Americo is excited to announce that we will be releasing new Medicare Supplement premium rates through their subsidiary company, Great Southern Life (GSL) in 10 new states.
Beginning August 5, 2019, GSL Medicare Supplement will be available in AL, DE, KY, LA, MI, ND, NM, TN, VA, and WY.
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.
Medicare Blog | Medicare News | Medicare Information
Short-term care (STC) plans, also known as Recovery Care, are geared toward people who need temporary medical insurance in order to bridge the gap between longer term plans.
Although the premiums can be much less expensive than long-term care insurance, the coverage provided is also far less robust than with long term care.
Having said that, short-term plans do have their place. It is important to perform a good needs analysis to define the gaps in coverage for each of your clients to properly determine if they might benefit from Short-term care.
When you add to that statistic the fact that 41% of LTC claims don’t last longer than 1 year, STC will likely be a piece of the puzzle that can alleviate the burden of healthcare costs for those seniors.
Commissions on short-term care (STC) are hard to ignore. Understanding the proper placement of STC will help fill coverage gaps for your clients, and help grow your bottom line.
STC health insurance plans are intended to protect against unforeseen accidents or illnesses, and, therefore, don’t typically include coverage for preventive care, physicals, immunizations, dental or vision care.
Starting in 2019, in some states, consumers will be able to purchase STC which are renewable for up to one year with the option to extend twice. This could give those who qualify a 3 year extended coverage.
STC plans can be used to pay for services from any doctor or hospital. So, you’re client can keep their doctor. In addition, there are no open enrollment restrictions with STC plans.
Customers can apply any time of the year and it only takes minutes to find out if their application is approved. Once approved, they can use their coverage as early as the next day.
What are the average costs of STC plans?
Plan costs will vary based on what is covered and the length of the coverage period. A plan that lasts one year may be 30% - 50% higher than the rates for a three month plan.
It’s important to review all of these details in full with your client to align their expectations and ensure they fully understand the coverage being discussed and how long that coverage would last.
These plans are certainly less expensive than other plans, but it’s important to remind your clients of the difference in coverage.
With the right mix of plans in your portfolio and an understanding of your customers needs, you will be able to offer a wide range of coverage for clients of all ages for years to come.
Talk to one of our experienced marketers today about what plans may be right for your portfolio.
Thanks for reading and happy selling.
|2020 Annual Enrollment Period (AEP) Checklist
What is AHIP Certification and How do I Get it?
DSNP - Dual Eligible Special Needs Plans
MACRA 2020: What the Changes Mean for Insurance Agents
CMS Administrator Seema Verma declared Medicare Advantage the most successful (function) of Medicare. “What works in the Medicare program is Medicare Advantage, because plans are competing on the basis of cost and quality, driving toward value and increasing choices for beneficiaries,” Verma told attendees at the Better Medicare Alliance 2019 Medicare Advantage Summit. “Many of you are driving success in Medicare Advantage, and I thank all of you for the important work that you do.” M/A added 600 new plans in recent years, which Verma attributed to the reduced regulations. Patients enrolling in M/A also benefit from premiums that decreased 6% since last year.
Medicare Advantage enrollment increased 10% since last year.
Tags: Medicare Advantage
Bright Health is the latest health insurer to announce plans to sell private Medicare Advantage plans in several new markets, hoping seniors flock to such coverage following federal rule changes that allow plans to offer more benefits.
The startup insurer said it will add seven new markets in six states for 2020. They are: the Orlando and Daytona areas of Florida; Palm Beach, Fla.; Chicago, Illinois; Omaha, Neb.; the Cleveland and Akron area of Ohio; Greenville, South Carolina and Memphis Tennessee. Bright Health currently sells Medicare Advantage plans in six metropolitan markets: Birmingham, Ala; Phoenix, Arizona; Denver, Colo.; New York City: several Ohio cities including Cincinnati and Nashville, Tenn.
Bright Health’s expansion into new regions is the latest expansion for such plans, which contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. And now insurers are rolling out more supplemental benefits in their Medicare Advantage plans following rule changes implemented.
In Bright Health’s case, the new Medicare offerings are part of a major expansion of all of its business lines that include individual coverage, “family plans,” Medicare Advantage and supplemental Medicare plans.
In all, Bright Health said it will begin selling its array of plans in 13 new markets across seven states beginning next year. “This market expansion brings Bright Health Plan’s footprint to a total of 22 markets in 12 states, building on its sizable growth last year when it added products in Arizona, New York, Ohio and Tennessee,” the company said in its announcement Wednesday.
The expansions are still subject to final regulatory approvals by state insurance departments, but executives say the expansion shows financial strength and confidence consumers and investors have in the company.
“In just four years, we’ve grown from serving consumers in our pilot market of Colorado to serving tens of thousands of members across six states,” Bright Health CEO Bob Sheehy said. “This substantial growth shows that consumers are hungry for a new healthcare model that is simple, personal and more affordable. We’ve been able to meet this demand because our Health Plan Care Partner Model allows us to scale quickly and effectively, and our significant expansion in 2020 is further validation of that.”
From 2005 to 2010, the nation’s Hispanic population grew by an average of 3.4% per year, but this rate has declined to 2.0% a year since then. The Latino population in the South grew 33% during this period, reaching 22.7 million in 2018, up 5.6 million from 2008.
Mutual of Omaha has filed a Medicare supplement product under their new affiliate Omaha Supplemental Insurance Company (OSIC) in the following state – TEXAS
Besides the new low rates, OSIC offers:
Not appointing with OSIC / Mutual of Omaha? Request details here
The Oldest Counties in Every State
According to U.S. Census Bureau projections, retirement-age adults will outnumber Americans under age 18 by 2035 for the first time in history. The aging of the U.S. population is driven by a falling birth rate and long-term improvements in life expectancy. While these demographic shifts are novel on a national scale, in many parts of the country, they are nothing new.
The median age in the United States is 38 years and is projected to hit 43 years as early as 2060. Age demographics vary considerably by region, and in every state, there are counties where the median age already exceeds Census Bureau’s 2060 projection. 24/7 Tempo reviewed median age by county using data from the U.S. Census Bureau’s 2017 American Community Survey to identify the oldest county in every state.
As the population ages, the United States will face new economic and public policy challenges. These challenges include increased health care, social security, and pension expenditures, with fewer workers to foot the bill. Not all states will be able to deal with those challenges well. As social and environmental factors vary by region, so too does the quality of life of elderly Americans – these are the worst states to grow old in.
The 2020 Annual Enrollment Period (AEP) is just a couple months away, starting on October 15th and ending on December 7th 2019. It is important to remember that The Centers for Medicare & Medicaid Services (CMS) do not allow any marketing for AEP to take place before October 1st. "Marketing" includes the following examples:
Rule of thumb: If the purpose of the marketing activity is to eventually solicit an appointment for AEP, per CMS, it is NOT acceptable before October 1st 2019. If an agent is found to be marketing for AEP before October 1st, the agent could be penalized from the insurance carrier being marketed, or from CMS.
It is a good idea for agents to take this time before October 1st to work certifications and becoming Ready to Sell for the 2020 AEP season. Save all marketing efforts for after October 1st in order to compliantly benefit from the work put into the activity.
Related article: Welcome to your 2020 AEP Headquarters
Get a First Look at 2020 plans
We're excited to share a first look at Aetna's 2020 Individual Medicare products and service areas, which are pending government approval.* To preview 2020 plans, just go to https://firstlook.aetna.com and login with your Producer World username and password.
→ Not appointed with Aetna? Click here to request contracting.
*IMPORTANT: Aetna's First Look is for producer-use only. It's confidential and proprietary. Plan designs and service areas described on the 2020 First Look site are pending government approval and are therefore subject to change. Distribution to consumers, other insurers or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.
2020 Aetna MA/MAPD highlights
2020 SilverScript PDP highlights
While Aetna does not have an Aetna-branded prescription drug plan (PDP) product for 2020, our parent company, CVS Health*, offers SilverScript® PDPs that you can sell. Agents must be contracted with Aetna and complete 2020 SilverScript certification prior to selling these plans. SilverScript is one of the leading PDP providers in the country, serving over 6 million people with Medicare. In 2020, SilverScript is offering two PDP options. Benefit highlights include $0 deductible for Tier 1 and Tier 2 generics; $0 Tier 1 copays at preferred pharmacies; and copays as low as $1 on Tier 2 drugs.
Login to our 2020 First Look site to learn more about plans that will be available in your market.
Not appointed with Aetna? Click here to request contracting.
Get certified to sell 2020 products
Remember, certification is just one of the requirements you need to complete to be ready to sell this AEP. Review requirements to sell.
This $430 credit per 10 sales can be used for initiatives including:
* Street level contract direct to PSM
In addition to our Top Flight Lead Incentive, we also provide the following value-added benefits:
At PSM we offer the industry's leading carriers, with the highest attainable contracts, along with the tools, resources and incentives necessary to grow your business and succeed in a booming market. We look forward to working with you!
Related Article: “The Benefits of Working with an Insurance FMO”
Mutual of Omaha: Med Supp
Not appointed to sell Mutual of Omaha Medicare Supplement plans?
At the time, value-based care, where providers are reimbursed for the health outcomes of their patients as opposed to the volume of services provided, was not yet the rallying cry of a health system in need of transformation. The impact of private competition on value-based care likely was not even contemplated at the time the legislation was passed. A closer look at the evolution of MA demonstrates that the private sector has proven to be a remarkable laboratory for innovation and progress in our health system’s core evolution—to align the payment and care delivery system with value and the outcomes we care about most for America’s seniors.
A Recent Move Toward Value
Today, approximately one-third of all beneficiaries choose MA insurance coverage. A number of private insurers (also known as payers or health plans) offer MA coverage, resulting in an increasingly competitive marketplace for consumers.
With competition comes lower costs. The average premium for MA plans that include pharmacy coverage will be $40 per month in 2019, down from $46 per month in 2018, and MA plans offer out-of-pocket cost caps to reduce beneficiary exposure to excessive medical costs. Flexibility in MA benefits allows private health plans to provide supplemental benefits such as preventive dental care, vision, and hearing assistance at no additional cost, benefits that are not provided by traditional Medicare. This helps seniors, many of whom are on a fixed budget, limit their exposure to high costs.
The move to value-based care was somewhat more recent and was hastened by the creation of the Center for Medicare and Medicaid Innovation (the Innovation Center) in 2011. There has been broad, bipartisan support of the effort to align the incentives of the payer and provider by rewarding better value and outcomes rather than volume.
Both the Centers for Medicare and Medicaid Services (CMS) and private payers have enthusiastically endorsed a variety of payment models to engage primary care providers, specialists, and health systems in taking accountability for the populations they serve and accepting financial risk for their performance. Examples of such payment models include accountable care organizations, bundled payments, and the comprehensive primary care initiative. Some of these models were initiated by CMS through the Innovation Center, while others came from the private sector, but all have been widely implemented in both traditional Medicare and MA.
Organization And Delivery
There is a stark contrast, however, in how value-based care is organized and actually delivered in traditional Medicare—which is administered by CMS—and Medicare Advantage. In traditional Medicare, the government contracts directly with providers to take risk and responsibility. This forces the provider organizations (whether a primary care practice, a specialist, or a health system) to invest in a wide variety of tools essential for managing population health: analytics infrastructure to assess risk profiles of patients; prevention and wellness programs; care coordination and care management teams to support chronically ill and complex patients; care transition programs; and integration of services delivered in home, community, and health care settings.
Moreover, the emerging recognition that social context has a considerable impact on health outcomes and costs has challenged risk-bearing providers to consider how to systematically address these upstream social determinants of health, such as social isolation, loneliness, and food insecurity. In payment models in traditional Medicare, providers are expected to build or contract for these services themselves to succeed in the mission of delivering better care and better health outcomes at a lower cost.
In Medicare Advantage, the payment models are similar in their financial alignment, but the execution is qualitatively different. Rather than putting that burden on providers alone, private MA health plans have themselves, for years, delivered the services that value-based models are demanding. The analytics, care management, and care coordination programs and efforts around wellness and prevention and quality improvement have been the mainstay of private payers’ delivery models. Thanks to the fact that they generally represent large populations, private payers can execute these services at scale.
Another example of how large MA plans can leverage their size to invest in new service models is the partnerships we’re developing with communities to address the social determinants of health. At Humana, where we are CEO and chief medical officer, we’ve committed to investing in the health of seven of the communities we serve: Louisville, Kentucky; Knoxville, Tennessee; Tampa Bay, Florida; New Orleans/Baton Rouge, Louisiana; San Antonio, Texas; Broward County, Florida; and Jacksonville, Florida.
A study of our community-based interventions to improve health, in what we call these targeted “Bold Goal” communities, found that the number of mean unhealthy days declined by 3.1 percent in 2016 in communities, and those improvements have only increased over time. Recognizing that health care is local and there is not one simple solution, our approach to address social determinants of health is driven by the specific market needs within each Bold Goal community.
That means interventions including, but not limited to, investing in meal deliveries that include a friendly visitor, transportation, social visits, emergency preparedness to help with anxiety, as well as standardized screening of social and clinical needs in non-traditional settings such as barber shops.
Our success highlights an emerging strategy that private payers can apply to positively impact the health of the communities they serve. For providers that are not participating in large vertically integrated health systems, such responsibility—to address these upstream social needs and determinants of health—would be quite onerous.
But not all of our innovation is taking place upstream. As private payers have learned and improved on how they manage complex, vulnerable members, the large MA plans have blurred the lines between payer and provider. In a competitive environment, MA providers have innovated in a variety of manners. One MA plan is now the largest employer of physicians in the US, and another has merged with a large retail pharmacy and will deliver care at retail sites.
At Humana, we’re actively developing capabilities to deliver, at scale, care in the home by investing in Kindred-at-Home, the largest provider of home care in the US, and integrating that care with owned and partnering primary care organizations. We’re doing this because our members have told us that they want to receive care in their homes, not in the hospital.
Today, each of the three largest MA plans has also integrated their pharmacy benefits and can deliver a more cohesive and coordinated service that does not silo pharmacy and clinical care. Private MA health plans have also made substantial investments in telehealth and analytics to support providers in their quest to deliver more patient-centered care.
A number of researchers and health policy experts have studied and quantified the impact of MA care coordination and population health management efforts. There is compelling evidence to suggest that quality of care in Medicare Advantage is better than or comparable to that of traditional Medicare, while costs are lower. A 2015 study compared quality of care for MA enrollees with diabetes or cardiovascular disease, against the care received by traditional Medicare enrollees with the same conditions; the authors concluded that quality of care was better in Medicare Advantage, requiring less frequent health services usage.
MA is also helping to focus on improving quality and delivering a consumer-centric experience. A 2017 publication sponsored by CMS included 9.9 million beneficiaries from three states and found that MA outperformed traditional Medicare on 16 of 16 clinical quality measures assessed and four of six patient experience measures. These improvements in quality in MA lead to lower acuity post-acute care, which translates to improved outcomes and lower cost, as demonstrated by another 2017 study in which MA members had fewer hospital readmissions and more time in the community when compared with traditional Medicare patients.
Medicare beneficiaries are increasingly choosing with their feet, and enrollment has been growing more rapidly in MA than traditional Medicare. Moreover, recent evidence suggests that MA reduces taxpayer outlays for health care. One recent study even demonstrated a decrease in traditional Medicare spending growth in counties where MA penetration is highest, suggesting that the benefits of MA spill over to traditional Medicare.
While the discussions about health care reform will likely only increase in frequency during this political cycle, both sides of the political spectrum have offered support for the MA program. As we continue our journey to value-based care in this country, it is important to consider the role that Medicare Advantage is playing in delivering improved health outcomes, greater quality, and lower costs. While best practices have not been definitively established, MA offers a very rich laboratory of investment, experimentation, and leadership in value-based care.
Tags: Medicare Advantage
Mutual of Omaha 2020 Medicare Advantage
Mutual of Omaha Medicare Advantage and Part D Market Overview Released
They’re here!! Mutual of Omaha Medicare Advantage Company (MOMAC), Omaha Health Insurance Company (OHIC) and Medicare Advantage Insurance Company of Omaha (MAICO) market overview information has been posted on Forms & Materials on Sales Professional Access (SPA) www.mutualofomaha.com/broker. This is your opportunity for a sneak peek at the service areas, provider networks and benefits that are anticipated for Plan Year 2020. You won’t want to miss out on this!
Because plan information is pending CMS bid approval, these documents are available as download only. Also, keep in mind, plan design and service areas are pending government approval and are subject to change. The posted material is for producer use only and cannot be shared with the general public.
AHIP and Product Training
America’s Health Insurance Plans (AHIP) Certification, Medicare Advantage product training and Part D Prescription Drug Plans (PDP) product training is now available on SPA: www.mutualofomaha.com/broker
Even better, your AHIP Certification results can now be submitted electronically to Mutual of Omaha. No need to fax or mail your certificate. If you have completed the assessment using another carrier, you can still have the results conveniently sent to us. Just navigate to the AHIP site using the link on SPA. You will find instructions on how to transmit your results electronically. You will not have to pay or take the assessment again.
Not appointed to sell Mutual of Omaha Medicare Advantage plans?
It’s time to get Ready to Sell for 2020 Medicare Products
Get Ready to Sell our Medicare Advantage and PDP products in just 3 easy steps!! Start the process today.
That’s all there is to it!
Re-contracting for Mutual of Omaha’s MA market expansion
If you are currently contracted for Medicare Advantage through Mutual of Omaha Medicare Advantage Company (MOMAC), a Medicare Advantage Insurance Company of Omaha (MAICO) Amendment will be required if you are planning to sell outside the current MOMAC markets. This new company is for Medicare Advantage plans rolling out this year in the following markets: Denver, Dallas/Fort Worth and El Paso.
And remember, to earn renewal compensation you will need to be Ready-to-Sell for the plan year compensation is to be paid.
Not appointed to sell Mutual of Omaha Medicare Advantage plans?