public or general use.

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Tags: Medicare Part D, silverscript

Americo Introduces High Deductible Plan F

Posted by www.psmbrokerage.com Admin on Mon, Oct 01, 2018 @ 04:57 PM

Americo Introduces High Deductible Plan F

We offer everything you need to be successful in the Medicare Supplement Market.

Instant decision eApplication now available; policy eDelivery available
Great rates on Plans F, G, and N
Rated "A" (Excellent) by A.M. Best*
10% Household Discount available in most states**
Voice, Tablet, and Electronic Signature options available to make it easy
UFirst Rewards Bonus

Sales tools and pre-approved client advertising available.

Not appointed to sell Americo's Medicare Supplements? Request Info here

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Tags: americo medicare supplement

Medicare Advantage Premiums to Decrease by 6% in 2019

Posted by www.psmbrokerage.com Admin on Mon, Oct 01, 2018 @ 04:16 PM

Medicare Advantage Premiums to
Decrease by 6% in 2019

CMS officially announced a six-percent decrease in Medicare Advantage premiums in 2019 as the result of MA enrollment, health plan options, and benefits increase. All signs point to the MA marketplace continuing to be a lucrative market for payers.

CMS stated that the average 2019 MA premium will decrease from $29.81 to $28.00 and improve health plan affordability for most beneficiaries. Eighty-three percent of MA enrollees are expected to have either the same or a lower premium in 2019. CMS estimates that 46 percent of MA beneficiaries in their current plan will have a $0 premium.

In addition, Medicare Advantage is offering 600 more health plan options and increasing the average number of MA choices for consumers in 2019. An estimated 3,700 MA health plans will be available in the market next year, with 91 percent of beneficiaries able to choose from 10 or more plan options. CMS anticipates MA enrollment to increase from 20.2 to 22.6 million in 2019, an 11.5% increase compared to 2018.

CMS touted the new changes in Medicare Advantage affordability, access, and enrollment as an example of effective private-public collaboration that benefits healthcare consumerism.

CMS Medicare Advantage/Part D FACT SHEET
CMS Premiums/Costs for 2019 MEDICARE PLANS
CMS State-by-state info on M/A and Part D INFORMATION

Read the full article here.

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Tags: Medicare Advantage, Medicare

Three Common Misconceptions About The Upcoming Medicare Annual Election Period

Posted by www.psmbrokerage.com Admin on Mon, Oct 01, 2018 @ 04:08 PM

Three Common Misconceptions About The Upcoming Medicare Annual Election Period

Many seniors have become victims of what they think they know about Medicare. Whether you’re new to Medicare or have been receiving benefits for a while, the complexities of Medicare can inspire a plethora of misconceptions.

The Medicare Annual Election Period (AEP) takes place from October 15 until December 7 every year. This allows Medicare beneficiaries to change Medicare Advantage or Medicare Prescription drug (Part D) coverage. Yet an analysis by the Henry J. Kaiser Family Foundation found that a whopping 78% of Medicare Advantage beneficiaries stayed on the same Medicare plan from 2013–2014.

Each year these plans experience policy changes, and seniors will need to look at their policy in comparison to the policies offered in their area. Medicare can be complex, so it's important to have a clear understanding of your options to make the best choice for your needs.

Find Out the Three Common Misconceptions Here.

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Tags: Medicare, Prescription Drugs

Pharmacists May Soon Be Allowed to Proactively Provide People with Medicare Information about Cheaper Medications

Posted by www.psmbrokerage.com Admin on Mon, Oct 01, 2018 @ 03:57 PM

Pharmacists May Soon Be Allowed to Proactively Provide People with Medicare Information about Cheaper Medications

This week, Congress passed two bipartisan bills aimed at removing barriers that may prevent people from paying the lowest possible price for their prescription drugs. The legislation will prohibit contractual limitations that can stop pharmacists from volunteering information about how consumers may be able to save money on their needed medications.

The Patient Right to Know Drug Prices Act (S.2554) bars insurers and Pharmacy Benefit Managers (PBMs) from restricting a pharmacy’s ability to tell consumers when there is a difference between how much they would pay for a drug using their insurance and how much they would pay without it. This bill applies to plans offered through the Affordable Care Act’s exchanges and by private employers. The Know the Lowest Price Act (S. 2553) provides this same protection for individuals who are covered by Medicare Advantage and Medicare Part D plans.

Aetna signed an agreement to divest all of Aetna’s standalone Medicare Part D business to a subsidiary of WellCare Health Plans

Posted by www.psmbrokerage.com Admin on Mon, Oct 01, 2018 @ 03:47 PM

Aetna signed an agreement to divest all of Aetna’s standalone Medicare Part D business to a subsidiary of WellCare Health Plans

On September 26, 2018, Aetna signed an agreement to divest all of Aetna’s standalone Medicare Part D business to a subsidiary of WellCare Health Plans, Inc. (WellCare). You can read the announcement here.

There are several important elements of this announcement to highlight:

The sale includes both Individual and Group standalone Part D members.
This transaction does not impact Individual Medicare Advantage (MA), integrated Medicare Advantage with Part D (MAPD) and standalone (MA-only) Group Medicare Advantage, Medicare Supplement, Ancillary, or Commercial plans and products.
The transaction will not initially impact your broker contract and its terms with regard to the divested standalone Medicare Part D business during the 2019 benefit year.
Your commissions for the plans that are impacted by this transaction will continue to be paid by Aetna in accordance with the existing commission agreements for the 2019 benefit year.
Aetna will continue to administer and provide service and support for the plans that are impacted by this transaction throughout the 2019 benefit year to provide continuity for the Medicare beneficiaries in those plans.
For the 2020 benefit year, for the divested standalone Medicare Part D business, you will need to become a contracted, appointed, and licensed broker with WellCare.

Regardless of the proposed transactions with CVS Health and WellCare, our teams remain focused on the Medicare annual enrollment period, and in serving new and existing members with a commitment to great service, care, and value.

In addition, for our Medicare producers, we will provide you with additional details in a subsequent communication following the closing of CVS Health’s acquisition of Aetna, which remains subject to federal and certain state regulatory approvals and the satisfaction of all closing conditions.

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna, AEP

Ameritas Dental Plans - Be The Hero During AEP Open Enrollment

Posted by www.psmbrokerage.com Admin on Mon, Oct 01, 2018 @ 03:29 PM

Be the Hero During AEP with
Ameritas Dental Plans

Ameritas

Did you know dental is the largest expense not covered by Medicare? Dental health is imperative, especially as we age. Your clients will thank you for offering PrimeStar dental alongside Medicare. The PSM team is here to support you, save you time, and save your clients money!

Contact us today and learn all about:

PrimeStar enhancements
the product and enrollment processes
3 simple ways to incorporate and sell dental with Medicare

Sell more using the Ameritas PrimeStar Hyperlink:

A one-stop-shop for clients to quote and purchase online
Opportunity for sales 24/7
Agent is automatically credited on purchases made through their personalized hyperlink

Request Information today on this new and exciting opportunity. Contracting can be done online in just a few minutes!

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Tags: dental hearing and vision insurance, ameritas

Aetna: How to avoid the AEP rush

Posted by www.psmbrokerage.com Admin on Mon, Oct 01, 2018 @ 03:19 PM

How to Avoid the AEP Rush

Did you know that you can submit Medicare Supplement applications with a January 1, 2019 effective date as early as October 1, 2018?

The Medicare Annual Enrollment Period (AEP) is October 15 through December 7, but you don't have to wait until then to submit your Medicare Supplement applications. Get started by using Aetna Quote & Enroll, our online enrollment tool.

Medicare Supplement is guaranteed renewable

The Medicare Annual Enrollment Period doesn't apply to Medicare Supplement insurance policies, which are guaranteed renewable. That means policyholders do not need to take any action to continue their Medicare Supplement coverage, as long as they continue to pay their premiums on time.

We'll be sending an email to our Medicare Supplement policyholders next week, reminding them that their policy is guaranteed renewable.

Online AEP resources

We've put our AEP agent resources in one place, so you can quickly access the information you need. Whether you're a new agent or have been around for a few years, it's easy to get caught up in all of the noise about AEP. It's important to know that Medicare Supplement applications during AEP are not automatically Open Enrollment (OE) or Guaranteed Issue (GI). Learn more about application types, proof of credible coverage requirements, and more in our helpful AEP resources.

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna, AEP

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