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With looming deadlines of October 15, for Medicare’s traditional open enrollment date, and the overlap of the first enrollment period for Patient Protection and Affordable Care Act set to start on October 1 – December 7, has caused a lot of confusion among seniors over their coverage.

Adding to the confusion is the increased media frenzy reporting of the state exchanges for individuals 65 and under, and insurance companies offering coverage to both the new exchanges and to Medicare recipients.

Federal health officials have stepped up the efforts to let seniors know they have nothing to worry about and that the Medicare benefits are not changing under the Affordable Care Act. They want Medicare recipients to know that the enrollment period of Oct 15th – Dec. 7th, will be business as usual and seniors will be able to sign up to new plans by continuing to go to Medicare.gov.

Federal health officials have ramped up their call centers, training for Medicare counselors and website. This is in preparation to the influx of calls they will be receiving in October, in anticipation of the 50 million Medicare beneficiaries who will be mailed a handbook with a prominent Q&A, stressing their benefits aren't changing. Calls are already being rerouted to Medicare call center from the state exchanges call centers, said Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services.

Worries still linger within the senior community despite federal efforts to stem down the confusion. Under the Affordable Care Act, seniors will not be able to purchase Medicare supplemental insurance or Part D drug plans through the state exchanges. This is what worries seniors such as, 72 year old Bob Roza who actively attended meetings in order to find out what ACA was and how it would affect him and his 69 year old wife with diabetes.

Roza, who underwent hip replacement this year, now worries how the ACA will affect his $614 monthly fee and his Medicare supplemental insurance, in spite of his Medicare coverage.

Advocacy groups have also taken an interest on the matter. They feel the federal health officials have put most of its efforts on those who already are on Medicare and have not done enough outreach to inform seniors without Medicare, said Jodi Reid, executive director of the California Alliance for Retired Americans. She feels that advocacy groups have picked up the tab and are using the majority of their advertising dollars to inform seniors affected by the exchange. Her group has put together a one-page fact sheet to educate nearly 1 million California seniors.

Officials of the AARP said they are organizing several events around the country, hosting 21 telephone town halls to clarify questions to seniors who are either Medicare or Non Medicare recipients.

As the Affordable Care Act inches closer, advocates are warning seniors not to give any personal information. To watch out for scams that may surface alongside legitimate Affordable Care Act outreach.

Source: LifeHealthPro

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A new bipartisan legislation was introduced last month by Senators Ron Wyden (D-Oregon) and Rob Portman (R-Ohio) that would allow Medicare to pay seniors to improve and maintain their health. The pinned Medicare Better Health Rewards program would measure the seniors' wellness using six criteria: blood pressure, cholesterol, tobacco use, body mass index, diabetes indicators, and up-to-date vaccinations and screenings.

With this plan, seniors would work with their doctors during their yearly Medicare "wellness" visits to evaluate their performance and to improve their health based on the set standards. Successful beneficiaries will be eligible for up to $200 by the program’s second year and $400 by its third year.

Rob Kind, (D-Wisconsin), a co-sponsor of twin House legislation stated "This is exactly the kind of bold, concrete and common-sense legislation that we need to rein in health care spending and help our seniors live healthy lives."

The initiative would be funded by Medicare savings generated by healthier seniors. However, it's only one of the options being considered to lower the program’s healthcare costs.

Source: The Hill

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On Tuesday, Congress passed a deal to avoid the fiscal cliff called the American Taxpayer Relief Act of 2012. This bill delayed the budget sequestration by two months in order to give more time for negotiations between the parties on how to reduce the deficit. This highly controversial bill still leaves several unresolved budget issues, including cuts to Medicare and Medicare payments. It also fails to address the required increase to the national debt ceiling.

Some of the highlights included in the American Taxpayer Relief Act of 2012 are:
(for a full list, go here)

• Medicare Advantage, health plans, hospitals, and dialysis centers were hit the hardest with payment cuts. Physicians, pharmacies, and other providers also saw large reductions.
  
  
• Physicians avoided a 26.5 percent cut that is required under the Sustainable Growth Rate (SGR) formula. Also, 2013 will be another year without any Medicare rate increases.*
  
  
• The law sets up another SGR physician rate cut for January 2014. Congress “punted” again because it’s easier for them to find $25 billion to delay the SGR cuts than it is for them to find $300 billion to repeal the formula altogether.
  
  
• State run Medicaid will see a $4.2 billion federal funding cut in 2022 for safety-net hospitals that serve a disproportionate low-income and uninsured population.
  
  
• Several special programs and add-on payments extended

CEOs, economists, and President Obama all agree that the fiscal cliff deal is barely a start, and while it has several breakthroughs, it also has several things it fails to do. There are two ways to look at the battle over the “fiscal cliff.” The first is the short term, limiting damage to the already weakened economy. The other is the long term, determining the shape of the government for years to come. Many more discussions and negotiations will be taking place in the upcoming months as Congress works to reach an agreement.

*This bill does not include an increase to Medicare.

Source: Piper Report

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Thursday the Supreme Court upheld the entire proposed health care law, concluding that Congress was acting within its powers under the Constitution to require most Americans carry a health insurance policy. This ruling is considered a victory for President Obama and the Democratic Party, passing the biggest reworking of the health care system since Medicare was introduced in the 1960s. This ruling also eliminates disruptions for hospitals, doctors, and employers who have spent the last two years preparing for the law to be put into place.

How has the Patient Protection and Affordable Care Act affected the senior market since its inception in 2010 and how does Health Care Reform impact the future of Medicare Supplements?

1. Modernized Medicare Supplement plans, including new Plans M and N, created new opportunities for agents to sell more economical options for coverage.
   
   
2. New carriers entering the market are providing more choice for consumers. The added competition is healthy and promotes new innovations to the market, including telephone and electronic applications, which can help reduce pending requirements and speed up issue time.
   
   
3. Many employers are reconsidering if, or for how long, they should offer group coverage for their retired workers due to Taxation of the Retiree Drug Subsidy (RDS) effective January 1, 2013. This tax can affect large company’s bottom line by tens and hundreds of millions and many have already started transitioning from group to individual coverage using a Medicare Coordinator model.
   
   
4. Deficit reduction talks have the politicians from both parties talking about ways to save money with Medicare. One suggestion is to add copayments to all Medicare Supplement plans, not just Plans M & N. Another proposal suggests charging up to a 20% tax on seniors choosing plans with First Dollar Coverage.
   
   

Other important things to note pertaining to the senior market is that from now until 2020 the “donut hole” is still in effect, with seniors receiving a 50% discount on covered brand name drugs; and, Medicare Advantage will continue with payment system reforms laid out in the ACA.

However, the debate is far from over. With the January 1, 2014 date of implementation and a Presidential election looming, there is certain to be several repeals and proposals before the final version of the health care law is agreed upon and actually goes into effect.

As an agent in the Medicare Supplement market, don’t worry. Medigap plans are the least impacted by health care reform so no big changes are on the horizon. Reduction in Medicare Advantage payment rates and the impact this will have on plan benefits appears to be the biggest unknown. For clients looking to avoid any unforeseen surprises, Medicare Supplements still appear to be the best solution for many of your clients.

Source: Red Pen Edition, Wall Street Journal, Healthcare.gov

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This week government auditors called for a cancellation of an $8.3 billion dollar Medicare program that some congressional Republicans think is a political ploy by the Obama administration. The money is going toward a three-year project intended to make quality improvements to Medicare Advantage plans and financially reward those plans that are scoring well by the Department of Health and Human Services. However the Government Accountability Office (GAO), the investigative agency of Congress, uncovered that the plan’s spending "dwarfs" all other Medicare pilots undertaken in the last 20 years. Plus, they found the majority of the money is going to plans earning only three to three-and-half stars, an "average" score.

Available through 2014, these quality bonuses to Medicare Advantage plans will postpone the drastic cuts Medicare Advantage plans will be faced with under the new health care law. However, the GAO questions whether the bonus program will actually be an incentive to promote quality in insurance providers. Defending the bonuses, the Health and Human Services Department issued a statement saying, "the demonstration supports our national strategy to improve the delivery of health care services, patient health outcomes, and population health."

Orrin Hatch, the ranking Republican on the Senate panel which oversees Medicare, questioned if the administration had the legal authority to create the program. Hatch stated, "The White House does not have the authority to green-light spending on whatever program it wants. This report is just the beginning — I will be demanding answers."

Hatch also questioned the Obama administration’s use of a technicality in order to sidestep Congress and "write itself a blank check to spend more money for political purposes leading into this year’s elections." He and other congressional Republicans see the spending as a way to appease seniors, a key constituency of swing voters during this election year.

The Medicare Advantage bonus program is the costliest in Medicare history, with money coming from the Medicare trust fund. Next week the Medicare trustees will be releasing their annual report on the status of the program, which is already facing a long-term financial crunch.

Please give us your feedback!
Do you think President Obama is misusing the $8.3 billion for his own agenda of being re-elected this year? Or do you think the bonus plan is a good incentive to make Medicare Advantage companies to take better care of their policyholders?

Source: CNN, Herald-Tribune

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Last week the Obama administration proposed an effort to raise $2.5 billion over the next 10 years by implementing a surcharge to Medicare enrollees who purchase Medicare supplements. This surcharge would affect all new enrollees who purchase Medicare supplements by adding an average of 15% to the premium on their Medigap policy. Those currently receiving benefits and those near retirement would not be affected.

One official said, "Of particular concern are Medigap plans that cover substantially all Medicare copayments, including even the modest copayments for routine care that most beneficiaries can afford to pay out of pocket." Administration officials explain that the reason for the surcharge is that since there is so little out-of-pocket charge seniors often do not think about the costs associated with the care they receive.

Bonnie Burns of California Health Advocates warns that this surcharge would be terrible for consumers. Burns, along with several insurance industry representatives and consumer advocates, agree on the need for affordable insurance costs for seniors.

Burns said, "Blaming Medigap issuers and customers for any over-use of care seems particularly unfair because federal law prohibits sellers of Medigap insurance from determining whether the care a policyholder has received is medically necessary." Instead, she encourages the government to guard against Medicare by requiring providers to document that the care received is medically necessary.

This surcharge plan will go into the federal fiscal 2013 budget proposal, beginning October 1st, and if passed would take effect in 2017.

Please give us your feedback!
Have any of your clients asked you about this surcharge? What do you say to them about it? How do you think it will affect your Medicare Supplement business in the future?

Source: LifeHealthPro

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As you are talking with seniors just aging into the Medicare market, it is important to advise them about the penalties they will pay if they do not sign up for Medicare Part B at the right time. For those seniors who have already filed for Social Security, they will automatically be enrolled in Medicare at age sixty-five. However, seniors who continue in the workforce, either by choice or necessity, and delay their Medicare coverage need to notify Medicare of their decision. Otherwise they will face a 10% Part B penalty for each year that they do not file. So someone filing for the first time at age seventy will face a 50% Part B penalty. The penalty is permanent and can translate into thousands of dollars in unnecessary penalty charges.

For your clients who decide to continue working, advise them to notify Medicare of their decision as soon as they turn sixty-five to ensure they will avoid penalties later. Especially, those seniors who work at a company with over twenty employees, as their employer will continue to provide their benefits. They can do this by choosing the option on the back of the Medicare card that is sent, calling the Social Security Administration, or visiting the SSA website. For their Part D prescription coverage, seniors can delay filing as long as their employer provides equal or better coverage.

Those seniors earning more should also be informed about the surcharges on high-income seniors. Currently, this affects only 5% of seniors, however those still in the workforce are more likely than those retired to fall into the income bracket. The extra charges can be applied not only to Part B, but also Medicare Advantage and Part D coverage.

Advising your prospects of these penalties is great for client retention and relationship growth. While they continue to receive their healthcare from their employer, you can work with them on their final expense, long-term care, and annuity needs until they require a Medicare Supplement.

Please give us your feedback!
Do you have clients who didn't know about these penalties and have suffered inflated costs due to delaying? How do you go about avising your clients who want to delay their Medicare benefits?

Source: KHN

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This week the federal government released a projected savings of $148 billion dollars over the next 10 years by increasing Medicare eligibility by two years to age 67 by 2021. This is lower than the Congressional Budget Office’s (CBO) March estimate of $162 billion, however that calculation did not include premiums paid by seniors into the program. Even though the savings will not significantly affect the budget deficit, they will be able to pay for “doc fix”; a permanent pay raise legislated by Congress for Medicare doctors every year with the proposed money accumulated by raising the eligibility age.

President Obama supports increasing Medicare’s eligibility whereas most Democrats in Congress are against it. Some of the CBO’s findings warn that raising the eligibility age may lead to more people applying for Medicaid, therefore receiving lower quality care and paying more out-of-pocket than they would on Medicare.

However on the positive side, those between 65 and 67 who need private health insurance could have better access to doctors. This is especially true if Obama’s healthcare law remains in place. Seniors would have access to private coverage though the new insurance exchanges.

The CBO also found that increasing the Social Security age in two-month increments for those born between 1949 and 1960 will save an additional $144 billion. However, increasing the Social Security eligibility age has remained politically untouchable by both parties in the 112th Congress.

Please give us your feedback!
What do you think about the proposal to increase the Medicare eligibility year from 65 to 67? How will that affect your Medicare Supplement business? What is your opinion on the decision to propose increase the age of eligibility for Medicare rather than Social Security?

Source: The Hill

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In the last five years, insurance producers have gone through exciting and risky times. Medicare insurers are on the rise and have added millions of policyholders while other sectors of the insurance industry have seen very little growth. Though the changes in the market have yet to end, there are several reasons to be optimistic about the Medicare Supplement market in the coming years.

1. Tremendous growth of Medicare beneficiaries. The projected increase from 2011 to 2030 is 70%, from 48.6 to 80 million. This is mainly due to the Baby Boomer generation qualifying for benefits at 3 million a year.
   
   
2. Prescription drug costs are lower. Even with the talk about health care costs increasing, the Part D donut hole is closing and seniors are now paying less for their prescription drugs than they were in 2006. Also, due so several brand name medications becoming generics, this amount will continue to decrease, at a rate of approximately $0.65 a day until 2015.
   
   
3. Quality Star Ratings. There is a consensus among Medicare agents that customer service from Medicare Supplement carriers exceeds that from Medicare Advantage carriers. However, in order to provide incentive for Med Advantage carriers to provide good service, CMS is now offering additional compensation for those carriers who score above three stars and the opportunity to sell year-round for those Med Advantage carriers with five stars.
   
   
4. Employers favor individual plans. Several larger Fortune 500 companies are beginning to no longer offer group retiree benefits. Thus, those retirees have to shop the individual market for their plans. Though call centers have captured the majority of this business, the replacement market is growing and the trend is expected to continue.
   
   
5. Interest in shopping online. The Boomer generation is very open to researching products online, and reaching buyers via Pay-Per-Click and Search Engine Optimization is becoming increasingly popular. Those agents interested in selling Medicare Supplements online have an advantage, especially for those seniors just turning 65.
   
   

Medicare is a growth-driven market due to the demographic shifts in the United States. With all of the agents needed to serve these seniors and the ability to reach infinite numbers online, the senior insurance market has many opportunities ahead. We at Precision Senior Marketing are dedicated to providing you with the best Med Supp products and Med Supp sales techniques to get the edge on the competition. Feel free to contact us directly at 800-998-7715 for more information.

Please give us your feedback!
Have you experienced the growth opportunities in the Medicare market? What do you think of the Med Advantage carriers with five stars getting to sell all year long? What aspects of the market excite you the most?

Source: LifeHealthPro

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