Great Southern Life Med Supp Release Updates

Are you ready to start selling GSL Med Supp?

Great Southern Life Medicare Supplement will be available in CO, FL, GA, IL, IN, IA, KS, MD, NC, PA, SC, SD, and TX beginning Monday, March 4th. Do you have everything you need to start selling? Below are some things to help you out.

Am I set up to sell GSL Med Supp?

• If you are contracted to sell Americo Med Supp you are ready to go.
• Your agent number remains the same.
• If you aren't contracted to sell Med Supp with Americo, contact us today

Are applications the same?

• There is a GSL specific application, however, the health questions remain the same.
• GSL application packets begin with form number 18-247-8-XX (03/19). State specific variations apply.
• The eApplication, commissions, pending business, etc. can be accessed using the GSL Med Sup link on the home page of the Americo.com Agent Portal.

Where do I find the eApplication?

• For eApplication, on the Americo.com Agent Portal home page, there will be a GSL option and an Americo option depending on the state you are writing in. Be sure to use the correct eApp for your state.
• The eApplication, commissions, pending business, etc. can be accessed using the GSL Med Sup link on the home page of the Americo.com Agent Portal.
• The Medicare Supplement portal will not be available on Saturday, March 2nd from 6:00 am - 11:00 am Central. After that time, GSL Med Sup eApplications will be available in CO, FL, GA, IL, IN, IA, KS, MD, NC, PA, SC, SD and TX.

Want to know more?

For more information or to get contracted to sell GSL Medicare Supplement Plans, call us today at 800-998-7715 or request info here.

Product Spotlight: Aetna Cancer and Heart Attack or Stroke Plus

On March 1, 2019 Aetna began offering CLI Cancer and Heart Attack or Stroke Plus in the following states: AL, AR, CO, CT, DE, GA, IA, IL, KY, LA, MI, MS, MT, NC, ND, NE, NV, OK, PA, SC, SD, TN, TX, WI, WV, WY

What is Cancer and Heart Attack or Stroke Plus?

There are four plans to select from… choose a cancer plan or a heart attack/stroke plan or one of each, with different benefit amounts. Watch the video above to learn more.

Sales materials and online enrollment

Agents can now order state-specific sales materials for these products. 

Aetna Quote & Enroll

Application cut-off for existing product

The last application signature and submission date for the existing Cancer and Heart Attack or Stroke product in these states will be June 27, 2019.

Not appointed with Aetna Supplemental? Request details here

Where Medicare Advantage is most popular

Click here for interactive version

States in the Midwest, South and West have the highest proportions of Medicare members enrolled in Medicare Advantage. Some states have more than 40% of their Medicare population in the taxpayer-subsidized private plans.

The big picture: Roughly a third of all Medicare enrollees are in MA, a program that has garnered bipartisan support despite its shortcomings, and some Wall Street estimates think MA will be the majority option by 2021.

By the numbers: More than 22 million seniors and people with disabilities have a Medicare Advantage plan, according to February 2019 enrollment data from the Centers for Medicare & Medicaid Services. The map highlights enrollment data from 2017, when there were 19.2 million MA enrollees.

• The state with the highest proportion of private Medicare plan enrollees (57.3%) is Minnesota, although many people are enrolled in "Medicare cost" plans that function as a hybrid between MA and traditional Medicare.
• MA is the choice of at least 40% of all Medicare enrollees in 6 other states (California, Florida, Hawaii, Oregon, Pennsylvania and Rhode Island).
• MA is far less popular in states with sparse populations, like Alaska, Vermont and Wyoming.

Between the lines: States with high concentrations of MA enrollees also have dominant systems of hospitals and doctors that sell MA plans.

• Many MA members in Pennsylvania buy plans from Highmark, Geisinger and UPMC, while Kaiser Permanente has a strong grip of the market along the West Coast.

What to watch: Health insurance companies will always aggressively pursue areas where there are a lot of seniors, like Florida and California, but the distribution shows there are pockets of the Midwest and Northeast that could be their next targets.

Source: https://www.axios.com/medicare-advantage-most-popular-states-5383fe1d-6a66-4eb7-93c6-c41dedb04886.html

Medicare Supplement New Business Rate Increase Trends

by Anna Patrick | Feb 22, 2019

CSG Actuarial has recently received a multitude of inquiries regarding the level of 2019 Medicare Supplement new business rate increases relative to previous years. The chart below shows the overall Medicare Supplement average new business rate increases by effective month from January 2015 through May 2019, based on information gathered by CSG Actuarial as of today. To date, the average rate increase amounts by month for 2019 are pretty consistent with the past couple of years.

Source: https://www.csgactuarial.com/2019/02/medicare-supplement-new-business-rate-increase-trends/

Medicare Advantage plans are expanding benefits for long-term care

The options may be limited in 2019 but that's likely to change in 2020 and beyond

Article: Danielle K Roberts / Considerable

If you use Medicare, you probably feel that it does a pretty good job of covering your medical costs. That’s the case for most people, since the government-run insurance plan covers about 80% of outpatient expenses and even more for inpatient expenses.

However, you may not realize that Medicare does not cover one major expense that might be looming for you or your spouse: long-term care. Often, by the time that people realize this, it’s too late or too expensive to pick up long-term care insurance.

And while people with very low incomes can qualify for Medicaid to help them with long-term care expenses, everyone else is left to privately pay for their assisted living centers and nursing home care.

The long-term care gap

About two-thirds of those eligible for Medicare enroll in Original Medicare, or Medicare Parts A and B, which covers hospital and medical costs. Most people who enroll in Original Medicare also opt for a Medicare Part D plan, which covers prescription drugs.

Another option is to choose a Medicare Advantage plan: These plans, offered by private insurers, offer the same coverage as parts A, B and D, and can also include ancillary benefits that Original Medicare does not provide, such as dental, vision and hearing expenses or gym memberships.

Until recently, however, neither the Original Medicare or Part C offered any coverage for long-term care. That changed last year, when the Centers for Medicare and Medicaid Services (CMS) announced that they would begin allowing Medicare Advantage plans to provide some supplemental long-term care services to their members the following year.

The new coverage options

Starting in 2019, Medicare Advantage plans had the option to build in some supplemental benefits that fall into the realm of home and community-based long-term care.

Some of the new long-term care options include:

• Adult day-care services
• In-home assistance with custodial care or activities of daily living
• Respite care benefits for caregivers
• Home safety modifications like bathroom grab bars, wheelchair ramps, and stair rails
• Non-emergency transportation services so that members can get to their doctor’s appointments
• In-home meal delivery

The goal of these newly allowed benefits is to prevent costly hospitalizations and help chronically ill beneficiaries continue living independently for months or even years beyond what they have been able to do in the past. 

Other new benefits

A few other key new benefits were also announced last year:

Better coverage for brand-name drugs: Starting this year, the dreaded “donut hole” for prescription drugs will be eliminated.

When Part D was first introduced in 2006, insurance companies could and did charge members 100% of the cost of their brand name prescription drugs when they reached the coverage gap (or donut hole). The Affordable Care Act changed this and the percentage of the cost that members are responsible for has been slowly falling over the last few years.

This year, members pay no more than 25% of the cost of their brand-name drugs in the gap in 2019.

A new open enrollment period: This year, the Open Enrollment Period from January 1^st to March 31^st each year has been reinstated.

This allows Medicare beneficiaries enrolled in Medicare Advantage plans to either change from one Medicare Advantage plan to another, or they can disenroll from their Medicare Advantage plan and return to Original Medicare and a standalone Part D drug plan. 

So if a beneficiary makes a mistake or finds that they don’t like their plan for any reason, they can make a one-time plan change during this period. It’s a welcome change that may make some beneficiaries feel less hesitant to try an Advantage plan, knowing that they won’t necessarily be locked in.  

Beneficiaries should keep in mind, though, that when they return to Original Medicare from an Advantage plan, they may have to answer health questions and go through medical underwriting in order to add that plan.

The future of long-term care

While the new long-term care benefits will appeal to many people, unfortunately existing plans were initially slow to build in the new benefits this year.

This was likely due to limited time to incorporate the new benefits between the time of the CMS announcement and deadline for plan designs to be submitted to Medicare for 2019 year.

However, given the expected popularity of these changes, it is hopeful that more plans will incorporate some of these supplemental benefits in 2020 and beyond.

As costs of healthcare continue to inflate, it’s likely that more and more beneficiaries living on fixed income will begin to gravitate toward Medicare Advantage plans that offer lower premiums.

These potential new benefits and additional window to change their minds about their plan are certain to increase the number of beneficiaries who choose a Medicare Advantage plan as their coverage in the coming years.

Source: https://considerable.com/medicare-advantage-plans-offer-new-long-term-care-coverage/

Photo from Pexels

Medicare program is falling behind on LTC Support Needs

A new study by the Commonwealth Fund examines the use of long-term services and supports (LTSS) among Medicare beneficiaries age 65 and older, and finds that the Medicare program is falling behind in offering the supports many older adults need. Currently, Medicare does not broadly cover most types of LTSS that could help older adults and people with disabilities remain in their homes and communities as they age. While Medicare Advantage does cover some limited LTSS, this coverage is spotty, and does not apply to the approximately two-thirds of Medicare beneficiaries who rely on Original Medicare.

Source: https://blog.medicarerights.org/many-older-adults-medicare-not-getting-long-term-help-need

Photo by rawpixel.com from Pexels

Updated Federal Poverty Guidelines Announced

Each year, the Department of Health and Human Services (HHS) updates the federal poverty guidelines, which are then used to determine eligibility for programs including Medicaid, the Low Income Subsidy for Part D (LIS), and Medicare Savings Programs.

Some government programs that rely on the guidelines to determine eligibility use the numbers directly, while other programs use a percentage multiplier. For example, the income limit for LIS, which is also called Extra Help, is 138% of the federal poverty guideline.

Source: https://blog.medicarerights.org/updated-federal-poverty-guidelines-announced

Photo by rawpixel.com from Pexels

Atlantic Coast Life Medicare Supplement

"Transforming the Agent & Customer Experience"

PSM is proud to be an exclusive distributor for Atlantic Coast Life's (ACL) Medicare Supplement Plans.

We are excited to introduce their new Med Supp product to you along with an agent experience like no other!

With state of the art features and technologies, securing Medicare Supplement coverage for your clients has never been easier. Along with competitive rates,excellent commissions and writing agent bonus, you don't want to miss this exciting opportunity.

What Beneficiaries Want in a Medicare Plan

By eHealth – February 20, 2019

Medicare beneficiaries love their coverage and think more Americans should have access. Only 6% express dissatisfaction with their Medicare coverage; 41% say that all Americans should have Medicare-like coverage (an increase from 34% since last August); an additional 11% say that at least people age 55 and older should be eligible for Medicare. A new report from eHealth defines what beneficiaries find most important in their Medicare Plans.

Source: https://www.prnewswire.com/news-releases/ehealth-survey-reducing-prescription-drug-costs-seen-as-key-to-ensuring-medicares-future-300797020.html

To read the full report, click here.

ABSTRACT

ISSUE: Medicare Advantage (MA), the private option to traditional Medicare, now serves roughly 37 percent of beneficiaries. Congress intended MA plans to achieve efficiencies in the provision of health care that lead to savings for Medicare through managed competition among private health plans.

GOAL: Two elements are needed for savings to accrue: a sound payment policy and effective competition among the private plans. This brief examines the latter.

METHODS: We use data from 2009–17 to describe market structure in MA, including the insurers offering plans and enrollment in each U.S. county. We measure both actual and potential competitors for each county for each year.

KEY FINDINGS AND CONCLUSIONS: MA markets are highly concentrated and have become more concentrated since 2009. From 2009–17, 70 percent or more of enrollees were in highly concentrated markets, dominated by two or three insurers. Since the payment system used to reimburse insurers selling in the MA market relies on competition to spur efficiency and premiums that more closely reflect insurers’ actual costs, these developments suggest that taxpayers and beneficiaries will overpay. We also find an average of six potential entrants into MA markets, which points to a source of competition that may be activated in MA. To tap into potential competition, further research is needed to understand the factors affecting entry into MA markets.

Source: https://www.commonwealthfund.org/sites/default/files/2019-02/Frank_market_concentration_medicare_advantage_ib_0.pdf

New Report: Deft Research’s 2019 Medicare Shopping and Switching Study

The recently published Medicare Shopping and Switching Study finds the Medicare Advantage switch rate grew from 11% in 2018 to 14% in 2019. This is the first increase since 2015. The latest research findings take a look at where the switching occurred and why Medicare shoppers looked at different options for coverage. 

Source: https://www.deftresearch.com/

2018 Medicare Advantage Enrollment by Insurer

Atlantic Coast Medicare Supplement - Transforming the Agent & Customer Experience

With state-of-the-art product features and technologies, securing Medicare Supplement coverage for your clients has never been easier. Along with competitive rates, excellent commissions and writing agent bonus, you don't want to miss this exciting opportunity.

Check out these highlights:

• Instant Issue™ Application Approval
• True Point-of-Sale™ Underwriting
• Live Review™ Underwriter Access
• Telephone Signature Capabilities
• Responsive eApplication

Ask about the APP BONUS program! 

• $160 per eApp Underwritten Bonus
• $40 per eApp Open Enrollment Bonus

Request details today to get contracted to sell Atlantic Coast Life's Medicare Supplement plans.

Check out the ACL promo video

Are you looking for Pre-Approved Medicare Marketing materials?

Great news! We are here to assist.

We are pleased to provide you with a library of pre-approved marketing materials to help you retain and grow your book of business. 

These pieces have been created to engage consumers and motivate them to consider working with you to meet their Medicare needs.

In today's competitive market, it is helpful to have marketing materials that help you stand out with potential clients.

We also understand the challenge of coming up with something creative and engaging, in addition to adhering to CMS guidelines.

Lucky for you, we have worked with our carrier partners to make sure our agents have access to not only carrier approved marketing materials, but also a library of generic pre-approved Medicare marketing materials. Get your free marketing materials here.

Direct mail is an effective means of driving response among Medicare eligibles. It allows you to target your message to specific people at specific times. 

Even though direct mail is considered more effective than other mass media options, it is important to do everything you can to help maximize your success.

Here are some tips to follow:

• Use a targeted and proven mailing list - Data has shown that consumers 65-75 are more likely to switch Medicare plans than their elder peers. So be sure that segment is included in your mailings.
  
• Segment your list - For Medicare prospects, low-income targets will likely respond better to low-price messages while higher-income prospects might be more attracted to value-added benefits or expansive network messages.
• Test your messages / creative executions - For Medicare marketing, it may be wise to execute A/B mail splits - dropping different messages to segments of the same audience at the same time. This will allow you to determine which messages are getting the best responses.
• Commit to a mailing plan based on your overall marketing activities - Mailboxes will be full especially during AEP, but you can't afford to be absent. If you sprinkle your marketing plan with other media exposure and events, your piece will like be more recognized in the mailbox and read.
• Think about consumer's behavior when planning your marketing - First they will research plans, then they'll shop, then they'll decide. You want to be present and available at each of these steps!
  

Marketing Pieces Include:

Age-In, CSNP, DSNP, Educational, Generic and more

To request access and speak with a marketing Representative about what pieces are available and how to have the customized, Get your free marketing materials here.

You can also call us at 800-998-7715 and speak with one of our friendly marketing representatives.

Carrier specific resources available through of our partners: Humana, Aetna, UnitedHealthcare, Cigna

By Sam Baker – Axios – February 13, 2019

Almost 70% of Congress signed onto new letters singing the praises of Medicare Advantage, Axios' Bob Herman notes.

Yes, but: That group only includes 2 of the congressional Democrats running for president: Sen. Amy Klobuchar (D-Minn.) and Rep. Tulsi Gabbard (D-Hawaii).

Between the lines: This is an annual ritual.

• Medicare proposes new MA payments and policies every January, and the health insurance industry gathers bipartisan signatures of support for the program before the final regulation comes out in April.
• This's years letters mark the most congressional support Medicare Advantage has ever gotten, and it crosses party lines.

But MA is still facing questions.

• The federal government recently signaled it wants to audit Medicare Advantage companies and claw back money that was improperly paid to plans.
• Lawmakers praised the plans' out-of-pocket caps and vision benefits — but did not mention tradeoffs and concerns, like narrower networks of doctors and the controversial billing practices that have led to inflated payments.

Source: https://www.axios.com/newsletters/axios-vitals-35a2170f-dbc1-4ab5-91e6-238c83691d02.html

Help your clients with their prescription costs: 

Extra Help, also commonly known as Low-Income Subsidy (LIS), is a federal program that aides Medicare beneficiaries with some or most of the costs associated with their Part D Prescription Drug coverage, based on their income and assets.  

The National Council on Aging (NCOA) has released the updated 2019 Income and Asset Limits for those who may qualify for Extra Help/LIS.  Below is a snapshot of the limits.

There are resources available to you and your clients regarding Medicare Part D, what it covers, applying for extra help, and much more.

Click on the link below for the complete LIS/Extra Help chart:

2019 Extra Help/LIS Chart

The comprehensive list of resources, provided by NCOA, can be found here:

https://www.ncoa.org/resources/

Each year there are set times a person can enroll in Medicare or change existing Medicare plans. There are separate enrollment periods for Medicare Parts A and B (Original Medicare) and Medicare Part C (Medicare Advantage).

Enrollment periods include:

• Initial Enrollment Period (IEP) – the first time an eligible person can enroll in Medicare Parts A and B. This timeline begins three months before the month of a person's 65th birthday and continues through the three months after a person's 65th birthday.
• Initial Coverage Election Period (ICEP) – the first time a newly eligible person can enroll in a Medicare Advantage plan. This often coincides with the Initial Enrollment Period.
• General Enrollment Period (GEP) – runs January 1 – March 31 each year and provides an enrollment opportunity for individuals who didn't sign up for Original Medicare (Part A and Part B) when they were first eligible. Individuals may have to pay a late enrollment penalty for not enrolling when first eligible and coverage will not start until July 1 of that year.
• Annual Enrollment Period for Medicare Advantage and Prescription Drug Plan (AEP) – current Medicare recipients can change or enroll in Medicare Advantage coverage during this period that runs October 15 through December 7.
• Special Enrollment Period (SEP) – certain life events can lead to an individual being eligible for enrolling in Original Medicare or enrolling in or changing Medicare Advantage coverage.

Opportunities for a Medicare Advantage Special Enrollment Period include:

• Moving to a new location where new plan options are available
• Losing employer coverage
• Being diagnosed with a qualifying chronic condition, such as diabetes or chronic heart failure
• Moving in or out of a skilled nursing facility or long-term care hospital

The Medicare Advantage Open Enrollment Period (OEP) runs from January 1 through March 31 and is new in 2019. Beneficiaries in a Medicare Advantage only or Medicare Advantage Prescription Drug plan as of January 1 can make a one-time change to:

• Switch to a different Medicare Advantage Plan
• Drop Medicare Advantage and return to Original Medicare (Part A and Part B)
• Sign up for a stand-alone Medicare Part D Prescription Drug plan, if an individual elects to return to an Original Medicare plan

The Medicare Advantage OEP is only accessible for current Medicare Advantage policyholders. During Medicare Advantage OEP, Original Medicare policyholders cannot:

• Switch from Original Medicare to a Medicare Advantage plan
• Join a Medicare Prescription Drug plan (Part D)
• Switch Medicare Prescription Drug plans

Source: https://markets.businessinsider.com/news/stocks/understanding-medicare-enrollment-periods-1027946178

The Medicare Plan Market Is Alive!

Here are numbers that show why issuers in the market still like to talk to agents.

By Allison Bell | February 08, 2019

Enrollment in all types of Medicare Advantage plans increased to 21 million in January, up 7.6% from the total for January 2018, according to the Centers for Medicare and Medicaid Services (CMS).

Enrollment in the core Medicare Advantage health maintenance plans increased 6.9%, to 13.5 million.

(Related: Medicare Activity Might Have Been Strong: Google Trends)

A separate CMS database shows that enrollment in the traditional Medicare program, which CMS calls Original Medicare, increased to 38.8 million in December 2018, from 38.3 million in January 2018.

Total Medicare enrollment increased to 60.4 million in December, from 59.4 million in January.

Medicare Enrollment Periods

The Medicare Fall Open Enrollment Period for 2019 coverage ran from Oct. 15 through Dec. 7. A more limited Medicare Advantage Open Enrollment Period started Jan. 1 and will run through March 31.

During the second open enrollment period, Medicare Advantage plan enrollees can shift from one Medicare Advantage plan to another, or return to the traditional Medicare program, but consumers cannot use that open enrollment period to sign up for Medicare Advantage coverage for the first time.

What Google Saw

Google search traffic during the fall open enrollment period suggested the enrollment activity was strong.

Search activity for the term “Medicare plan” appeared to be about 20% higher throughout the latest open enrollment period than during the comparable open enrollment periods in 2016 and 2017.

Why This Matters to Agents and Brokers

Because of factors such as low interest rates and regulatory confusion, insurers have mixed feelings about selling many of the products on their shelves.

They have a good shot at making money on selling Medicare Advantage and Medicare supplement insurance plans, and many are still paying commissions on Medicare plan sales.

What a Web Broker Saw

Analysts at eHealth Inc., the parent of the eHealthMedicare.com site and other web-based health insurance shopping sites, found that insurers’ interest in the Medicare plan market translated into tough competition for web shoppers’ business, and good deals for those shoppers.

Many consumers signed up for Medicare Advantage plans with no drug coverage and no monthly premium bills for the enrollees. For consumers who chose plans with a monthly premium for the enrollees, the average bill fell to $52 for 2019 coverage, from $72 per month for 2018 coverage.

For Medicare Advantage plans that offer prescription drug coverage and charge a premium, the average monthly premium fell to $43, from $50.

The average monthly premium for Medicare supplement insurance, or Medigap insurance, increased to $152, from $141.

The eHealth analysts could not include some important measures of plan quality, such as provider network adequacy, but they found that out-of-pocket cost figures improved, or stayed about the same.

For Medigap plans, the average deductible fell to $207, from $210.

For Medicare Advantage plans with drug benefits, the average deductible fell to $130, from $150, and the average annual out-of-pocket spending limit for covered services fell to $5,415, from $5,589.

For Medicare Advantage plans without drug benefits included, the average annual out-of-pocket spending limit fell to $5,249, from $5,387.

Resources

Overall Medicare enrollment figures are available here.

Information about Medicare Advantage and Medicare Part D drug plan enrollment is available here.

Source: https://www.thinkadvisor.com/2019/02/08/the-medicare-plan-market-is-alive

Image: Freepik

Lyft expands rideshare services for BCBS and Humana Medicare Advantage members

The move was driven in part by a CMS decision to open reimbursement channels for Medicare Advantage plans looking to innovate with supplemental benefits that can promote health outside of the clinical care setting.

By Kevin Truong – MedCityNews – February 8, 2019

Seeing the tremendous need in the non-emergency medical transportation (NEMT) market, rideshare service Lyft have stepped in to fill in the gaps in the existing transportation infrastructure with the overarching goal of cutting that number in half by 2020.

Now, Lyft has expanded its partnerships with Blue Cross Blue Shield and Humana (through its collaboration with LogistiCare) to service Medicare Advantage plan members.

The move was driven in part by a CMS decision to open reimbursement channels for Medicare Advantage plans looking to innovate with supplemental benefits that can promote health outside of the clinical care setting.

Lyft initially inked a deal with BCBS back in 2017 to provide its service to members without transportation alternatives to get them to healthcare facilities for appointments.

That partnership is being expanded to include certain BCBS MA plan members to provide transportation – not only to medical appointments – but to the pharmacy and fitness centers as well.

Traditionally, NEMT has been provided through a series of specialized transportation brokers, which have often seen low customer patient satisfaction, long wait times, as well as issues with fraud and abuse.

Lyft pitches its solution as faster, more reliable and cheaper than alternatives and has partnered with NEMT providers like Circulation, RoundTrip and Logisticare to make its service available to healthcare organizations.

Lyft and Logisticare’s partnership dates back to 2017 when the companies announced a deal to provide on-demand rideshare services to Logisticare’s network of private, commercial and government assisted clients.

Building on that work, Lyft NEMT services will now be available to select Humana MA plan members through LogistiCare.

“At Humana, we understand that health is about more than what happens in the doctor’s office – many other social factors, like transportation, can have a direct impact on health and well-being,” Alan Wheatley, president of Humana’s Retail Segment, said in a statement.

In order to enable these service expansions Lyft has also further developed its Concierge feature, which allows organizations request or schedule rides for others and manage their portfolio of rides.

These capabilities are especially important for the patient population in Medicare Advantage members, who may not own a smartphone or lack the technical or physical capabilities to request their own rides.

The upgrade now allows organizations to quickly compare cost options upfront and track members along their rides.

Since launching its healthcare business back in 2016, the business line has become the largest segment of Lyft’s enterprise division with customers across a range of health care categories including startups like Call9, health systems like Hackensack Meridian Health and electronic healthcare vendors like AllScripts.

Source: https://medcitynews.com/2019/02/lyft-expands-rideshare-services-for-bcbs-and-humana-medicare-advantage-members/

Image: Lyft

AHIP Thanks Congress for the Overwhelming Support for Medicare Advantage

WASHINGTON, D.C. – 368 bipartisan leaders in Congress signed their support for the Medicare Advantage program. On behalf of the nearly 22 million Americans who depend on Medicare Advantage, America’s Health Insurance Plans (AHIP) thanks the 66 members of the United States Senate and the 302 members of the House of Representatives who signed bipartisan letters to express their strong support for the program.

These letters underscore the fact that Medicare Advantage delivers real results for millions of Americans. This letter was sent to Administrator Seema Verma at the Centers for Medicare and Medicaid Services (CMS).

“Americans deserve a strong Medicare Advantage program. That’s why I want to sincerely thank every member of Congress who showed their strong support to protect such a vital program,” said Matt Eyles, President and CEO of AHIP.

“Each year Medicare Advantage enrollment grows because it delivers better services, better value, and better access to care with higher levels of satisfaction than traditional Medicare. We look forward to continuing to work with Congress and the Administration to ensure this program remains strong and stable for the millions who rely on it – now and in the future.”

Medicare Advantage letters

2019 Bipartisan Senate Medicare Advantage letter

2019 Bipartisan House Medicare Advantage letter

Source: https://www.ahip.org/ahip-thanks-congress-for-the-overwhelming-support-for-medicare-advantage/

Walgreens Partnership Boosts Humana's Medicare Enrollment

By Bruce Jepsen – Forbes – February 7, 2019

Humana says its joint venture with Walgreens Boots Alliance is helping boost enrollment in Medicare Advantage, the fast-growing privately administered health coverage for U.S. seniors.

Humana reported a 9% increase in Medicare Advantage membership the health insurer attributed to physicians at more than 230 clinics including two sites inside Walgreens stores. It’s the latest sign showing the early stages of a joint venture between Humana and the nation’s largest drugstore chain is working and could be expanded beyond a pilot in the Kansas City market.

"Our 233 owned, joint ventured and alliance clinics, the majority of which are payer agnostic, including our two 'Partners in Primary Care' clinics inside Walgreens stores experienced positive results in the annual election period," Humana CEO Bruce Broussard told analysts Wednesday during the company's fourth quarter earnings call.  "Humana MA membership grew over 9% in these clinics in the (annual election period) excluding the more mature Conviva clinics."

Humana, which has invested hundreds of millions of dollars acquiring and partnering with medical care providers in recent years, said its relationships helped it take Medicare Advantage market share away from rival insurers. Humana said it expects 2019 individual Medicare Advantage membership growth of “375,000 to 400,000 members, representing 12% to 13% growth,” the insurer reported Wednesday as part of its fourth-quarter 2018 earnings release.

Walgreens and Humana last year opened “senior-focused primary care clinics” inside drugstores as a way to complement Walgreens pharmacy services and Humana’s Partners in Primary Care centers that opened last year in Kansas City. The effort is designed in part to keep people out of the more expensive hospital setting and make sure Medicare patients have their care more closely monitored by Walgreens pharmacists and physicians in Humana’s health plan networks.

The two companies think they can do a better job of reaching patients who visit Walgreens retail locations and making sure they get better care upfront before they get sick. When the partnership was announced, Walgreens and Humana called it “a senior-focused neighborhood approach to health that brings together primary care, pharmacy, in-person health plan support and other services for Medicare beneficiaries.”

The Medicare Advantage growth is key for Humana, which is in a competitive battle with rival insurers like Aetna, UnitedHealth Group and Cigna, looking to tap into a market of more than 10,000 baby boomers aging into the Medicare population every day.

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. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

Humana ended 2018 with 3.06 million individual Medicare Advantage members, which was up 7% from 2.86 million as of Dec. 31, 2017.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/07/humana-walgreens-clinic-venture-boosts-medicare-enrollment/#1ce9cb783f39

GTL Launches Groundbreaking Precision Care Cancer Insurance

Covering the High Cost of Cancer is Good...
Beating Cancer is Better.

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Humana To Add Nearly 400K Seniors To Medicare Advantage Plans

By Bruce Jepsen – Forbes – February 7, 2019

Buoyed by growth in Medicare Advantage enrollment, Humana is the latest insurer to report solid fourth quarter profits as seniors flock to private coverage sold via contracts with the federal government.

The health insurance industry is tapping into a market of more than 10,000 baby boomers aging into the Medicare population every day. Humana is the latest insurer to report Medicare Advantage growth that is slightly ahead of the projected record growth the Centers for Medicare & Medicaid Services (CMS) predicted for Medicare Advantage last fall.

Following the recent open enrollment period, Humana expects 2019 individual Medicare Advantage membership “growth of 375,000 to 400,000 members, representing 12% to 13% growth,” the insurer reported Wednesday.

The additional membership comes as Humana and its historic rivals like UnitedHealth Group and Aetna expanded their Medicare Advantage offerings into new regions and several startup plans and new competitors emerged.

But Humana CEO Bruce Broussard said the insurer did a good job holding its own while taking Medicare Advantage business away from rivals he didn’t name during a Wednesday morning call to discuss earnings with analysts.

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. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

Humana ended 2018 with 3.06 million individual Medicare Advantage members, which was up 7% from 2.86 million as of Dec. 31, 2017, the insurer said Wednesday. The performance helped the Louisville-based provider of health insurance and outpatient medical care increase net income to $436 million, or $2.58 per share in the fourth quarter of last year. That compares to $490 million, or $1.29 per share in the fourth quarter of 2017. Revenue rose to nearly $14.2 billion.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/06/humana-to-add-nearly-400k-seniors-to-medicare-advantage-plans/#35f430fa1013

Image: Freepik

When Does Enrollment in Part B Become Effective?

If you accept the automatic enrollment in Medicare Part B, or if you enroll during the first three months of your initial enrollment period, your coverage will start with the month you are first eligible.  If you enroll during the last four months of your initial enrollment period, your coverage will start from one to three months after you enroll. 

The following chart shows when your Medicare Part B becomes effective:

For more information, you may click on the link below to see a reference document found within the Social Security website: Social Security Website.  Scroll down to the section on signing up for Medicare.

By Bruce Japsen – Forbes – February 5, 2019

Health insurers are reporting unprecedented growth in the number of seniors flocking to private Medicare Advantage plans amid talk of a single payer government-run approach that could uproot such coverage.

The same week U.S. Sen. Kamala Harris (D-California) made news with her support for “Medicare for All,” insurers Anthem and Cigna reported strong growth from Medicare Advantage, private coverage sold via contracts with the federal government.

Anthem’s Medicare Advantage enrollment jumped by 35% to more than 1 million at the end of 2018 compared to 746,000 in the fourth quarter of 2017, the operator of Blue Cross and Blue Shield plans reported last week. “Our individual Medicare Advantage business is on track to achieve our mid-double digit growth target,” Anthem CEO Gail Boudreaux told analysts during the company’s fourth quarter earnings call last week. “In total, we estimate our Medicare Advantage growth will exceed 20% by the end of 2019.”

Meanwhile, Cigna reported Friday that its Medicare Advantage enrollment was up one percent to 436,000 from 432,000 and UnitedHealth Group ended 2018 with 4.9 million Medicare Advantage enrollees, which was up nearly 12% from 4.4 million at the end of 2017. Other insurers including Aetna, which is now part of CVS Health, are expected to report higher Medicare Advantage enrollment later this month after these plans expanded into new markets.

The industry is tapping into a market of more than 10,000 baby boomers aging into the Medicare population every day . The insurers that have reported 2018 earnings thus far are reporting overall industry growth that’s slightly ahead of the projected record growth the Centers for Medicare & Medicaid Services (CMS) predicted for Medicare Advantage last fall. “We completed a strong Medicare Advantage enrollment season . . . and are on track to achieve 2019 growth within the 400,000 to 450,000 range of expectations,” Steve Nelson, CEO of UnitedHealthcare, UnitedHealth’s insurance business told analysts two weeks ago.

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. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

As seniors flock to Medicare Advantage, analysts say it’s going to make it difficult for Democrats on the presidential campaign trail to support a Medicare for All approach that would bring an end to the private insurer’s role.

The insurance industry worries most about so-called “single payer” forms of health insurance that would conceivably replace the private insurer’s role with a government-administered form of coverage. U.S. Sen. Bernie Sanders of Vermont has espoused the single payer approach for years but the Medicare for All Act of 2017 that he, Harris and others supported does mention “the ability to enroll in a Medicare Advantage plan.”

America’s Health Insurance Plans, the health insurance lobby that includes Anthem, Cigna and other insurers that sell Medicare Advantage, said Americans don’t want a “a one-size-fits-all health care system.”

“Today, health insurance providers deliver coverage that is working for hundreds of millions of Americans – including 180 million Americans who are covered through an employer, 20 million covered through Medicare Advantage, 55 million covered through Medicaid managed care, and 20 million who buy their own coverage,” AHIP spokeswoman Kristine Grow said.

”The vast majority of these 300 million Americans are satisfied with their existing coverage," Grow added. "One of the reasons they like their coverage is it provides them with choice and control. Health care is personal – all Americans are unique individuals with different health care needs depending on their stage of life, where they live, their income and resources, and physical and mental health. People should be able to get the care they need, when they need it, at a cost they can afford.”

Source: https://www.forbes.com/sites/brucejapsen/2019/02/03/as-democrats-talk-single-payer-private-medicare-advantage-soars/#71a5c29458f3

Medicare Advantage Enrollment Surges For Centene And WellCare

By Bruce Japsen – Forbes – February 5, 2019

Centene and WellCare Health Plans are the latest to report a surge in seniors signing up for private Medicare coverage administered by health insurers.

Centene and WellCare, which reported earnings Tuesday, have been expanding beyond their historic business lines dominated by administering Medicaid benefits for states into Medicare Advantage. Centene also has a large business offering subsidized individual coverage offered under the Affordable Care Act.

But these health insurers are joining the parade of health plans and startups taking advantage of more than 10,000 baby boomers turning 65 every day and rule changes administered by the Centers for Medicare & Medicaid Services (CMS) to allow private insurers to offer more benefits in Medicare Advantage plans they sell.

Centene’s enrollment in Medicare plans, including Medicare Advantage, rose 25% to 416,900 in the fourth quarter compared to 333,700 in the fourth quarter of 2017. Meanwhile, WellCare reported Tuesday its enrollment in Medicare plans including Medicare Advantage increased nearly 10%, or by 49,000, to 545,000 in the fourth quarter of last year compared to 496,000 in the fourth quarter of 2017.

Such growth reported by Centene and WellCare Tuesday comes following double-digit percentage growth in Medicare Advantage enrollment already released by Anthem and UnitedHealth Group. Humana reports its earnings later this week and Aetna, now owned by CVS Health, reports its fourth quarter results later this month.

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. CMS' rule changes to allow Medicare Advantage plans to provide broader coverage in the future is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

The rising enrollment in privately-administered Medicare Advantage plans comes as members of Congress and Democrats running for president in 2020 talk about expanding Medicare to all Americans. 

Some of the plans include allowing private insurers to maintain their role offering Medicare Advantage but others urging "Medicare for All" including Sen. Bernie Sanders of Vermont and Sen. Kamala Harris of California have talked about a diminished role for the health insurance industry in administering Medicare benefits.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/05/medicare-advantage-enrollment-surges-for-centene-and-wellcare/#2db5bf1610f0

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Why Lyft is Making Medicare Advantage a Key Focus of Its Health Care Work

By Paige Minemyer – FierceHealthCare – February 5, 2019

Ride-hailing service Lyft has been in the healthcare space for the past several years, and it sees Medicare Advantage plans as a key demographic for its health platform.

On a call with reporters on Monday, Megan Callahan, vice president for healthcare at Lyft, said its first MA partner was CareMore, a subsidiary of Anthem. Their partnership, which dates back to 2016, has led to beneficiaries’ ride costs going down by 39% and wait times decreasing by 40%.

These successes, Callahan said, have led CareMore to book 90% of needed nonemergency transportation through Lyft. She said that one-third of Lyft’s passengers report using to the service to get a ride for medical care.

“Lyft is in a unique position to help Medicare Advantage plans,” she said.

Callahan was one of several speakers on the call, which was hosted by the Better Medicare Alliance to spotlight the recent expansion of supplemental benefits in MA.

The Centers for Medicare & Medicaid Services, in its draft call letter for the 2020 plan year, said it wants to offer MA plans greater flexibility to offer supplemental benefits to beneficiaries with chronic illness.

That proposal comes on the heels of CMS’ decision to allow Medicare Advantage plans to offer supplemental benefits for 2019.

James Michel, policy director for the alliance, said on the call that while the group is excited for CMS to expand these benefit options, there’s a catch—the agency isn’t offering additional funding to MA plans to offer them.

So, plan sponsors will need to be creative and harness data on their beneficiaries to determine the most effective supplemental services for their members, he said.

“Plans will probably have to be very thoughtful about how they offer these benefits,” Michel said.

For Lyft, the expansion of supplemental benefits in Medicare Advantage is a jumping-off point to expand elsewhere, including potentially to traditional fee-for-service Medicare, Allyson Schwartz, president of BMA, said.

The company’s platform is designed with seniors in mind, she said, and allows the partner insurer or provider to call a ride directly for the beneficiary, in case they don’t have a smartphone or know how to use Lyft’s app themselves, Callahan said.

Callahan said that ongoing research in partnership with the AARP and UnitedHealthcare found that seniors with unlimited access to Lyft covered by their insurance reported a 30% boost in physical activity and a 90% increase in quality of life.

Lyft also sees significant potential in tailoring its healthcare platform to meet the needs of certain patients, such as those in need of dialysis care.

Source: https://www.fiercehealthcare.com/payer/cms-planning-to-expand-supplemental-benefits-medicare-advantage-for-members-chronic-illness

Image: Lyft

5 Tips from a 5-Star Medicare Advantage Plan

By John Harding, MD – Welltok – January 28, 2019

As the Senior Medical Director for Tufts Health Plan’s Five Star Medicare Advantage and FIDESNP products, I’m often asked about our secret to achieving the coveted Five Star Rating. In reality, we don’t have just one secret – we have five focused strategies that we keep front of mind (read on and you’ll see what I’m referring to).

To achieve the kind of results we have, it takes a lot of hard work, a dedicated team, a passion for improving member care and consumer-centric technologies.

Star Ratings Matter

If you manage a Medicare Advantage plan, you know the importance of the Five Star Ratings system. The Ratings range from one (lowest) to five (highest) Stars. Created by the Centers for Medicare and Medicaid Services (CMS), the Star Ratings system allows for increased accountability for health plans, health systems and providers. It measures five broad categories, including:

• Preventive care (health tests and screenings, vaccines)
• Chronic disease management
• Quality of care and responsiveness to members
• Member complaint handling, and how many members leave the plan
• Overall customer service

Aside from the Five-Star seal to showcase a higher quality of service, one of the most unique benefits of being a Five Star plan is that you qualify for a longer special enrollment period. This allows for plans to be more competitive with member acquisition efforts in the marketplace. In short, a Medicare Advantage plan’s Star Ratings matter, and they matter a lot.

My Top 5 Tips  

Whether a plan wants to gain a few points or maintain their current spot, here are my top five tips for becoming a Five Star plan:

TIP #1: Make the member the focal point of your strategy.

Medicare seeks out members’ input about their ease of getting appointments and care, getting necessary information from the plan, coordination of benefits and their overall experience with the health plan. Some processes or technologies may be designed from the plan's perspective to handle operational or administrative needs, but are not member-centric or user-friendly. Are they being bombarded by coordination of benefit letters?  How many steps does it take to schedule an appointment?  Are they aware of free preventive benefits? Put yourself in the members’ shoes. Member satisfaction and experience with the health plan is a significant portion of the Star Ratings system, so keeping them engaged in their health has its direct benefits – not only for the member but for the health plan as well.

TIP #2: Incorporate a multi-channel communications approach into your outreach efforts.

Communication is a critical aspect of the health plan and member relationship, and it’s one that Medicare takes very seriously. Sending mass communications to members and assuming that they will respond is fairly ineffective. Today’s technology enables plans to communicate with members based on their preferences and across multiple channels. Plans that take a multi-touch approach, such as a combination of text, email, IVR, and/or paper mail will definitely see an uptick. For example, Tufts Health Plan mailed a paper HRA (a CMS requirement), but the response rate was low – less than 50%. To help improve the response rate, we partnered with Welltok’s engagement team to coordinate a multi-channel outreach campaign, which included phone calls, access to a website with information, and for those who prefer it, mail. We saw an immediate increase in response rates:

• 69% HRA survey completion rate
• 49% completed HRA via outbound automated call
• 83% who started the outbound call survey, responded to all 34 health-related questions
• 53% increase in overall survey completion with web & paper completes
• 21% lift in completion by allowing members who started survey via automated call to finish via web or paper

TIP #3: Measure and report continuously.

Don’t wait for Medicare to survey your members to get an understanding of their perception of the health plan. Instead, be proactive and collect data throughout the year. For example, ask for member feedback before Medicare’s CAHPS surveys are distributed. As stated above in tip #2, use a multi-channel approach to gain the most engagement. Oversampling your population and having drill down questions that provide real-time consumer data is very valuable. At Tufts Health Plan, we utilize IVR for our surveys – it’s the most cost effective and allows us to collect information from a majority of our target population. Our surveys, for the most part, are predictive of the CAHPS survey to help us anticipate where we need to make improvements.

TIP #4: Have a solid relationship with your provider network.  

Apart from having a good relationship with members, another relationship to keep in focus is the one health plans have with their provider network. Having a strong, symbiotic and productive relationship means that health plans and their provider network understand that they share risk when it comes to the health and wellbeing of the members/patients. This relationship needs to be built over time. At Tufts Health Plan, we work very hard to maintain a solid foundation with our provider network. For us, they are key partners for delivering high quality care for our members, especially related to Stars measures around preventive care and chronic disease management.

TIP #5: Have a dedicated strategy, time and focus on Star Ratings specifically.

High Star Ratings don’t happen overnight. It takes time, resources and a lot of dedication to achieve. All Star measures are important and they need to be worked on year-round. There are more than 40, so divide and conquer. From steering to reporting committees, we’ve developed an organized structure to hold our staff accountable. We have an entire team focused just on Stars and each year, our focus may shift more from one measure to another, however we do work on every single one. In the world of Star Ratings, you have to keep improving and be better than the year before.

Bring it all together

It takes a lot of work to become and maintain the Five Star Rating status. We face challenges every day – from budget restraints to staff turnover to limited provider bandwidth – however, we haven’t lost sight of the people we serve and the care we provide. Our mission is to improve the health and wellness of the diverse communities we serve, which is rooted in our Stars improvement strategy. Each year, our goal is to be better, more effective and efficient than the year before. It’s an ongoing process and we do it with our members in focus.

Source

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