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Medicare Advantage plans that don't embrace telehealth 'will get left behind'

Posted by www.psmbrokerage.com Admin on Wed, Oct 28, 2020 @ 01:53 PM

Healthcare Technology

Deloitte: Medicare Advantage plans that don't embrace telehealth 'will get left behind'

COVID-19 has dramatically accelerated the adoption of digital health, and a new analysis from Deloitte finds that trend extends similarly to Medicare Advantage (MA) beneficiaries.

Deloitte researchers surveyed executives at MA plans, as well as digital health companies, and found that through April 2020 more MA members used telehealth than did so in all of 2019.

telehealth in medicare advantage

Through April, 26% of beneficiaries said they used telehealth or had a virtual visit for any reason, compared to 13% saying the same across all of 2019.

As open enrollment for Medicare continues, insurers that are embracing digital are getting a leg up on the competition, the analysis found.

“COVID has been a game changer. None of this was table stakes six months ago," the Medicare sales lead at one MA plan said. "As we go into the next open enrollment, if you don’t have telemedicine, you’re going to hurt.”

"There's a significant and growing portion of people who are beginning to expect to get enrolled virtually," she said.

The researchers also found that providers, who are critical partners in growing the use of these benefits, are also "surprised" by how effective these tools are.

Deloitte analysts surveyed physicians prior to the pandemic and found that these tools were making their work more efficient and a bit easier. They're also finding it an effective way to deliver care in many circumstances, Thomas said.

“We have a primary care provider-centric view of technology. That’s our tech strategy," the chief technology officer at one plan told Deloitte. "We arm our PCPs with as much tech as possible. The best product or tool to engage the seniors are the PCPs."

The pandemic's impact on digital health has included insurers' supplemental benefits that target MA members' social determinants of health.

Insurers pointed to several key areas where they've focused amid the pandemic: transportation, home drug delivery, food and nutrition and social isolation. All of these get at one of the main challenges under COVID-19: the push for people, especially populations at high risk like seniors, to stay home to avoid exposure.

MA plans are offering transportation benefits to assist members in getting to their doctor's office or to buy groceries and are also partnering with local food banks and other services to provide food delivery.

In addition, they're offering programs to provide companionship and help members secure medications from their homes, according to the report.

"The direction and the emphasis on digital—there is no turning back," Thomas said. "Health plans that are sort of waiting on the sidelines and hoping to be a fad follower will get left behind."

See the latest report from Deloitte


Nassau Medicare Supplement Producer Bonus Program

Posted by www.psmbrokerage.com Admin on Tue, Oct 27, 2020 @ 09:05 AM

Tags: Medicare Supplement, Nassau

Medicare Advantage Enrollment Up 125% Among Dual-Eligible Beneficiaries

Posted by www.psmbrokerage.com Admin on Thu, Oct 22, 2020 @ 08:47 AM

growth chart header

Medicare Advantage Enrollment Up 125% Among Dual-Eligible Beneficiaries

We know that Medicare beneficiaries have the opportunity to enroll in Medicare Advantage (MA) every year during annual open enrollment.

We also know that the number of beneficiaries choosing MA each year has been steadily increasing.

Among the beneficiaries choosing MA in increasing numbers is the cohort of Dual Eligible beneficiaries, those that qualify for both Medicare and Medicaid. 

According to a new report from actuarial consulting firm Milliman,
2019 MA enrollment was 60% more than in 2013, but fee-for-service Medicare (FFS) increased by only 5%.

In 2013 there were 9.6 million full or partial dual beneficiaries, with 2.4 million (25%) enrolled in Medicare Advantage.

By 2019 the total number of partial or dual eligibles had increased to 12.3 million, with 5.4 million (42%), enrolled in Medicare Advantage.

This represents an overall increase in dual eligibles from 2013 to 2019 of 28%, while MA enrollment grew by 125% and FFS dropped by 5.6%

medicare among full and partial dual elegible


Medicare Advantage Growth

From 2013 to 2019, the number of Medicare beneficiaries enrolled in MA plans increased faster than overall Medicare enrollment.

The FFS population grew by 5% in that time period, while the MA population grew by 60%.

2013-2019 change in enrollment


In 2019 MA made up about 37% of total beneficiaries.

The Congressional Budget Office (CBO) projects that Medicare Advantage enrollment will grow to nearly 50% by 2029.

It’s pretty clear at this point that Medicare Advantage is poised for even more growth for the foreseeable future, and the Dual Eligible population is choosing MA in increasing numbers.

We hope you can utilize this information to better serve the Dual Eligible population, as they have been largely underrepresented in the Medicare landscape.

Check out the full report by Milliman and the Better Medicare Alliance.


Additional Updates:

    • An Agent Guide to Dual Eligible Special Needs Plans - View
    • Learn How to Sell Medicare Advantage Plans - View
    • What is AHIP Certification and How do I Get It? - View
    • 7 Ways to Grow Your Insurance Business - View


Leave These Things Behind to Get Ahead

Posted by www.psmbrokerage.com Admin on Wed, Oct 21, 2020 @ 09:04 AM

Agent Compliance Guide - Checklist

Posted by www.psmbrokerage.com Admin on Mon, Oct 19, 2020 @ 12:52 PM


Agent Compliance Guide - Checklist


We all need help remembering tasks that need to be completed throughout the week.

Especially when it comes to the amount of documentation and compliance issues an insurance agent needs to deal with.

So we’ve put together a detailed 10 page checklist with interactive check boxes to help remind you of all the things that are required to remain compliant before, during, and after a sale.

Use the PDF digitally or print it out as a reminder of all the things you need to be aware of.

The check list includes reminders for things such as :

  • Completing a Scope of Appointment
  • Licensing
  • Meeting with a client
  • Making a compliant presentation
  • Communicating with a client after the sale
  • Avoiding and dealing with canceled applications
  • Avoiding and dealing with Rapid Disenrollment’s
  • Dealing with complaints
  • And much, much more..


Below you can see an example of the 10 page checklist.


agent compliance 1


Download the complete 10 page interactive PDF checklist


Tags: Medicare Advantage, Medicare Part D, Compliance

Part D Overview for AEP 2021

Posted by www.psmbrokerage.com Admin on Fri, Oct 16, 2020 @ 03:41 PM

Medicare Advantage, Part D members shifting to higher-rated plans

Part D Overview for AEP 2021

In 2021, 996 Prescription Drug Plans will be offered across the 34 PDP regions nationwide (excluding the territories).

This represents an increase of 48 PDPs from 2020 (a 5% increase) and an increase of 250 plans (a 34% increase) since 2017.
This fact sheet provides an overview of the Medicare Part D program, plan availability, enrollment, spending and financing.

Part D Benefit Parameters Increasing in 2021

Part d parameters 2021

The Part D standard benefit has several phases, including a deductible, an initial coverage phase, a coverage gap phase and catastrophic coverage.

Between 2020 and 2021, the parameters of the standard benefit are rising, which means Part D beneficiaries will face higher out-of-pocket costs for the deductible and in the initial coverage phase, as they have in prior years, and will have to pay more out-of-pocket before qualifying for catastrophic coverage (see graph above).

  • The standard deductible increases from $435 in 2020 to $445 in 2021;
  • The initial coverage limit increases from $4,020 to $4,130, and;
  • The out-of-pocket spending threshold increases from $6,350 to $6,550 (equivalent to $10,048 in total drug spending in 2021, up from $9,719 in 2020).

Part D Standalone Enrollment has Declined, But Increased in Medicare Advantage Plans

Part D Enrollment

In 2020, 46.5 million Medicare beneficiaries are enrolled in Medicare Part D plans, including employer-only group plans; of the total, just over half (53%) are enrolled in stand-alone PDPs and nearly half (47%) are enrolled in Medicare Advantage drug plans.

Full article with many interactive graphs

Tags: Medicare Part D

5 Tips To Make Your AEP Successful

Posted by www.psmbrokerage.com Admin on Tue, Oct 13, 2020 @ 09:32 AM


Photo by Gerd Altmann from Pexels

5 Tips To Make Your AEP Successful

About 23 million of the 62 million people eligible for Medicare have Medicare Advantage coverage, and about 14 million have Medigap coverage.

Some of the other Medicare enrollees have other types of Medicare plans. Companies in the Medicare market are so enthusiastic that, last spring, as the first C-19 wave was peaking, distributors put out press releases announcing they were hiring a total of thousands of call center agents.

Here are five things to know about the Medicare plan market heading toward Thursday:

 ► The market looks competitive: UnitedHealthcare has put out rate sheets showing that, in states like Alabama and Maine, its typical standard rates will be going up about 6% to 7% in 2021.

CMS has spreadsheets showing what’s happening to Medicare Advantage and Part D prices. There, the average monthly premium is on track to decrease 11% in 2021, to $21;

► 31% of people aging into Medicare plan to get enrollment help from live humans: GoHealth, a broker, came up with that statistic in an online survey of 2,106 people 62 and older and not enrolled in Medicare; or 65 and older and enrolled in Medicare;

► Agents and marketers in the field are feeling the effects of the increased level of competition: Jesse Slome of the American Association for Medicare Supplement Insurance (AAMSI) said the “pace of change has been greatly accelerated compared to a year ago.

There is accelerated consolidation and acquisition of companies
that will give larger national distributors significant competitive advantages.”;

► COVID-19 itself might not have that much effect on experienced retail agents: Lindsay Engle, a Medicare market tracker who works for

MedicareFAQ.com, said the image of local agents meeting with clients at a kitchen table is off the mark. “Social distancing won’t have much of an impact, since most sell over the phone.”;

► At least some in the private Medicare plan sector are excited about the idea of the possibility of a change in Medicare age eligibility: Looking ahead, the growth potential for the industry is enormous if the eligibility age is dropped to 60.

If the federal government cuts the regular Medicare eligibility to age 60, “That will result in an immediate growth of the market by 20.5 million,” said Jesse Slome of the AAMSI.

Read The Full Article


Tags: Medicare Advantage, Medicare Part D, 2021 aep

Star Ratings Released for Medicare Advantage, Part D

Posted by www.psmbrokerage.com Admin on Fri, Oct 09, 2020 @ 01:41 PM

Star ratings

Star Ratings Released for Med Adv, Part D

The CMS released Star Ratings for Medicare Advantage and Part D plans Thursday, and the quality ratings of M/A and prescription drug plans remain strong.

Most Medicare beneficiaries – about 77% – who enroll in M/A plans with drug coverage will be in plans with 4-or-more stars in 2021, compared to 69% of beneficiaries enrolled in such plans in 2017.

The 21 health plans earning 5 stars include:

  • KelseyCare Advantage
  • Kaiser Permanente
  • UnitedHealthcare
  • CarePlus by Humana
  • Tufts Health Plan
  • Health Partners
  • Capital District Physicians' Health Plan
  • Quartz Medicare Advantage of Wisconsin
  • Cigna
  • Health Sun - Anthem
  • BCBS - Health Now New York and Martins Point
  • and more

MA star ratings 2020

Almost half – about 49% – of M/A plans offering prescription drug coverage will have an overall rating of four stars or higher, up from about 45% in 2017.

The average Star Rating for all M/A plans with prescription drug coverage improved to 4.06 out of 5 stars in 2021, up from 4.02 in 2017.

2021 Star Rating Fact Sheet

Full Article


Tags: Medicare Advantage, Medicare Part D, star ratings

Enrollment 2020: A Different Challenge

Posted by www.psmbrokerage.com Admin on Thu, Oct 08, 2020 @ 12:04 PM

uncertainty in health coveragephoto created by creativeart

Enrollment 2020: A Different Challenge

The unpredictable impacts of the coronavirus pandemic on Medicare open enrollment will require both broker and member engagement to be technology-enabled, transparent, and streamlined.

Britta Orr, chief Medicare officer at Allina Health l Aetna, told HealthPayerIntelligence that she could see the pandemic having two disparate effects on member decision-making during this open enrollment season.

“There's been sort of a shift in the market and the mindset around insurance,” said Orr. “We see a lot of employers in small and large group plans really choosing to stay put right now with what they're offering their employees.”

These employers and members may be more hesitant to switch out of their current plan given the unpredictable economy and uncertain healthcare environment.

Instead of shifting to an untested plan, those in this category prefer to stay in a plan where they already have an idea of what their costs will be. This could improve retention in the health payer industry, Orr noted.

Meanwhile, other employers and members may be more eager to switch plans and may be more interested in educating themselves about their options than in previous years, given the possibility that they may catch COVID-19.


Whereas last year the changes to Medigap Plan F stirred up a lot of confusion among members, brokers, and navigators alike, this year there have been no major regulatory shifts to trigger uncertainty.

Medicare covers COVID-19 lab testing, antibody tests, medically necessary hospitalizations and hospital quarantines—though some copays may apply—, and the potential COVID-19 vaccine.

Medicare Advantage plans cover many of these same services and may provide coverage for additional benefits, such as telehealth and meal delivery.

However, some of these benefits are not permanent. For example, according to a Peterson-Kaiser Family Foundation brief published in August, coronavirus waivers for a little over 31 percent of payers on the individual and fully-insured markets will end in December 2020.

This extends to some Medicare Advantage plans as well.


This is a time for payers to streamline and focus their messaging, Orr emphasized.

The coronavirus pandemic creates a lot of noise for members. In order to support careful, informed decision-making during open enrollment, payers need to pare down their messaging for both members and brokers to the most relevant content.

For the first half of the year as the country struggled to manage the pandemic, preventive and direct, clinical care fell lower on the priority list for payers and members alike. Humana recently reported a sharp decline in preventive care when COVID-19 struck.

Now, however, preventive care and primary care services are more important than ever.

The payer has resumed its emphasis on these services by participating in Aetna’s Time for Care campaign.

The campaign informs members about how to get wellness checks and safely meet with their providers.

Agents Need to be on top of all the information coming out about plans and Medicare COVID-19 related coverage, as there are a lot of questions around the subject.

The better you are able to explain the situation and put your clients at ease, the better chance you have of finding the right plan for the right person.

Full Article

Life Insurance Sales: August 2020

Posted by www.psmbrokerage.com Admin on Tue, Oct 06, 2020 @ 11:05 AM


Life Insurance Sales: August 2020

LIMRA tracks monthly sales in order to provide continuing insight into the COVID-19 pandemic’s impact on individual life sales and applications.

Sales in August (the most recent month for which information has been compiled) continued the positive trend from July with a 4% increase in premium and 8% increase in policy sales.

Policy growth was driven primarily by large, direct-to-consumer carriers.

Monthly Sales Growth

monthly life sales growth


Sales Growth by Product

life sales growth by product


Premium growth was driven by indexed universal life, which lead on both a growth rate and overall dollar increase basis.

IUL premiums were driven by a one-time occurrence for one carrier and a new product introduction.

Two participants dropped their IUL product this year. Overall, just under half of IUL companies had a premium increase in August.

IUL policy gains were more widespread. VUL and whole life premiums also increased in August.

On a policy basis, term and whole life also increased.

August Premium Growth Range by Product

august life premium growth by product


August Policy Growth Range by Product

life policy growth rate by product


August applications were up 6%, however less than half of participants reported an increase over August 2019.

Applications increased for all products except fixed universal life and variable universal life.

For companies able to respond, face-to-face application submissions dropped off in August after increasing in July while online/mobile applications continue to do better.

Face-to-face channels fared slightly better than in previous months, with a slightly higher percentage experiencing an increase.

Download the Full Report


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