It is essential that agents are aware of CMS and Carrier expectations when conducting telephonic enrollments. Doing so not only protects the client, but also protects the agent from corrective action.
Please review the information below and ensure these elements are covered during a telephonic sale to remain compliant and to protect clients.
Complete the SOB (Summary of Benefits) per approved script requirement.
Read all relevant disclosures as outlined in CMS approved script (i.e., verbally or via IVR(INTERACTIVE VOICE RESPONSE)) and collect agreement/understanding. This will include disclosures listed in the application (i.e.: pop up, required statements)
Provide the plan name
Provide carrier name and customer service phone number
Thank you for your continued support in upholding compliant sales practices! If you have any questions regarding this information, please contact us.
Medicare Blog | Medicare News | Medicare Information
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Tags: Medicare Advantage, phone sales, Telesales, Compliance
The Centers for Medicare and Medicaid Services has created a Special Enrollment Period for people with insulin to change their Part D coverage and ensure they are not paying more than $35 each month for the insulin product.
In response to new legislation and falling prices, there have been several significant changes to Insurance coverage for insulin.
Last fall, President Joe Biden signed the Inflation Reduction Act which included policies that cap the monthly cost of insulin at $35 and reduce the cost of other diabetes drugs for those on Medicare.
Here’s what’s now in effect.
Caps on insulin costs
As of Jan. 1, 2023, Medicare can’t charge you more than $35 for a one month supply of each Part-D covered insulin, regardless of whether or not you have met the deductible.
*Note: Medicare Part D is Medicare’s prescription drug coverage. This includes several diabetes drugs and insulins – including Lantus, Jardiance, Novolog, and Trulicity.
If you use a disposable insulin patch pump, you’ll continue to get your insulin through your part D plan, and the insulin for your pump won’t cost more than $35 each month for each covered insulin product. The pump is not subject to the $35 cap and may cost more than $35.
If you do pay more than $35 for any month’s supply of insulin between January 1, 2023, and March 31, 2023, your Part D plan must reimburse you within 30 calendar days for the amount you overpaid. (Plans have until March 31, 2023 to update their systems to make sure you’re not charged more than $35).
Extended enrollment period for Medicare Part D coverage
The Medicare Plan Finder can help you compare and choose prescription drug plans. However, because the Inflation Reduction Act was signed after the premiums and copays were set on the Medicare Plan Finder, the $35 insulin copay cap was not included.
Because of this, the CMS created a Special Enrollment Period for people who use insulin; people on Medicare can change their Part D coverage until Dec. 31, 2023.
If you use a covered insulin product and decide you’d like to be in a different Part D plan for 2023, you can change your coverage one time between now and December 31, 2023. Call 1-800-MEDICARE if you take insulin and want to change your plan. Your true out-of-pocket costs will carry over from your old plan to your new one.
Medicare beneficiaries who make between 135% and 150% of the federal poverty level ($18,347 to $20,385 for a single person) can access additional discounts through the Extra Help program. Starting in 2024, people who are eligible will have a set, low out-of-pocket cost for each prescription. This could save people an average of $300 a year on out-of-pocket costs, according to government estimates.
For more information on how the Inflation Reduction Act could lower healthcare costs in your state, click here.
You can also learn more about Medicare’s coverage and insulin costs at https://www.medicare.gov/coverage/insulin.
eHealth research highlights economic factors that drive enrollment in Medicare Advantage vs Medicare Supplement. eHealth released findings from original research into more than 3,800 Medicare beneficiaries, contrasting the demographics and sentiments of those who enroll in Medicare Advantage plans with those who enroll in Medicare Supplement plans.
eHealth found that both Medicare Advantage and Medicare Supplement enrollees are overwhelmingly satisfied with their coverage (89% and 87%, respectively). However, Medicare Supplement enrollees are significantly more affluent than Medicare Advantage enrollees and less vulnerable to higher premiums and other costs.
"The challenges that lie ahead for Medicare Advantage underscore the importance of highlighting the financial vulnerabilities of millions of beneficiaries who depend on the program," said eHealth CEO Fran Soistman. "We'll continue to advocate on their behalf with our carrier partners to ensure that enrollees' need for both affordable premiums and affordable out-of-pocket costs are given the attention they deserve."
Additional highlights from eHealth's report:
For more insights, please review the full report and methodology information.
Increase your sales with the right attitude
As a marketing firm, we get calls everyday from agents looking to better one aspect of their business or another. One of the most common questions we receive is “What are your top producing agents doing and how can I replicate it?"
This is a good question and an understandable one. As an agent you are trying to build a business for yourself and are looking for ways to make that business more successful.
The answer to this question is simple, however it isn’t usually the answer the agent is hoping for. There isn’t a perfect lead source or infallible script.
After speaking with thousands of agents over the past 15 years I’ve noticed what separates the top producing agents from the rest of the pack is attitude.
This is great news because changing your attitude is free. It takes time and discipline but it doesn’t take any money.
When I speak of attitude I am not talking about simply smiling and being friendly when speaking with your clients. Top producing agents have three key attributes that defines their attitude.
If you ask any high-volume producer how they write so much business, their first answer is going to be that they work really hard.
As an independent agent you don’t have a boss. You don’t have someone telling you what to do or when to do it.
Most importantly you don’t have anyone checking to make sure you did what you were supposed to do when you were supposed to do it. You have to act as your own manager, setting a daily schedule and following it.
Top producers have the mindset that they are running a business and this means that they section off their day and know what they are going to be doing and when they are going to be doing it.
For example, if you have blocked off the first half of your day to call leads and the first person you call purchases a policy from you, it is easy to say “I’ve made my sale for the day” and move on to something else.
This is a mindset that many agents fall into. The best agents don’t have that attitude though. They know that those leads they purchased work best when they are fresh and that they have allotted that portion of their day to calling those leads.
They don’t give themselves an easy out or allow themselves to slow down because of an early success.
As an agent you have to have the attitude that you are going to drive yourself to be as successful as you possibly can. You must outline standards and practices that will make you successful and hold yourself accountable to those without exception.
Reputation is something that I have noticed that all high-level agents value. Your reputation not only generates referrals for you but it also directly impacts your persistency.
Whether you are selling face-to-face or over the phone your reputation is important. It is vital not only for your business to be successful but also for you to be happy and confident in what you are doing.
When you know that your clients and your peers respect you and the way you conduct your business you will have more confidence in yourself.
That confidence will translate through in every interaction you have and you will see clients more willing to trust you and an increase in sales.
Managing your reputation is simple, but not always easy. You will need to make sure that you are consistent in your approach and apply the same high level of standards to every client interaction.
You can and will have bad days. You can’t let those bad days be visible to your clients. Your reputation is dependent on you being professional and pleasant during every interaction.
Establishing and maintaining your reputation will take a little personal reflection and effort but you will see an increase in sales and job satisfaction.
Finally, genuinely caring about your clients is paramount.
I have never spoken with a high-volume producer who didn’t have a clear passion for making sure their clients were taken care of fully. Your clients are trusting in you to help them make a decision that directly affects their health and finances.
You have a duty to make sure that their best interest is at the forefront of every decision you make. Those clients need to know that you care about their health as much or more than they do.
Seniors get post-card after post-card every month from agents who can sell them a policy. You aren’t just selling them a policy. You are giving them peace of mind. You are protecting them.
You are listening, advising and befriending them. Once you start really connecting with and taking a true interest in the well being of the people you serve you will notice a much stronger relationship with those clients.
Your sales will increase, your persistency will increase, your referrals will increase, and the fulfillment you get from helping your clients will increase.
I realize everything I’ve said to you today is basic common sense. Work hard, present yourself well and care about others.
We’ve all heard these principles our whole lives. They are simple, they are basic and they are what we try to teach our children on a daily basis.
They are also the qualities that people respect the most and look for in others. The highest producing agents we speak to don’t have any magic secret that helps them write more business.
Yes, they invest in their business, organize well and are great sales people. But their real key to success is they work harder, more professionally and with more empathy than the average agent.
Their clients see them as a friend to trust and depend on. Your attitude will directly impact your success in this or any industry and the good news is it is free.
Thanks for your time today. As always if you have any questions over any of this or the industry in general please reach out to one of our marketing directors at 800-998-7715.
We are happy to talk insurance and look forward to speaking with you.
How to Scale Your Medicare Business
What does every agent have in common? They all want to write more business.
Anyone who has been in the industry for any amount of time can tell you that increasing your production isn’t something that just happens. You have to plan and work to make it happen.
There are numerous paths you can take to grow your business, and what’s right for you depends on your personal preferences and goals.
Today I don’t want to talk to you about how to grow your business, I want to talk to you about some key principles you will need to consider when coming up with your business plan.
I’m going to share with you what factors the largest call centers and agencies in the country focus on to make sure they are running a successful business.
To start with we need to quickly go over the three most important factors in an agencies business. Cash flow, CPA, and LTV.
It’s imperative that you're be able to calculate your total CPA because you need to make sure it is lower than the third key factor, lifetime value or LTV.
Too often I talk to agents who are hesitant to invest in their business because they are only looking at first year profit margin. You are running a business and just like any other business you are going to have to invest in it to see it grow.
Download the guide in PDF here.
Now that we know how to calculate how much business it will take to reach your goals we need to talk about your budget. Your budget is how much you have to spend on your business.
Once you’ve got your budget squared away it’s time to consider the management side of starting an agency. The hardest part of running an agency is managing agents and managing leads.
You also want to have procedures in place to make sure that you are getting the most out of your leads.
When I say this most peoples minds immediately go to selling techniques and how to close more sales.
Often it’s more effective to focus on solidifying the sales you are already making to reduce attrition.
If you can reduce the percentage of clients who leave you yearly from 15% down to 5% then you will most likely see more profit from that than you would by increasing your closing percentage.
Here at PSM we focus on Medicare advantage so I’m going to use that as an example but this will apply to any product line.
By doing all of this you will drastically increase your placement and persistency rates. Placement and persistency are vital to your success. You spent the money to acquire these clients so you need to make sure you keep them.
So far we’ve covered the key factors you need to consider when planning to scale your business. How to maximize commissions, managing your leads to workforce ratio and how to calculate the profitability of your business using LTV and CPA.
The last thing I want to leave you with is how to calculate the value of your business using a ratio. This simple method will give you a snapshot of the overall health of your business model.
If I told you I’d give you $300 tomorrow for every hundred dollars you give me today you would take that deal, right? Of course you would.
That’s all I have for you today. I hope that you are able to take some of this information and apply it to your own personal situation. And more importantly I hope you do take the chance, invest in your business and realize your goals.
If you have any questions or want to talk about how to best scale your business please give us a call at 800-998-7715 and ask to speak with one of our marketing directors. We’ll be happy to take the time to go over any of this in more detail and can even run a personalized calculation for you on what kind of ROI you can expect.
Thanks for your time and have a great day.
Download the guide in PDF here.
Tags: Agency Building
Important Resource: Medicaid Redetermination Resource Document
Related Article: https://www.psmbrokerage.com/blog/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-provision
Tags: Medicare Advantage, Medicare-Medicaid, Special Needs Plans
At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. Primarily due to the continuous enrollment provision, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. But, when the continuous enrollment provision ends, millions of people could lose coverage that could reverse recent gains in coverage.
As part of the Consolidated Appropriations Act, 2023, signed into law on December 29, 2022, Congress set an end of March 31, 2023 for the continuous enrollment provision, and phases down the enhanced federal Medicaid matching funds through December 2023. States that accept the enhanced federal funding can resume disenrollments beginning in April but must meet certain reporting and other requirements during the unwinding process.
This brief describes 10 key points about the unwinding of the Medicaid continuous enrollment requirement, highlighting data and analyses that can inform the unwinding process as well as recent legislation and guidance issued by the Centers for Medicare and Medicaid Services (CMS) to help states prepare for the end of the continuous enrollment provision.
Tags: Medicare Advantage, Medicare-Medicaid, Special Needs Plans
Give clients the freedom to choose. With this bundled solution from LifeShield, producers and clients can enjoy a unique and exclusive Medicare Supplement and Dental, Vision, and Hearing (DVH) combo sale opportunity with more benefits and more freedom – meeting clients' financial and coverage needs.
Become a LifeShield agent today and start providing your clients with unbeatable coverage at an affordable price.
Competitive Rates With Great Commissions - PAID DAILY - Policyholders can enjoy market leading rates across Plans F, G, and N, while producers can enjoy a great commission rate that’s PAID DAILY.
A Seamless eApp Experience - Point-of-sale underwriting decision notification for clean apps and declines, with 48-hour turnaround for referred underwritten cases.
Combo Sale approved in 19 states w/ more coming soon!
LifeShield National Insurance Co. is an Oklahoma City-based life and health insurance company, and a member of the LifeShield National family of insurance companies. Together with its affiliates Individual Assurance Company Life, Health, & Accident, and Life Assurance Company, LifeShield has been protecting families for nearly 50 years with affordable life, health, and accident insurance solutions to help you live the life you choose. LifeShield National Insurance Co. is rated B++ (Good), the 5th highest rating possible out of a total of 16 by AM Best, a widely recognized independent insurance industry ratings firm. For the latest rating information, visit www.ambest.com
Tags: dental hearing and vision insurance, Medicare Supplement, LifeShield
Cross-selling insurance is a highly effective strategy. A study by McKinsey revealed that cross-selling can increase profits by 30% and sales by 20%. The likelihood of selling to an existing customer is in the 60-70% range versus the 5-20% range of selling to a potential customer.
Anyone interested in making the most of their time?
There are many reason why you should be cross-selling as part of your business strategy. Please reach out to one of our marketing representatives for ideas, resources and approved materials.
Tags: Medicare Supplement, Medicare Solutions, cross selling
We’re well aware that many agents aren’t all that excited about updating their website, creating content with SEO in mind, and using social media for their business.
It’s not always easy for those of us that didn’t grow up with the internet, and it can be a lot of work. But if you want to grow your business, it’s not an option to invest in digital marketing and social media marketing any longer.
I know, even hiring the right people to do your marketing can be a daunting task. Who do you hire, and for what? Do you hire full time or outsource it?
It’s ideal, of course when you can find a single source to help with all those needs, at a cost that is sustainable.
We are excited to introduce our new digital marketing suite of services – YourDigitalLab.
YourDigitalLab (YDL) is a leading full-service digital marketing agency for agent and advisors. They work to optimize various campaigns made specifically to deliver the results you want. YDL is the trusted choice for agents and advisors looking to drive sales and leads with online marketing.
Consumers are savvy these days and it takes only about half a second for visitors to form an opinion about your website. 38% of people will stop engaging with a website if the content or layout is unattractive.
So if you are in need for these types of services, or if you would just like to take a deeper look at what some of these items can do for your business, I highly recommend a consult with the YourDigitalLab team.
They will take the time to assess your business and develop a package that caters to you and fits your need, at a very competitive price.
We’re very excited about this new exclusive offering and we hope you can take advantage of these services to help take your business to the next level.
Let’s face it, whether you’re an agency trying to scale and recruit new agents, or a business trying to grow and attract new clients, everyone and their grandmother are using social media today. And if that’s where your customers are spending their time, then that’s where you should be spending your marketing budget.
So, go to www.yourdigitallab.com quick, and check out the reasonably priced services they offer. I know you’ll be impressed, and you’ll find these services can help take your business to new heights!
Thanks for your time, and happy selling!
Aetna Med Supp & YourMedicare SunFire
For quite some time now you’ve asked us to add more Medicare Supplement plans to YourMedicare SunFire. It’s still the beginning of the year and we’re already making it happen! Aetna’s Med Supps are slated to go live for agents and agencies on 3/21!
This is just the beginning, plenty more to come and we’ll keep you updated as they do!
• You can use your existing login to access the Aetna Medicare Supplement plans.
Tags: Aetna Medicare Supplement, Medicare Supplement, Medicare Solutions, YourMedicare, SunFireMatrix
Tags: Cigna, Medicare Part D
We also believe that as an organization, it is our obligation to invest in our agents' future by providing resources to help educate your prospective clients on Medicare-related topics.
To that end, we have developed a Medicare 101 presentation that can be used to assist in your Medicare sales. This presentation is CMS compliant and also can be customized with your unique branding.
If you would like more detailed information on how to plan, organize and drive traffic to a seminar please call one of our marketing representatives today.
We will work with our compliance department to provide you with a personalized seminar presentation and give you best practices on the seminar process from start to finish.
Medicare 101 presentations when utilized correctly can be an extremely advantageous lead-generation avenue, having the right partnership and strategy in place is imperative to an agent’s success in the Medicare space.
Call to speak with one of our experienced marketers and make this the best year yet!
Tags: Medicare Advantage, Medicare Supplement, Medicare Part D, CMS, Medicare Solutions
Historically anchored on a foundation of financial integrity, responsible management, and a strong commitment to every policyholder, American-Amicable Life Insurance Company of Texas looks to the future with great enthusiasm.
American-Amicable Final Expense Product Highlights:
Tags: Final Expense, American-Amicable