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New state releases include:Colorado, Florida, Missouri, Ohio, and Utah.
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eApp Technology Highlights:
Instant Decision | open enrollment applications are processed and issued instantly.
Responsive eApp Questioning | answer the only questions needed to help accelerate automated underwriting.
Automated Underwriting | a powerful underwriting engine automatically processes underwritten applications to generate a decision at the completion of the application process.
Paper or Electronic Policy Delivery | choose paper or electronic policy delivery.
Electronic and Voice Signature capabilities | with multiple signature capabilities, choose the option that works the best for you and your clients – electronic, voice or email capabilities available.
Social Security Billing | clients can choose to have their premium paid on the same date that their Social Security check is deposited.
For Agent Use Only. Not Intended to Create Public interest in an Insurance Product, an Insurer, or Agent. Prosperity Life GroupSM is a marketing name for products and services provided by one or more of the member companies of Prosperity Life Insurance Group, LLC, including SBLI USA Life Insurance Company, Inc., S.USA Life Insurance Company, Inc., and Shenandoah Life Insurance Company. Members not licensed in all states. Only SBLI USA Life Insurance Company, Inc. is authorized to do business in New York. Each company offers a variety of insurance products and is solely responsible for its own financial and contractual obligations. SBLI USA Life Insurance Company, Inc. is not affiliated with The Savings Bank Mutual Life Insurance Company of Massachusetts or The Savings Bank Life Insurance Company of Connecticut. Product underwritten by SBLI USA or S.USA depending on state, policy form series MSPAAS21[xx], MSPFAS21[xx], MSPGAS21[xx], MSPNAS21[xx] ([xx] varies by state). Not available in all states. C-PEBMEDECW21-2
Zero-dollar health plans are bringing average Medicare Advantage premiums lower, continuing an ongoing trend, an eHealth reportfound.
eHealth surveyed over 4,200 Medicare beneficiaries who were eHealth consumers between October 12 and October 25, 2021.
The researchers found that the average Medicare Advantage premium was $4 per month for plan selections made in the first half of the 2022 open enrollment period, lower than both 2021, 2020, and 2019 open enrollment periods for the same timeframe.
The average premium has been substantially diminished due to the prevalence of zero-dollar premium Medicare Advantage plans. In the first half of the 2019 open enrollment period, zero-dollar premium health plans accounted for 76 percent of health plan selections. However, in the first half of the 2022 open enrollment season 86 percent of Medicare beneficiaries have selected zero-dollar premium plan.
The survey also found that stand-alone Medicare Part D drug plans are seeing a steady premium rate compared to the first half of the 2021 and 2020 open enrollment periods. The average premium for Medicare Part D drug plans was slightly higher in the first half of the 2019 open enrollment period, hitting $23 per month.
Not all selected Medicare plans saw a favorable trend in premiums. In the first half of 2022 open enrollment, average Medicare supplement plan premiums hit $172 per month. Medicare supplemental plans that were chosen in the first half of the open enrollment season saw an eight percent increase from 2021 to 2022.
This continued a trend spanning at least a couple of years. In 2019, average premiums of selected Medicare supplemental plans cost $146 per month in the first half of the open enrollment season.
However, the researchers noted that Medicare beneficiaries can enroll in Medicare supplement plans at other times of the year apart from the open enrollment period. This reality might affect final average premiums over the course of a year.
The survey also referenced some of the data from areportthat eHealth published previously in the same month. That previous report found that health insurance enrollees overall were most concerned about out-of-pocket healthcare spending, covering premiums, and keeping their providers in-network.
The eHealth survey noted that Medicare beneficiaries also were primarily concerned about out-of-pocket costs, with 39 percent citing this as their biggest concern related to their Medicare coverage.
However, there was variation regarding how big of a concern this was for Medicare beneficiaries based on the type of Medicare coverage in which they were enrolled. Among Medicare Advantage, Medicare supplement plans, and Medicare Part D prescription drug plans, Medicare Advantage members were the most likely to have out-of-pocket cost concerns.
In contrast, beneficiaries inMedicare supplement planswere the least likely to face affordability barriers. Slightly less than a third of beneficiaries in these plans reported that out-of-pocket healthcare spending was their greatest Medicare coverage concern.
These results related to members’ experiences of out-of-pocket healthcare spending sync with previous research on the subject. Beneficiaries in Medicare supplemental coverage have fewer cost-related hurdles to overcome, a Kaiser Family Foundation issue briefestablished.
Although Medicare Advantage members were most likely to have concerns about out-of-pocket healthcare spending, only eight percent of Medicare Advantage beneficiaries found premiums to be their top concern.
The remainder of the 2022 Medicare open enrollment season will show whether these trends continue and will provide a fuller picture of members’ priorities.
Dual eligible beneficiaries enrolled in Medicare Advantage plans sought preventive care more often and saw lower healthcare costs compared to beneficiaries in fee-for-service Medicare.
- Dual eligible beneficiaries were more likely to choose a Medicare Advantage plan over a fee-for-service Medicare plan, astudycommissioned by Better Medicare Alliance (BMA) found.
To understand the demographics, health outcomes, and healthcare spending trends among the dual eligible population, ATI Advisory analyzed data from the 2018 Medicare Current Beneficiary Survey and Cost Supplement File.
Researchers found that 44 percent of dual eligible beneficiaries were enrolled in Medicare Advantage compared to 35 percent who were enrolled in fee-for-service Medicare. Additionally, 23 percent of all Medicare Advantage members were dual eligibles whereas 17 percent of fee-for-service Medicare beneficiaries were dual eligibles.
Dual eligible beneficiaries who were enrolled in Medicare Advantage were more likely to have a usual source of care compared to beneficiaries enrolled in a fee-for-service Medicare plan, the report found. Medicare Advantage dual eligibles received preventive care services more often than fee-for-service dual eligibles as well.
In the past year, 42 percent of Medicare Advantage dual eligibles had a mammogram compared to 34 percent of fee-for-service dual eligibles.
Nearly 68 percent of Medicare Advantage dual eligible beneficiaries received a flu shot in the last year compared to 62 percent of dual eligibles on a fee-for-service Medicare plan. Medicare Advantage members were also more likely to have had their blood cholesterol measured than fee-for-service beneficiaries (92 percent and 84 percent, respectively).
Since dual eligible beneficiaries qualify for both Medicare and Medicaid, they typically have incomes that are near or below the federal poverty level. Dual eligibles are also more likely to identify as part of the Black or Latinx communities, compared to beneficiaries who are eligible for Medicare only.
Black beneficiaries and Latinx beneficiaries comprised more than half of all dual eligible beneficiaries enrolled in Medicare Advantage special needs plans (SNP), accounting for 29 percent and 27 percent of the overall dual eligible population respectively, the report noted.
Just over 40 percent of dual eligibles in a Medicare Advantage plan without SNP identified as part of the Black or Latinx communities, with the percentage dropping to 34 percent among dual eligibles in fee-for-service Medicare. In contrast, only 13 percent of Medicare-only beneficiaries identified as Black or Latinx individuals.
Dual eligible beneficiaries tend to have complex medical and social needs, another reason why they may flock toward Medicare Advantage instead of fee-for-service Medicare. Medicare Advantage and SNP canprovide supplemental benefitsthat are tailored to members’ specific health conditions.
BMA found that 72 percent of dual eligible beneficiaries enrolled in a Medicare Advantage SNP reportedhaving three or more chronic conditionscompared to 56 percent of dual eligibles enrolled in fee-for-service Medicare. Th Medicare Advantage population without SNP fell in the middle, with 64 percent of dual eligible enrollees reporting three or more chronic conditions.
“This latest research is a powerful testament to Medicare Advantage’s capacity to meet the needs of an increasingly low-income, at-risk, and diverse population,” Mary Beth Donahue, president and chief executive officer of BMA, said in apress release.
“While dual eligible beneficiaries in Medicare Advantage often present even more complex needs than their FFS Medicare counterparts, Medicare Advantage is nonetheless delivering better results in pairing beneficiaries with a usual source of care and providing them with needed preventive services.”
Dual eligibles in a Medicare Advantage SNP saw an average annual premium of $279 and dual eligibles in Medicare Advantage without SNP had a premium of $304. Meanwhile, fee-for-service dual eligibles saw an average annual premium of $435, the report revealed.
Dual eligible beneficiaries in Medicare Advantage saw lower average annual out-of-pocket costs as well, amounting to $1,112 for Medicare Advantage SNP beneficiaries, $1,960 for Medicare Advantage without SNP, and $2,647 for fee-for-service dual eligible beneficiaries.
“Policymakers should ensure the Medicare Advantage program is able to continue providing critical cost protections, targeted and high-touch care models, and supplemental benefits that are particularly meaningful to medically, functionally, and socially complex beneficiaries,” the report concluded.
Many seniors chose not to make a shift during the 2022 open enrollment season because they did not think they could find a health plan better than their current one.
Nearly nine out of every ten American seniors had not changed Medicare plans with less than a month left in the 2022 open enrollment season, according to aMedicareGuide.com survey.
MedicareGuide.com surveyed over 2,280 seniors over the age of 65 from November 15 through November 17, 2021. At the time of the survey, there were three weeks left in the 2022 Medicare open enrollment season.
“Historically, most beneficiaries don’t change plans, but coverage and cost can change significantly year to year, especially now because of Covid,” said Jeff Smedsrud, the co-founder of HealthCare.com, MedicareGuide’s parent company. “It is becoming easier to use online tools to review your plan and find potential savings. It pays to shop around.”
Seniors reported that they were not considering switching health plans. More than two-thirds had not reviewed their health plans and 88 percent of beneficiaries had not changed their coverage at the time.
Seniors noted a handful of reasons why they chose not to change Medicare Advantage plans. Most seniors who did not change health plans (67 percent) said that they could not find a better health plan than the one that already covered them.
Nearly one in five seniors said that they did not change health plans because they would not have saved on their premiums. Cost seemed to be a major factor in seniors' health plan selection process in 2022.Zero-dollar premium Medicare Advantage planshave gained in popularity, driving down the average health plan premium to $4 per month.
However, most beneficiaries who did switch plans and found a plan with a lower premium (85 percent) saved between $0 and $50 each year.
Another 18 percent of seniors did not change health plans because they found the process overwhelming. Lack of healthcare literacy and general confusion about the health plan selection process are perennial problems during open enrollment season. According to a survey commissioned by GoHealth, almost four in ten beneficiariesfound Medicare resources confusing.
Eleven percent of all respondents switched to Medicare Advantage from Original Medicare, primarily due to Medicare Advantage’s benefits.
The hesitance to change health plans is not new. Most beneficiaries have never switched health plans before (66 percent). Eighteen percent reported that they had changed health plans one time.
Even more beneficiaries (85 percent) reported that they did not change their prescription drug health plan during the 2022 open enrollment season. For 9 percent of those who changed their prescription drug plans, pricing was the primary driver.
Seniors also prioritized supplemental benefits. Fifteen percent of respondents were looking for dental, hearing, and vision benefits, while 13 percent sought improved drug coverage.
A new report from the U.S. Department of Health and Human Services (HHS) found that massive increases in the use of telehealth helped maintain some health care access during the COVID-19 pandemic, with specialists like behavioral health providers seeing the highest telehealth utilization relative to other providers. The report, which was produced by researchers in HHS's Office of the Assistant Secretary for Planning and Evaluation (ASPE) and analyzes Medicare fee for service (FFS) data in 2019 and 2020, also highlights that telehealth services were accessed more in urban areas than rural communities, and Black Medicare beneficiaries were less likely than White beneficiaries to utilize telehealth.
“This report provides valuable insights into telehealth usage during the pandemic,” said CMS Administrator Chiquita Brooks-LaSure. “CMS will use these insights – along with input from people with Medicare and providers across the country – to inform further Medicare telehealth policies.”
“During the COVID-19 pandemic, various telehealth flexibilities enabled patient access to their providers,” said HHS Acting Assistant Secretary for Planning and Evaluation Rebecca Haffajee. “Pre-pandemic telehealth visits for Medicare beneficiaries went from hundreds of thousands to tens of millions, with many utilizing telehealth for the first time. Today’s report offers a detailed data analysis on important trends for policymakers.”
To help beneficiaries maintain some access to care amid stay-at-home orders to reduce COVID-19 related exposure, CMS used emergency waiver authorities enacted by Congress, as well as existing regulatory authorities to implement policies expanding access to telehealth services during the pandemic. These included waiving several statutory limitations such as geographic restrictions and allowing beneficiaries to receive telehealth in their home. Outside of the public health emergency (PHE), Medicare is generally restricted to payment for telehealth services in certain, mostly rural areas, and when beneficiaries leave their home and go to a clinic, hospital, or other type of medical facility for the service. There were some exceptions for beneficiaries with end-stage renal disease, stroke and other specific conditions. Additionally, in response to the pandemic, the HHS Office for Civil Rights relaxed enforcement of Health Insurance Portability and Accountability Act (HIPAA) of 1996 privacy requirements for videoconferencing.
Taken as a whole, the ASPE report found that the share of Medicare visits conducted through telehealth in 2020 increased 63-fold, from approximately 840,000 in 2019 to 52.7 million. States with the highest use of telehealth in 2020 included Massachusetts, Vermont, Rhode Island, New Hampshire and Connecticut. States with the lowest use of telehealth in 2020 included Tennessee, Nebraska, Kansas, North Dakota and Wyoming. The report also found insightful trends on the kinds of services Medicare beneficiaries sought through telehealth. While overall health care visits for Medicare beneficiaries declined in 2020 as compared to 2019, telehealth was particularly helpful in offsetting potential foregone behavioral health care. In 2020, telehealth visits comprised a third of total visits to behavioral health specialists, compared to 8 percent of visits to primary care providers and 3 percent of visits to other specialists. These findings prominently show an increased interest in seeking behavioral health care through telehealth.
To help protect access to care as informed by data, CMS recently announced that for the first time outside of the COVID-19 PHE, Medicare will pay for mental health visits furnished by Rural Health Clinics and Federally Qualified Health Centers via interactive video-based telehealth, including audio-only telephone calls. Additionally, CMS is permanently eliminating geographic barriers and allowing patients in their homes to access telehealth services for diagnosis, evaluation, and treatment of mental health disorders, including via audio-only communications technology. These provisions were included in the Consolidated Appropriations Act of 2021.
Other Medicare services added to the telehealth services list temporarily during the PHE will remain in place through December 31, 2023, while CMS continues to evaluate whether these services should be permanently added to the Medicare telehealth services list. And to provide more transparency and visibility into telemedicine usage, CMS is also releasing a new snapshot showing the number of people with Medicare who utilized telemedicine services between March 1, 2020 and February 28, 2021. The snapshot includes Medicare FFS claims data, Medicare Advantage (MA) encounter data, and Medicare enrollment information.
While utilization of telehealth services increased and improved access to services for many beneficiaries, more research is needed to understand the impact on quality of care and why certain beneficiaries used less telehealth than others.