BackgroundIn 2018 and 2019, the Centers for Medicare & Medicaid Services (CMS) expanded the types and flexibility of supplemental benefits that Medicare Advantage (MA) organizations can offer to their enrollees. The changes are dramatic because they demonstrate a shift in the underlying principles of health insurance regulation. The new CMS approach emphasizes flexibility over equality.Historically, health insurance regulators approached consumer protection through the principle of equality. Under Equality all MA's had to offer substantially the same benefits to all of the enrollees of a particular plan. This was to ensure all enrollees have access to the same care and that nobody was treated inequitably. Under the new approach, the principle of flexibility depending on need is emphasized. Not all benefits have to be offered to all enrollees of a plan -- for instance, the cost sharing for diabetics can be reduced without similar reductions being offered to other consumers. Under Flexibility supplemental benefits can be organized for the specific needs of individuals, rather than defined as one-size fits all. For example, in-home services can be delivered by medical or non-medical personnel depending on the need. According to an analysis by Milliman, for the 2021 plan year, expanded supplemental benefits are included in 575 MA plan benefits. This is a significant increase from 351 plans offering expanded benefits in 2020. We view the increase as evidence that MA plans are a responsive vehicle for designing the delivery and financing of expanded benefits. How This Shows Up When Seniors Switch Health PlansWhether 2020 MA plans offered or did not offer supplemental benefits is related to whether seniors switched from plans during last fall's Annual Election Period (AEP). The chart below provides evidence from Deft Research's 2021 Medicare Shopping and Switching Study. The chart compares percentages of seniors who switched health plans for 2021 with those who did not. We note that the most flexible benefit, a benefit allowance, sits at the top of the chart as most often noted by switchers as missing. This supports the idea that a flexible allowance which provides some assurance of extra coverage for needs that cannot be foreseen, is highly valued by consumers. Flexibility is linked to trust and both are fundamental to the value perception. ![]() |
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Medicare Advantage enrollment in chronic illness benefits tripled in 2021
Posted by www.psmbrokerage.com Admin on Tue, Feb 09, 2021 @ 10:00 AM
The analysis, released Friday by consulting firm Avalere Health, also found the number of enrollees in MA plans that offer such benefits increased this year compared to 2020. The analysis comes as the Biden administration is likely to make social determinants of health a major priority, with supplemental benefits in MA plans an area in which to address those issues. “Stakeholders should consider engaging with the Biden administration around their early experiences with [supplemental benefits for the chronically ill] and any policy change that could facilitate their wider adoption,” the analysis said. The analysis found that this year, 787 MA plans are offering special supplemental benefits that range from meal delivery to pest control and virtual visits. The plans represent 16% of all plans that Avalere analyzed. “Overall, in 2021, 15% of enrollees in non-employer MA plans are enrolled in plans offering [supplemental benefits], as compared to 6% in 2020,” Avalere said. RELATED: Study: Higher MA star ratings associated with improvements in members’ outcomes The analysis also found that 86% of the total Medicare beneficiary population live in a county with at least one MA plan that offers one of the benefits. Plans could start to offer the supplemental benefits that were not specifically health-related starting in 2020. This year, plans started offering new benefits like prescription deliveries for those who must stay home due to the COVID-19 pandemic. “However, the number of plans offering these benefits—and associated enrollment—are relatively small compared to the most prevalent benefits,” the firm said. The most popular supplemental benefit was meals, with 356 plans employing the benefit. The second-most popular was food and produce with 336 plans, and pest control was a benefit offered by 200 plans. Avalere looked at the plan benefit package data from the Centers for Medicare & Medicaid Services in 2020 and 2021. ![]() |
Tags: Medicare Advantage plans, Medicare News, DSNP, Special Needs Plans, CSNP
Google search activity for "Medicare Advantage" is up
Posted by www.psmbrokerage.com Admin on Wed, Dec 09, 2020 @ 04:38 PM
Google search activity for "Medicare Advantage" is up
The Google Trends tool shows that search activity for the term “Medicare Advantage” was about 13% higher during the Medicare annual election period that ended Monday than it was during the comparable period in 2019. The annual election period for Medicare Advantage plan coverage and Medicare Part D prescription drug coverage runs from Oct. 15 through Dec. 7 every year. The annual election period that just ended was for coverage that starts Jan. 1, 2021. Medicare supplement insurance products, or Medigap products, have an open enrollment period system tied to people’s birthdays, rather than a single enrollment period for all consumers. Google Trends BarometerGoogle uses its own search traffic to power its Google Trends search activity analysis tool. One problem with this method as a market strength barometer this year is the COVID-19 pandemic. Many Medicare enrollees are trying to stay home as much as possible, and many are still avoiding face-to-face meetings with financial professionals. But search activity for other terms older consumers might use, such as “AARP,” “home care” and “grocery delivery,” have been about the same during the 2019 annual election period and the annual election period that just ended. YouTube BarometerRecently posted YouTube “Medicare plan” videos sorted by views reveals that UnitedHealth Group Inc. and eHealth Inc. have been especially active at marketing Medicare plans through YouTube videos and YouTube commercials this year. But a comparison of search activity for “Medicare Advantage” with other terms consumers ages 65 and older might use shows:
Consumer Knowledge GapsMedicare plan marketers say they continue to see widespread problems with Medicare enrollees’ health insurance literacy. Managers of MedicareAdvantage.com, a Medicare plan lead-generation site affiliated with Tranzact, an arm of Willis Towers Watson LLC, recently reported that only 44% of the Medicare enrollees they surveyed could define the term “deductible.” Similarly, Oak Street Health, a company that provides routine health care, found that 25% of the Medicare enrollees were confused about the differences between the various Medicare plan options. About 78% of the Oak Street survey participants said they were satisfied with their Medicare benefits, but only 53% said they understood their Medicare benefits. What Consumers Are BuyingWhen eHealth analyzed its Medicare plan shoppers, it found that what the shoppers are paying out-of-pocket for their share of the coverage premiums may stay about the same in 2021. Midway through the annual election period, consumers’ share of the monthly premiums for 2021 Medicare Advantage plan coverage was $5, or about the same as the 2020 average. Consumers’ share of the monthly premiums for 2021 Medicare Part D prescription drug plan coverage was $20, unchanged from the 2020 average. Shoppers’ Medicare supplement insurance premiums increased to $160 per month for 2021 coverage, from $157 per month for 2020 coverage.
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Tags: Medicare Advantage plans, google
New Study Shows Why the Coronavirus Pandemic is Leading Many Americans to Enroll in a Medicare Advantage Plan For 2021
Posted by www.psmbrokerage.com Admin on Wed, Dec 09, 2020 @ 09:41 AM
Out of 67.7 million Medicare beneficiaries in the United States in 2020, roughly 24 million (36%) are enrolled in a Medicare Advantage plan, which represented a 9% year-over-year increase. By 2030, the Congressional Budget Office projects that 51% of all Medicare beneficiaries will be enrolled in a Medicare Advantage plan. And with the COVID-19 pandemic continuing to ravage the nation, it looks like Medicare Advantage plans will become even more popular according to findings from a recent study conducted by MedicareAdvantagePlans.org.
MedicareAdvantagePlans.org surveyed adult Americans that are eligible for Medicare and already enrolled in a Medicare Advantage plan for 2021. First, we wanted to uncover why these consumers have opted for a Medicare Advantage plan for the upcoming year.
As mentioned earlier, Medicare Advantage plans are becoming in vogue because they are cost-effective, flexible, and will oftentimes include Part D prescription drug coverage so the three most populated answers found in the pie chart come as no surprise. The next most-populated answer, “I like the supplemental benefits that are included in a Medicare Advantage plan,” is where things get more interesting, especially considering the pandemic we currently find ourselves in. COVID-19 Related Supplemental Benefits a Big Reason For Increasing Popularity of Medicare Advantage PlansSupplemental benefits are a big reason why many Americans are switching to Medicare Advantage plans. They do not need to be provided by Medicare providers or at Medicare-certified facilities, but only need to abide by the rules laid out by a specific Medicare Advantage plan. Popular supplemental benefits include vision, dental, over-the-counter benefits, and fitness. Supplemental benefits have become such an important selling point for Medicare Advantage plans that there will be a 64% year-over-year increase in the number of Medicare Advantage plans that are offering such benefits in 2021. And as a result of the coronavirus pandemic, 34% of Medicare Advantage plans are now offering COVID-19-related supplemental benefits in 2021, which includes covering costs for things like testing, PPE, and care packages. Amongst our survey respondents that indicated supplemental benefits as the reason they are enrolling in a Medicare Advantage plan for 2021, here’s how many cited COVID-19-related supplemental benefits specifically.
Other than the common supplemental benefits, like dental and vision, that respondents cited, “COVID-19 related supplemental benefits” was one of the most populated answer choices as 35% of respondents that were drawn to a Medicare Advantage plan cited this type of supplemental benefit specifically. In regards to how the coronavirus pandemic is shaping the Medicare Advantage plan market, it’s also noteworthy that 27% of applicable respondents pointed to a telehealth supplemental benefit. With people trying to limit their exposure to potential COVID-19 hotspots, like a doctor’s office, the telehealth industry has boomed so it’s easy to understand why many Medicare Advantage beneficiaries have become more attracted to this supplemental benefit. Medicare Advantage plans were already surging in popularity, but it looks like the coronavirus pandemic will further catalyze that surge because beneficiaries can likely have their COVID-19 related costs covered through specific supplemental benefits. Many Beneficiaries Are Switching From Original Medicare Plans to Medicare Advantage PlansThe data shows Medicare Advantage plans are becoming more and more popular with each passing year. Compared to original Medicare plans, Medicare Advantage plans can be more cost-effective, while still offering prescription drug coverage and a variety of supplemental benefits. And according to our survey data, eligible Americans want to experience the possible benefits of a Medicare Advantage plan for themselves as many are switching from original Medicare coverage in 2020 to a Medicare Advantage plan in 2021.
Further, 52% indicated they are not making the same switch, which likely indicates they were happy with their Medicare Advantage plan in 2020 and want to keep it for the new year. When looking at this data and other external sources, all signs point to Medicare Advantage plans continuing to increase in popularity as eligible Americans look for more flexible coverage options outside of what original Medicare coverage can offer. Are Medicare Advantage Beneficiaries Simply Doing More Research?A recent story by The New York Times discussed how the Medicare marketplace has become more competitive as of late, especially with the rollout of Medicare Advantage plans, and that enrollees would benefit the most by doing their research and pricing out the market. However, the story cited a recent study that found 57% of Medicare enrollees don’t review or compare their coverage options annually, including 46% who “never” or “rarely” revisit their plans. This isn’t great news when you think about all the consumers out there that are possibly missing out on Medicare Advantage benefits because they either don’t know what they are or understand how it could be better (or more cost-effective) for them. Interestingly, when we asked our Medicare Advantage enrollees if they’ve done their research, here’s what we found.
Only 7% said they never or rarely do any research before enrolling. What can be drawn from this? 91% of Medicare Advantage beneficiaries do some amount of research before selecting their plan while the New York Times story found 57% of all Medicare enrollees never did any research, so perhaps if every eligible consumer did their homework before enrolling we would have far more opting for a Medicare Advantage plan. Is it possible that the benefits of Medicare Advantage plans so outweigh original Medicare coverage that all it takes is a bit of research to understand which option is generally more consumer-friendly? MethodologyThe data from this report comes from an online survey administered by online survey platform Pollfish. The survey was created and paid for by MedicareAdvantagePlans.org. In total, 700 adult Americans that were eligible for Medicare in 2021 and enrolled in a Medicare Advantage plan for 2021 were surveyed on the questions found in this report. By using screener questions, we were able to find adult Americans that were eligible for Medicare in 2021 and enrolled in a Medicare Advantage plan in 2021. Survey ResultsBefore enrolling in Medicare for 2021, did you review or compare your available coverage options before eventually enrolling in a specific program?
Are you switching from another Medicare plan in 2020 to a Medicare Advantage plan in 2021?
Why are you going with a Medicare Advantage plan in 2021?
(If applicable) What specific supplemental benefits encouraged you to enroll in a Medicare Advantage plan? (SELECT ALL THAT APPLY)
Source: https://www.medicareadvantageplans.org/medicare-advantage-plans-2021-coronavirus-survey/ ![]() |
Tags: Medicare Advantage plans, COVID-19
Learn How Your Efforts Help Support Feeding America
Posted by www.psmbrokerage.com Admin on Thu, Nov 19, 2020 @ 09:57 AM
PSM has teamed up with YourMedicare ℠ to bring you a revolutionary new tool to write more Medicare business. With our all-inclusive platform, you can sell Medicare plans on your terms. Offer top carriers, receive the best commissions, all with industry-recognized service and support. Request access to this game-changing platform today. ![]() |
Tags: Medicare Advantage plans, Online Enrollment, Medicare Part D, YourMedicare
2021 Medicare Advantage Open Enrollment Period (OEP)
Posted by www.psmbrokerage.com Admin on Thu, Nov 19, 2020 @ 09:37 AM
Medicare Advantage Open Enrollment Period With Medicare’s Annual Enrollment Period (AEP) coming to an end, agents and advisors have spent the last month enrolling Medicare beneficiaries in Medicare Advantage (MA) and Prescription Drug Plans (PDP) for 2021. Come Dec. 7 – the date AEP ends – many agents and advisors will take some well-deserved time off to recharge and reconnect with family and friends. But smart agents and advisors know that another important enrollment period starts on Jan. 1: the Medicare Advantage Open Enrollment Period (OEP). Post-Enrollment Period It’s a simple step during the AEP process to ask clients the best ways to contact them for follow up. Make a note if they prefer a phone call, email or postal mail. Confirm and document their contact information and respect their decisions. Insurance professionals ensure their clients have the best coverage by keeping the lines of communication open. Developing a follow-up system is the best way for agents and advisors to make sure their client’s plan is working for them. Agents and advisors also need to follow through with their commitments. Some insurance professionals think the burden is on clients to contact them if there are issues with a plan. Agents and advisors shouldn’t risk losing clients due to poor customer service and lack of follow up.
During OEP, the beneficiary can:
Agents and advisors need to be keenly aware that Centers for Medicare and Medicaid Services (CMS) has put in place rigid rules regarding the communications they can have with clients about OEP. We are in the business of providing exceptional services to agents and advisors. It’s more than products and services. It includes giving you the valuable insights – such as contacting a client to make sure their plan is working for them. And, if necessary, use OEP as the time to help your clients change plans.
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Tags: Medicare Advantage plans, Medicare Part D, OEP, 2021
Supplemental Benefits in 64% of Medicare Advantage
Posted by www.psmbrokerage.com Admin on Thu, Nov 19, 2020 @ 08:51 AM
The number of Medicare Advantage plans offering at least one of five expanded supplemental benefits increased 64% for the 2021 coverage year compared with 2020. The analysis released Wednesday by Better Medicare Alliance comes as plans offer wider benefits on adult day care and home-based palliative care among other expanded benefits for 2021. CMS greatly expanded in 2018 and 2019 the types and flexibility of supplemental benefits that MA plans can offer. The five supplemental benefits: adult day health services, home-based palliative care, in-home support, caregiver support and therapeutic massage. BMA found 575 plans offer the supplemental benefits for the 2021 coverage year, a major increase from the 351 that decided to offer the benefits for 2020, the analysis found. Supplemental benefits have become a key selling point to Medicare beneficiaries. ![]() |
Tags: Medicare Advantage plans
Marketing for 2021 Annual Enrollment Period - Reminder
Posted by www.psmbrokerage.com Admin on Mon, Sep 14, 2020 @ 03:01 PM
Marketing for 2021 Annual Enrollment Period - Reminder
Rule of thumb: If the purpose of the marketing activity is to eventually solicit an appointment for AEP, per CMS, it is NOT acceptable before October 1st 2020. If an agent is found to be marketing for AEP before October 1st, the agent could be penalized from the insurance carrier being marketed, or from CMS. It is a good idea for agents to take this time before October 1st to work on certifications and becoming Ready to Sell for the 2021 AEP season. Save all marketing efforts for after October 1st. 2021 AEP Resources:
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Tags: Medicare Advantage plans, Medicare, Medicare Supplement, Medicare Part D, CMS, 2021 aep
Highmark Medicare plans will lose in-network access to UPMC in 2019
Posted by www.psmbrokerage.com Admin on Tue, Aug 07, 2018 @ 03:57 PM
Highmark Medicare Plans will lose in-network
Seniors with the plans will lose in-network access at the end of June 2019, when a state-brokered consent decree between the two health care giants expires. A Commonwealth Court judge had interpreted the consent decree to mean UPMC would have to continue to accept the insurance through June 2020.
Doctor visits and hospital services typically cost much less when the doctors and hospitals are in an insurer’s network than when they aren’t. Seniors with Highmark Medicare Advantage plans who see UPMC doctors will have to either switch doctors or pay much higher prices to see their UPMC doctors as of next July. Or they can switch insurers during the open enrollment period for the plans, which will run from Oct. 15 to Dec. 7, to pick a plan that includes their UPMC doctors and hospitals. Some Highmark Medicare Advantage plans include access to UPMC hospitals and doctors and some don’t. About 50,000 seniors living in Allegheny and Erie counties have Security Blue and Freedom Blue plans, which include UPMC, Billger said. People with Community Blue plans, which don’t include UPMC, won’t see any changes, he said. About 17,000 seniors in Westmoreland County have Medicare Advantage plans that provide access to UPMC.
The change to networks coming in the middle of the plan year could create confusion for seniors who don’t know it’s coming, said Bill McKendree, coordinator for the Allegheny County APPRISE program, which helps seniors with enrollment. McKendree said the federal Centers for Medicare and Medicaid Services could decide to create a special window in which seniors losing access to UPMC doctors could switch plans after June 30. Or CMS might not do that, he said. “This is a big old question mark,” he said. UPMC Health Plan, Aetna, Cigna and United Healthcare have all sold Medicare Advantage plans in the region in previous years. Highmark owns Allegheny Health Network and includes its hospitals in its plan networks. Seniors may also elect to enroll in traditional Medicare, rather than the Medicare Advantage plans. The traditional program includes all hospitals and doctors in the country who accept Medicare. McKendree advises seniors considering traditional Medicare to think about getting a Medigap supplemental plan, which covers many of the co-pays, deductibles and other costs of traditional Medicare. McKendree said all hospitals and doctors who accept Medicare must accept Medigap. The state brokered the consent decree between Highmark and UPMC in 2014 to govern relations between them until 2019. The two nonprofits had been unable to resolve contract disputes on their own that arose after Highmark Inc. announced it was buying the former West Penn Allegheny Health System to form the basis of Allegheny Health Network. UPMC said it wouldn’t contract with an organization owning competing hospitals. |
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Tags: Medicare Advantage plans, Medicare
Aetna releases New telephonic enrollment option for Medicare Advantage Sales
Posted by www.psmbrokerage.com Admin on Tue, Aug 07, 2018 @ 01:43 PM
Aetna releases New telephonic enrollment option for Medicare Advantage sales
To use RATE, you must have an iPad. You’ll also need to complete a short user training and quiz. Just contact us at 800-998-7715 to schedule a training session. How it works Step 1: First, you meet with your client and provide the required sales presentation and materials. (Please note that RATE does not replace your one-on-one client appointments.) If your client decides to enroll sometime after that meeting, you can schedule an appointment to complete the enrollment by phone. Step 2: At the scheduled date and time, your client will call you on your unique RATE-specific 1-800 phone number. You’ll receive that call on your iPad. Step 3: Next, you’ll walk them through an approved telephonic enrollment script that’s built into RATE to complete the enrollment. The calls are instantly and automatically recorded. What are the benefits?
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Tags: Medicare Advantage plans, Medicare, aetna