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When zero-dollar premium plans were removed, costs still dropped by 13%, according to a survey from eHealth. Average Medicare Advantage (MA) premiums dropped by more than 30% in Q1 2019, according to data released by eHealth on Thursday morning. The health insurance exchange reported a 87% year-over-year increase in the amount of MA and Medicare Part D applications received during the open enrollment period (OEP) that lasted from January to March. 2019 marked the first year that consumers enrolled in a MA plan could switch to a different MA plan during OEP or leave MA and supplement their original Medicare coverage with a Part D prescription drug plan. Between 2011 and 2018, consumers weren't able to switch to a MA plan outside of the fall OEP unless they had "a circumstance that allowed you a Special Enrollment Period." Despite the opportunity for additional coverage options, including those with lower average monthly premiums, 51% of respondents did not know about OEP prior to shopping for a new plan, according to eHealth. Those surveyed gave several responses for why they switched to a new Medicare plan, including unhappiness with a former insurer, increased copays, doctor leaving network, and changes to drug coverage. During the OEP, the average monthly for MA plans was $8, down from $12 in Q1 2018, while the average out-of-pocket limits decreased 11%, from $5,815 to $5,164.
PDF for the report here. Source: https://www.healthleadersmedia.com/finance/medicare-advantage-premiums-fall-33-q1 Image: www.Canva.com
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Tags: Medicare Advantage
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Lyft Hails Medicare Advantage As Next Profitable Ride
Lyft is signing new contracts and targeting a booming number of Medicare beneficiaries choosing private Advantage plans as a lucrative new growth area for the ride-sharing company. New rules that allow health insurance companies to include more supplemental benefits in their Medicare Advantage plans is opening the door to Lyft and rivals to have more of their services woven into benefits for next year. Health plan bids to participate in Medicare Advantage for 2020 are due Monday, June. 3. "We expect to be working with the majority of the largest MA plans by 2020,” said Lyft’s vice president of healthcare Megan Callahan, who was hired last year to lead the company’s growing healthcare businesses. 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. But the ability of Medicare Advantage plans to integrate ride-sharing services into bids is taking off given new rules announced last year “reinterpreting the standards for health-related supplemental benefits in the Medicare Advantage program to include additional services that increase health and improve quality of life.” As health insurers move away from fee-for-service medicine to value-based care and population health models that make sure patients are getting quality care in the right place and at the right time, ride-sharing companies say they can have a key role. Image: Lyft |
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Tags: Medicare Advantage, Medicare, Lyft
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Beginning June 3, 2019, GSL Medicare Supplement will be available in AR, AZ, ID, MS, NE, NV, OH, OK, UT and WV. If you are already contracted to sell Americo Financial Life (AFL) Med Sup, there's nothing you need to do. You are ready to sell GSL Med Supp, use your current Americo Agent number. Rates are now available on the CSG Quoting Tool. If you have Americo selected as a "my company", on the CSG quoting tool, you will also need to add Great Southern Life to your "my company" list. Note that AFL Med Supp rates will no longer be available in these 10 states effective June 3rd. Application packets, marketing materials, and sales tools are available on Americo.com and AmericoMedSup.com. The GSL eApplication will be available on June 3, 2019. Fore more information about GSL Medicare Supplement, see this helpful Information Sheet. If you are not appointed with Americo / GSL, you can request contracting details here.
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Tags: americo medicare supplement, GSL Med Supp, Great Southern Life Medicare Supplement
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Earn June 1 - September 30 For a limited time, you can earn marketing credits just for placing your dental insurance business with Mutual of Omaha. You can earn the following credits for your issued dental applications for up to 600 total credits:
Each marketing credit gives you $1 to help build your Mutual of Omaha Medicare supplement business. Use your credits for things like:
You'll receive monthly emails - July through October - with your current balance. You may redeem your credits at any time during the program. All credits must be redeemed by December 1. Not appointed to sell dental insurance with Mutual? Request details here
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Tags: mutual of omaha, dental plans
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Oral health is an integral part of overall health, but its importance to overall health and well-being often goes unrecognized. Untreated oral health problems can lead to serious health complications. Having no natural teeth can cause nutritional deficiencies and related health problems. Untreated caries (cavities) and periodontal (gum) disease can exacerbate certain diseases, such as diabetes and cardiovascular disease, and lead to chronic pain, infections, and loss of teeth. Lack of routine dental care can also delay diagnosis of conditions, which can lead to potentially preventable complications, high-cost emergency department visits, and adverse outcomes. Medicare, the national health insurance program for about 60 million older adults and younger beneficiaries with disabilities, does not cover routine dental care, and the majority of people on Medicare have no dental coverage at all. Limited or no dental insurance coverage can result in relatively high out-of-pocket costs for some and foregone oral health care for others. This brief reviews the state of oral health for people on Medicare. It describes the consequences of foregoing dental care, current sources of dental coverage, use of dental services, and related out-of-pocket spending. Key Findings
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Tags: dental plans
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Medicare Advantage and Part D Commission Rates
TO: Medicare Advantage Organizations, Prescription Drug Plan Sponsors, Section 1876 Cost Plans, and Medicare-Medicaid Plans FROM: Kathryn A. Coleman / Director SUBJECT: Contract Year 2020 Agent and Broker Compensation Rate, Referral/Finder’s Fees, Submissions, and Training and Testing RequirementsThis memorandum provides contract year (CY) 2020 compensation and referral/finder’s fee limits for agents and brokers, directions for submitting amounts into the Health Plan Management System (HPMS), as well as training and testing requirements. Compensation Rates and Referral/Finder’s Fees for CY 2020As provided in 42 C.F.R. §§422.2274(b)(1) and 423.2274(b), the compensation amount an organization pays to an independent agent or broker for an enrollment must be at or below the fair market value (FMV) cut-off amounts published yearly by the Center for Medicare and Medicaid Services (CMS). 42 C.F.R. §§422.2274(h) and 423.2274(h) states that referral/finder’s fees paid to independent, captive, or employed agents may not exceed a CMS specified amount. Additionally, referral/finder’s fees paid to independent agents/brokers must be included in FMV for that CY. The CY 2020 FMV cut-off amounts for all organizations and referral/finder’s fees are as follows:
The renewal amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-years 2 and beyond. Compensation Rate Submission for CY 2020As in past years, all organizations must inform CMS via HPMS whether they are using employed, captive, or independent agents. Organizations that use independent agents must provide the initial and renewal compensation amount or range of amounts paid to these agents. Additionally, if an organization pays referral/finder’s fees, the organization must disclose the amount. CMS has provided instructions for data entry in the HPMS Marketing Module User Guide. Organizations must submit their agent/broker information in the HPMS Marketing Module between June 1, 2019 and July 26, 2019, 11:59 pm EST. Please note that CMS does not consider the submission process complete until the organization’s CEO, COO, or CFO has completed the attestation in HPMS. Organizations that fail to submit and attest to their agent and broker compensation data by July 26, 2019 will be out of compliance with CMS requirements. Organizations will not be able to make changes to those submissions after the July 26, 2019 deadline. CMS expects organizations to keep full records documenting that they are updating compensation schedules and paying agents and brokers according to CMS requirements. Please note that CMS will make the CY 2020 organization-submitted compensation information available for the public to view on www.cms.gov prior to the annual election period for CY 2020. Curricula for Training and Testing Agents and Brokers for CY 2020Regulations at 42 C.F.R. §§422.2274 and 423.2274 require that organizations train and test all agents and brokers selling Medicare products, including employees, subcontractors, downstream entities, and/or delegated entities annually on Medicare Parts A, B, C, D, and plan specific information. CMS further requires that all agents and brokers obtain an 85% passing rate on the test. In order to ensure the quality of agent and broker training and testing programs, CMS annually provides minimum training and testing requirements to organizations. Organizations should review these requirements before developing their own agent and broker training and testing programs to ensure compliance with CMS requirements. CMS permits and encourages organizations and third-party training and testing vendors to include other relevant topics, in addition to the minimum required elements. Image: www.Canva.com
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Pharmaceutical Spending Will Reach $370B in 2019
U.S. pharmaceutical spending is expected to grow by 2.5% in 2019, topping $370 billion, while overall healthcare spending is projected to grow by 4% and reach $3.6 trillion, according to a Fitch Solutions report released Monday. By 2023, Fitch Solutions estimates pharmaceutical sales will top $420 billion, account for nearly 1.7% of the national GDP, and 9.7% of overall health expenditures. Overall healthcare spending is expected to reach $4.3 trillion during the same period of time. Source: https://www.healthleadersmedia.com/finance/pharmaceutical-spending-top-370b-2019
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Tags: Medicare Part D, Part D, Prescription Drugs
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Read the press release about the new rule Read Medicare Rights’ comments on the proposed rule Source: https://blog.medicarerights.org/coming-soon-to-a-tv-near-you-drug-prices Image: www.Canva.com
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Tags: Medicare, Prescription Drugs
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Humana Certification & Recertification Course Details for Plan Year 2020!
Top 4 Improvements:
Certification & Recertification Launch Dates *NOTE: Does not include Spanish translation. Spanish versions will be available on a delayed basis. Look for additional communications on Spanish versions. Recertification Completion Deadlines
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Tags: Humana, Medicare Advantage, Medicare, certification
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We want to notify you about an issue affecting all Medicare members who elected to pay plan premiums from their Social Security Administration (SSA) or Railroad Retirement Board (RRB) check.
Background Normally, when members select this premium payment option, the SSA/RRB withholds funds from members’ SSA/RRB checks to cover their plan premiums. Unfortunately, due to a system issue, this did not occur for two or more months starting February 1, 2019. This issue affected all carriers, not just Aetna. Although the system issue is now fixed, the SSA/RRB cannot retroactively deduct premium payments from members’ checks. What do members need to do? Because these members now have past-due accounts, their premium payment method has changed to direct billing, effective February 1, 2019. This means they now need to pay any past-due premium amounts to Aetna directly. Member communication Members will receive a letter explaining what happened and what they need to do later this month. Letters are being mailed in waves, between May 10-24, so members will receive them over several weeks. View the member letter. What happens next?
Encourage members to call us with any questions Although this issue was out of our control, we realize it will be an inconvenience for our members. If they have any questions, please encourage them to call Member Services by dialing the number on their member ID card. The Member Services team is available 7 days a week, from 8 a.m. to 8 p.m. As always, thank you for your dedication to our members and for your help educating them on this matter. If you have any questions, please contact the Aetna Medicare Broker Services Department at 1-866-714-9301 or brokersupport@aetna.com. |
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Tags: Medicare Advantage, Part D, aetna
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Aetna is constantly adding new materials to the Studio. Make sure you check back often to find out what’s new. If you are not appointed with Aetna, Click here to request contracting and sales materials. |
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Tags: Insurance Marketing, aetna, DSNP
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We have some exciting news to share! Mutual of Omaha is releasing a new Medicare Supplement in Virginia. Call us at 800-998-7715 and one of our marketing representatives would be happy to share this valuable information with you.
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Tags: Medicare Supplement, Mutual of Omaha Medicare Supplement
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We have some exciting news to share! Mutual of Omaha is releasing a new Medicare Supplement in Wyoming. Call us at 800-998-7715 and one of our marketing representatives would be happy to share this valuable information with you.
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Tags: Medicare Supplement, Mutual of Omaha Medicare Supplement
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Nearly two-thirds of insurance agents reported increased sales of Medicare supplement insurance in 2018 and a higher percentage expect continued growth in 2019, according to a survey conducted by the American Association for Medicare Supplement Insurance. "The vast majority of agents (64.1%) experienced increased Medigap sales in 2018 compared to the prior year," reports Jesse Slome, director of the association. The organization polled 1,000 insurance professionals who market Medicare insurance in advance of the association's national Medicare Supplement industry conference. Over 300 agents completed the survey questions. Some 64.1 percent of the agents reported increased or higher sales of Medigap insurance in 2018. Just over one-in-four (27.2%) indicated that their sales were about the same as the prior year with only 8.7 percent reporting decreased or lower sales. The association asked agents to predict their 2019 sales compared to 2018. "An ever greater majority of agents (68.6%) were more optimistic that their Medigap sales during the year would be higher," Slome said. "The percentage who expect decreased sales dropped to 3.8 percent. "With 11,000 Americans turning 65 daily, it's no wonder why more agents are focusing on selling Medicare Supplement and Medicare Advantage products," he added. "There is every reason to be optimistic about the future and the continued growth of the industry." Image: www.Canva.com
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By Taylor McDonald – CSG Actuarial – May 7, 2019 CSG Actuarial, with information from the NAIC and other sources, reports total earned premiums in the Medicare Supplement market in 2018 totaled $32.4 billion, a 4.9% increase over 2017. The total Med Supp lives covered in 2018 increased to 14.05 million, up 3.9% from 2017. The top 12 carriers in terms of 2018 Medicare Supplement premiums were:
The 2018 overall Med Supp market loss ratio of 79.0% reflects a continued trend in the market of the overall loss ratios creeping back up towards “Pre-Modernized” levels of around 80%.
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Tags: Humana, Cigna, Medicare, Medicare Supplement, CSG Actuarial, aetna, mutual of omaha
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Great Southern Life Med Supp Release Updates
We are excited to announce that Americo will be releasing new Medicare Supplement premium rates through our subsidiary company, Great Southern Life (GSL) in 10 new states. Beginning August 5, 2019, GSL Medicare Supplement will be available in Want to know more? Rates will be available on CSG beginning July 29th. Note that AFL Med Sup rates will no longer be available in these 10 states effective August 5th. Application packets, marketing materials, and sales tools will be available on Americo.com and AmericoMedSup.com July 29th. The GSL eApplication will be available on August 5th. 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. Earn More Than Ever Before on Med Supp Business Meet the minimum UFirst Rewards requirements by April 30, 2019 and receive a bonus check in May. Keep producing and get an additional bonus checks on any new qualifying business in July and September. Make even more money by hitting $30,000 and get paid retroactively! View Bonus details here. |
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Tags: americo medicare supplement, GSL Med Supp, Great Southern Life Medicare Supplement
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By Shelby Livingston – ModernHealthCare – May 7, 2019 The health insurance industry often attributes lower spending among Medicare Advantage seniors compared with those in traditional Medicare to care management strategies. But a study published Monday turns that claim on its head. Researchers at the Kaiser Family Foundation found that traditional Medicare beneficiaries who opt to enroll in a Medicare Advantage plan offered by a private health insurer have lower average spending and use fewer services—before they ever switch to Medicare Advantage—than their counterparts who stay in traditional Medicare. The findings raise questions about how much Advantage plans actually lower spending. Moreover, the results suggest that the CMS, which uses traditional Medicare spending to calculate Advantage payments, overpays Medicare Advantage plans to the tune of billions of dollars each year, the researchers concluded. A little more than a third of the 60 million Medicare enrollees are in an Advantage plan. The CMS paid Medicare Advantage insurers about $233 billion in 2018, a figure expected to grow as more seniors choose Advantage plans. "Medicare Advantage plans are perhaps getting paid more than the actual expected costs of their enrollees," said Gretchen Jacobson, a Kaiser Family Foundation associate director who co-authored the study. Researchers looked at average Medicare Part A and B spending among people who were enrolled in traditional Medicare in 2015. Those enrollees who switched to a Medicare Advantage plan in 2016 spent $1,253 less in 2015 on average than beneficiaries who did not switch, after controlling for health risks. Image: www.Canva.com
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Tags: Medicare Advantage, Medicare
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Answer: Yes! By the Kaiser Family Foundation – May 7, 2019 People on Medicare can choose coverage from either traditional Medicare or Medicare Advantage plans, typically trading off broad access to providers for potentially lower premiums and out-of-pocket costs. Beneficiaries who choose Medicare Advantage may differ from those in traditional Medicare in both measurable and unmeasurable ways, which may influence their use of services and spending. Yet, Medicare payments to Medicare Advantage plans per enrollee are based on average spending among beneficiaries in traditional Medicare. This analysis looks at whether beneficiaries who choose to enroll in Medicare Advantage plans have lower spending, on average – before they enroll in Medicare Advantage plans – than similar people who remain in traditional Medicare. We compare average traditional Medicare spending and use of services in 2015 among beneficiaries who switched to Medicare Advantage plans in 2016 with those who remained in traditional Medicare that year, after adjusting for health risk. We adjust Medicare spending values for health conditions and other factors, with a model similar to the CMS HCC Risk Adjustment Model that is used to adjust payments to Medicare Advantage plans (see Methods). Key Findings
Even after risk adjustment, the results indicate that beneficiaries who choose Medicare Advantage have lower Medicare spending – before they enroll in Medicare Advantage plans – than similar beneficiaries who remain in traditional Medicare, suggesting that basing payments to plans on the spending of those in traditional Medicare may systematically overestimate expected costs of Medicare Advantage enrollees. Image: www.Canva.com
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Tags: Medicare Advantage, Medicare
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Virtual Care for Medicare Advantage
Under the Centers for Medicare & Medicaid Services (CMS) proposed rule issued on October 26, 2018, Medicare Advantage plans will be able to provide “additional telehealth benefits” as basic benefits for purposes of bid submission and payment by CMS beginning in the 2020 plan year. With this landmark regulatory shift that expands reimbursement for virtual care services, CMS has opened the door for the advancement of differentiated offerings reliant on innovative care models. A comprehensive virtual care strategy provides a pathway for health plans to expand their Medicare Advantage offerings by:
Conclusion Medicare Advantage represents a significant growth opportunity for health plans serving the 65-plus consumer population. Recognizing the expansive and changing needs of this group—the “age-ins” along with the older demographic—the most-successful health plans will pivot quickly to partner with a trusted and proven virtual care provider to unlock value by incorporating comprehensive, scalable, and innovative strategies. Read the Report Source: https://www.teladoc.com/
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Tags: Medicare Advantage, Medicare
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Last week’s Medicare Trustees’ report predicts the Part A Hospital Insurance (HI) trust fund will be partially depleted in 2026. This is the same as last year’s projection, and three years earlier than in 2017—the last report issued before the GOP tax bill took effect. This is not a coincidence. The 2017 tax bill directly cut funding for the Part A Trust Fund by significantly reducing one of its primary revenue streams—the taxation of Social Security benefits. It also caused some of the projected growth in Part A expenditures. By zeroing out the Affordable Care Act’s individual mandate, the tax bill also increased the number of uninsured—driving up Medicare hospital payments for uncompensated care. Higher spending projections can also be attributed to the tax bill’s repeal of the Independent Payment Advisory Board, which would have helped to control Medicare spending if the growth rate exceeded certain target levels. Read the 2019 Medicare Trustees Report Source: https://blog.medicarerights.org/medicare-is-strong-and-built-to-last Image: www.Canva.com
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Tags: Medicare
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CMS Maintains Important Changes in Draft 2020 Medicare & You Handbook Julie Carter / May 2, 2019 / Medicare Watch Last year, the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, released a draft version of the annual “Medicare & You” handbook that contained several glaring inaccuracies. In a significant advocacy success, Medicare Rights and our allies convinced CMS to correct these major errors and release a final 2019 handbook that was greatly improved. Read more about our original concerns with the “Medicare & You” handbook in 2019. Read our thank you letter to CMS as a response to the changes to 2019’s “Medicare & You.” Source: https://blog.medicarerights.org/cms-maintains-important-changes-in-draft-2020-medicare-you-handbook |
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Dual Eligible Member Study
Deft Research surveyed over 1,300 Dual eligible seniors to show insurers how they can position supplemental benefits not only as additions to core insurance benefits, but also as solutions to address social and economic barriers to health care that many Duals face. Check out the Preview Slides from the 2019 Dual Eligible Member Study for more key findings. Source: https://www.deftresearch.com/ Related: https://www.psmbrokerage.com/grow-your-medicare-business-with-special-needs-plans |
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Tags: Medicare Advantage, Dual Eligibles, DSNP
