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?

• We’ve already submitted a new request to restart SSA premium deduction for the affected members, effective June 1, 2019. If the request is accepted by SSA, they will send members a letter of approval. Please be aware this can take up to 90 days.
• Please explain to your clients that SSA will only deduct future premiums from their Social Security check as of the effective date noted in their approval letter, so any balances owed up until that effective date must be paid to Aetna directly. Members need to pay premiums directly to us for any months the SSA or RRB doesn’t cover.
• While these members are not currently at-risk for termination due to nonpayment, they do need to begin making payments to ensure their plan does not face termination for nonpayment in the future.

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.

If you have Dual-eligible Special Needs Plans (DSNPs) in your market, you can now find, download, print and order DSNP marketing materials on the Aetna Medicare Marketing Studio (MMS). You can find the materials in the designated DSNP category on the MMS menu. DSNP materials include: 

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.

Aetna Supplemental: Your opportunity to go beyond the Golden Gateway

Beyond the Golden Gateway

We’re excited to take our next broker incentive trip to San Francisco, where top producers will experience magical moments beyond the Golden Gateway.

Aside from the mild weather, food, wine, cable cars, coffee shops and vintage classic architecture and culture, San Francisco is the opportunity for us to connect with each of you and showcase this city in a way you cannot even imagine! 

To give you a sneak peek of what to expect, here are two special guests -- legendary Pro Football Hall of Fame member Joe Montana and Aetna’s own Ty Wooldridge -- to share why we not only value the relationship we have with each of you, but also, why we love San Francisco and why you will too!  

You can view complete trip qualification details here.

Aetna Supplemental: Hot Medicare Supplement Rates in Texas

Aetna is now offering NEW Medicare Supplement* in Texas with competitive rates.

Not appointed with Aetna Supplemental? Request details here

You can use Aetna Quote & Enroll to submit electronic applications or order state-specific sales materials.

We look forward to helping you grow your business with this competitive new product!

Product Spotlight: Aetna Cancer and Heart Attack or Stroke Plus

On March 1, 2019 Aetna began offering CLI Cancer and Heart Attack or Stroke Plus in the following states: AL, AR, CO, CT, DE, GA, IA, IL, KY, LA, MI, MS, MT, NC, ND, NE, NV, OK, PA, SC, SD, TN, TX, WI, WV, WY

What is Cancer and Heart Attack or Stroke Plus?

There are four plans to select from… choose a cancer plan or a heart attack/stroke plan or one of each, with different benefit amounts. Watch the video above to learn more.

Sales materials and online enrollment

Agents can now order state-specific sales materials for these products. 

Aetna Quote & Enroll

Application cut-off for existing product

The last application signature and submission date for the existing Cancer and Heart Attack or Stroke product in these states will be June 27, 2019.

Not appointed with Aetna Supplemental? Request details here

Walgreens Partnership Boosts Humana's Medicare Enrollment

By Bruce Jepsen – Forbes – February 7, 2019

Humana says its joint venture with Walgreens Boots Alliance is helping boost enrollment in Medicare Advantage, the fast-growing privately administered health coverage for U.S. seniors.

Humana reported a 9% increase in Medicare Advantage membership the health insurer attributed to physicians at more than 230 clinics including two sites inside Walgreens stores. It’s the latest sign showing the early stages of a joint venture between Humana and the nation’s largest drugstore chain is working and could be expanded beyond a pilot in the Kansas City market.

"Our 233 owned, joint ventured and alliance clinics, the majority of which are payer agnostic, including our two 'Partners in Primary Care' clinics inside Walgreens stores experienced positive results in the annual election period," Humana CEO Bruce Broussard told analysts Wednesday during the company's fourth quarter earnings call.  "Humana MA membership grew over 9% in these clinics in the (annual election period) excluding the more mature Conviva clinics."

Humana, which has invested hundreds of millions of dollars acquiring and partnering with medical care providers in recent years, said its relationships helped it take Medicare Advantage market share away from rival insurers. Humana said it expects 2019 individual Medicare Advantage membership growth of “375,000 to 400,000 members, representing 12% to 13% growth,” the insurer reported Wednesday as part of its fourth-quarter 2018 earnings release.

Walgreens and Humana last year opened “senior-focused primary care clinics” inside drugstores as a way to complement Walgreens pharmacy services and Humana’s Partners in Primary Care centers that opened last year in Kansas City. The effort is designed in part to keep people out of the more expensive hospital setting and make sure Medicare patients have their care more closely monitored by Walgreens pharmacists and physicians in Humana’s health plan networks.

The two companies think they can do a better job of reaching patients who visit Walgreens retail locations and making sure they get better care upfront before they get sick. When the partnership was announced, Walgreens and Humana called it “a senior-focused neighborhood approach to health that brings together primary care, pharmacy, in-person health plan support and other services for Medicare beneficiaries.”

The Medicare Advantage growth is key for Humana, which is in a competitive battle with rival insurers like Aetna, UnitedHealth Group and Cigna, looking to tap into a market of more than 10,000 baby boomers aging into the Medicare population every day.

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. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

Humana ended 2018 with 3.06 million individual Medicare Advantage members, which was up 7% from 2.86 million as of Dec. 31, 2017.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/07/humana-walgreens-clinic-venture-boosts-medicare-enrollment/#1ce9cb783f39

Industry support gathers for expanding MA benefits in 2020

By Amy Baxter – HealthExec – February 5, 2019

Since CMS proposed expanding supplemental benefits for Medicare Advantage for the 2020 plan year at the end of January, several industry groups have voiced their support, seeing opportunities to improve care for individuals with chronic illnesses and lower costs.

The proposal allows MA plans––which are private health insurers that contract with Medicare to provide all healthcare services under original Medicare––more flexibility to design benefits centered around specific chronic conditions. CMS previously expanded supplemental benefits for the 2019 plan year to include services such as in-home care, which can keep older adults out of acute care settings and improve health and wellness.

The new expansion, if finalized, would enable plans to cover more benefits that directly address social determinants of health, such as home modifications, transportation and meals. For people with chronic conditions, addressing these issues can prevent or delay more serious health events. The benefits would also extend to those affected by opioid addiction seeking treatment.

“Meeting the needs of patients with chronic disease requires a team-based approach to care,” president and CEO of the American Medical Group Association (AMGA), Jerry Penso, MD, MBA, said in a statement following the proposal. “This also may include services that traditionally were not thought of as healthcare-related, including ones that deal with socioeconomic barriers to care. That is why AMGA is supportive of CMS’ effort to provide flexibility in how Medicare Advantage plans in order to help support the total needs of a patient by, for instance, ensuring their nutrition and transportation needs are met.”

The expanded benefits could help attract more Medicare beneficiaries to MA plans if plans include them in their 2020 bids. Over the next several years, MA enrollment is expected to significantly rise. In 2019, enrollment is anticipated to reach an all-time high of 22.6 million, or 36.7 percent of all Medicare beneficiaries, according to CMS.

With this in mind, Matt Eyles, president and CEO of association group America’s Health Insurance Plans (AHIP), is taking a close look at the proposal and its potential impact.

“We appreciate the ongoing bipartisan commitment from both Congress and the Administration to protect the Medicare Advantage program — ensuring its long-term stability, so that it can continue to improve seniors’ access to quality, affordable health care that meets their individual needs,” he said in a statement. “We will continue to review the advance rate notice carefully and look forward to participating in the comment period.”

Better Medicare Alliance, which advocates for MA through healthcare policy and research, also plans to comment on the proposal and voiced stronger support for the expansion of the supplemental benefits to people with chronic illness and those affected by opioid addiction.

“We are encouraged by CMS’ proposals to allow Medicare Advantage plans and providers greater flexibility to meet the needs of chronically ill beneficiaries with the expansion of supplemental benefits,” BMA President and CEO Allyson Y. Schwartz said in a statement. “Evidence has shown that beneficiaries in Medicare Advantage experience lower rates of opioid use. CMS’ proposals will build on this success by increasing access to effective treatments for opioid addiction and promote non-opioid therapies available in Medicare Advantage.”

Source: https://www.healthexec.com/topics/policy/industry-support-gathers-ma-benefits-2020

By Bruce Japsen – Forbes – February 5, 2019

Health insurers are reporting unprecedented growth in the number of seniors flocking to private Medicare Advantage plans amid talk of a single payer government-run approach that could uproot such coverage.

The same week U.S. Sen. Kamala Harris (D-California) made news with her support for “Medicare for All,” insurers Anthem and Cigna reported strong growth from Medicare Advantage, private coverage sold via contracts with the federal government.

Anthem’s Medicare Advantage enrollment jumped by 35% to more than 1 million at the end of 2018 compared to 746,000 in the fourth quarter of 2017, the operator of Blue Cross and Blue Shield plans reported last week. “Our individual Medicare Advantage business is on track to achieve our mid-double digit growth target,” Anthem CEO Gail Boudreaux told analysts during the company’s fourth quarter earnings call last week. “In total, we estimate our Medicare Advantage growth will exceed 20% by the end of 2019.”

Meanwhile, Cigna reported Friday that its Medicare Advantage enrollment was up one percent to 436,000 from 432,000 and UnitedHealth Group ended 2018 with 4.9 million Medicare Advantage enrollees, which was up nearly 12% from 4.4 million at the end of 2017. Other insurers including Aetna, which is now part of CVS Health, are expected to report higher Medicare Advantage enrollment later this month after these plans expanded into new markets.

The industry is tapping into a market of more than 10,000 baby boomers aging into the Medicare population every day . The insurers that have reported 2018 earnings thus far are reporting overall industry growth that’s slightly ahead of the projected record growth the Centers for Medicare & Medicaid Services (CMS) predicted for Medicare Advantage last fall. “We completed a strong Medicare Advantage enrollment season . . . and are on track to achieve 2019 growth within the 400,000 to 450,000 range of expectations,” Steve Nelson, CEO of UnitedHealthcare, UnitedHealth’s insurance business told analysts two weeks ago.

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. CMS is changing regulations to allow Medicare Advantage plans to provide broader coverage in the future, which is also expected to boost enrollment. L.E.K. has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

As seniors flock to Medicare Advantage, analysts say it’s going to make it difficult for Democrats on the presidential campaign trail to support a Medicare for All approach that would bring an end to the private insurer’s role.

The insurance industry worries most about so-called “single payer” forms of health insurance that would conceivably replace the private insurer’s role with a government-administered form of coverage. U.S. Sen. Bernie Sanders of Vermont has espoused the single payer approach for years but the Medicare for All Act of 2017 that he, Harris and others supported does mention “the ability to enroll in a Medicare Advantage plan.”

America’s Health Insurance Plans, the health insurance lobby that includes Anthem, Cigna and other insurers that sell Medicare Advantage, said Americans don’t want a “a one-size-fits-all health care system.”

“Today, health insurance providers deliver coverage that is working for hundreds of millions of Americans – including 180 million Americans who are covered through an employer, 20 million covered through Medicare Advantage, 55 million covered through Medicaid managed care, and 20 million who buy their own coverage,” AHIP spokeswoman Kristine Grow said.

”The vast majority of these 300 million Americans are satisfied with their existing coverage," Grow added. "One of the reasons they like their coverage is it provides them with choice and control. Health care is personal – all Americans are unique individuals with different health care needs depending on their stage of life, where they live, their income and resources, and physical and mental health. People should be able to get the care they need, when they need it, at a cost they can afford.”

Source: https://www.forbes.com/sites/brucejapsen/2019/02/03/as-democrats-talk-single-payer-private-medicare-advantage-soars/#71a5c29458f3

Medicare Advantage Enrollment Surges For Centene And WellCare

By Bruce Japsen – Forbes – February 5, 2019

Centene and WellCare Health Plans are the latest to report a surge in seniors signing up for private Medicare coverage administered by health insurers.

Centene and WellCare, which reported earnings Tuesday, have been expanding beyond their historic business lines dominated by administering Medicaid benefits for states into Medicare Advantage. Centene also has a large business offering subsidized individual coverage offered under the Affordable Care Act.

But these health insurers are joining the parade of health plans and startups taking advantage of more than 10,000 baby boomers turning 65 every day and rule changes administered by the Centers for Medicare & Medicaid Services (CMS) to allow private insurers to offer more benefits in Medicare Advantage plans they sell.

Centene’s enrollment in Medicare plans, including Medicare Advantage, rose 25% to 416,900 in the fourth quarter compared to 333,700 in the fourth quarter of 2017. Meanwhile, WellCare reported Tuesday its enrollment in Medicare plans including Medicare Advantage increased nearly 10%, or by 49,000, to 545,000 in the fourth quarter of last year compared to 496,000 in the fourth quarter of 2017.

Such growth reported by Centene and WellCare Tuesday comes following double-digit percentage growth in Medicare Advantage enrollment already released by Anthem and UnitedHealth Group. Humana reports its earnings later this week and Aetna, now owned by CVS Health, reports its fourth quarter results later this month.

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. CMS' rule changes to allow Medicare Advantage plans to provide broader coverage in the future is also expected to boost enrollment. L.E.K. Consulting has projected Medicare Advantage enrollment will rise to 38 million, or 50% market penetration by the end of 2025.

The rising enrollment in privately-administered Medicare Advantage plans comes as members of Congress and Democrats running for president in 2020 talk about expanding Medicare to all Americans. 

Some of the plans include allowing private insurers to maintain their role offering Medicare Advantage but others urging "Medicare for All" including Sen. Bernie Sanders of Vermont and Sen. Kamala Harris of California have talked about a diminished role for the health insurance industry in administering Medicare benefits.

Source: https://www.forbes.com/sites/brucejapsen/2019/02/05/medicare-advantage-enrollment-surges-for-centene-and-wellcare/#2db5bf1610f0

Image: Freepik