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Medicare Blog | Medicare News | Medicare Information

What Medicare Advantage means for private insurers

Posted by Guadalupe Cantu on Fri, Nov 15, 2013 @ 03:36 PM

Medicare AdvantageAs seniors reach 65 many are faced with a lot of questions about their health, health coverage, and the many plans accessible to them. Currently there has been a tremendous enrollment increase for Medicare Advantage (MA) plans or Medicare Plan C as they are known. This growth has been on the rise since 2004, and it currently makes up about 25 percent of traditional Medicare enrollee opting for MA plans, reports the Kaiser Family Foundation. This trend has more the doubled beneficiaries’ enrollment from 5.3 million to 13.1 million in 2012.
According to the Congressional Budget Office, Medicare Advantage enrollment is expected to grow from 14 million, in 2013, to 21 million by fiscal year 2023.

What it means to seniors?
More and more seniors choose to enroll in Medicare Advantage plans because these plans provide comprehensive medical coverage which are of higher-quality care, with better services, and provide additional benefits. These plans are also used by elderly and people with disabilities to cover additional medical expenses that Medicare does not already cover.  Additionally, MA plans are more likely to be purchased by healthy seniors than other supplemental insurance options because these policies are more affordable on a monthly basis.

Cost savings is the driving force behind the increased enrollment of Medicare Advantage plans. With Medicare’s Part A, the insured is provided with inpatient hospital care; however, the enrollees are stuck to cover fluctuating deductibles associated with this plan yearly. Part B covers doctor’s expenses and preventive services, such as, flu. Medicare Part C is the Med Advantage plan that covers the additional expenses not covered by both Part A and B plans, excluding End-Stage Renal.

Further savings can be seen with MA premiums. The Kaiser Family Foundation reports that 50% of seniors enrolled in Medicare Advantage plans have no extra premiums, and two-thirds enrolled in the HMO Advantage plans pay nothing extra.

What does this growth mean to private insurers?
Earlier this year the House mandated a proposal that would make payment cuts to MA plans beginning 2014. By law, Medicare Advantage plans are required by law, to lower cost as much as 7 to 8%, and use 85 percent of their revenue on medical care and quality improvement efforts. Those who fail to meet the requirements will be prohibited from accepting new enrollees, and their plans will be terminated after five years of noncompliance.

However, that proposal changed when the Centers for Medicare and Medicaid Services (CMS) decided to increase payments by 3.3 percent. The proposed change could average $50 or more per month for a Med Advantage enrollee.  According to the CMS, the change was made to improve program stability and payment accuracy.

Selling Medicare Advantage plans is not as simple as having a basic health insurance license. By law, CMS requires agents, brokers and all licensed sales representatives to complete a CMS certification program before any marketing and selling can be done.

Additionally, with the certification comes responsibility. It is very important for agents to educate enrollees to what exactly the products they are buying.

Another factor private insurer’s face is the CMS Complaint Tracking Module. The CTM is a complaint tracking module used to track the accuracy of incidents and complaints, responses to those complaints and to ensure compliance.
  
With the advancement in technology, private insurers should embrace the latest technologies to facilitate the response time to any compliance needs. And with the help of their well-trained CMS certified representatives and producers, they should be able to quickly address any concerns or request their clients may have.


Please give us your feedback!
Question: Do you feel that the CMS abrupt change to increase MA payments by 3.3% will further encourage the quality of care seniors receive? Will this help insurers improve CTM compliance?

Source: LifeHealthPro
Additional Updates:

    • 2014 Medicare Advantage and Part D Certifications are now available! Learn More

Tags: Beneficiaries, Centers for Medicare & Medicaid Services, Medicare benefits, Medicare Part A, Medicare Part B, Medicare Advantage, Medicare, Medicare News, Medicaid

CMS keeps steady Medicare Part B premiums

Posted by Guadalupe Cantu on Fri, Nov 08, 2013 @ 10:50 AM

Medicare Supplements The Centers for Medicare & Medicaid Services (CMS) have decided to keep Medicare Part B monthly premiums at bay.

Medicare Part B helps pay for physician services, medical supplies, and other outpatient services not covered by Medicare Part A service plan.

In 2014, the monthly base actuarial rate for seniors’ participants will be $209.80 per month, while those low to moderate-income enrollees will pay premiums at $104.90.

2013 monthly premium levels remain unchanged and the $147 deductible will continue for Part B plans per year.

Less relevant to participants are the Medicare Part A hospitalization premiums, this is highly due to about 99% of Medicare enrollees qualify for Part A coverage without having to pay a premium, says CMS.

In a notice published at the Federal Register, October 30, CMS notice, CMS-8055-N, enrollees that do pay monthly premiums will range between $15 $426 in 2014.

An income-related monthly adjustments amount has been imposed by the Medicare program on beneficiaries with an annual taxable income less than or equal to $85,000 or joint annual taxable income less than or equal to $170,000, is $104.90.

The most a Medicaid enrollee can pay in monthly premium is $335.70, with an annual taxable income greater than $214,000 or joint annual taxable income greater than $428,000.


Please give us your feedback!
Question: Do you think the government will keep Medicare Part B premiums at bay in 2015 or will there be a premium hike?

Source: LifeHealthPro
Additional Updates:
    • Omaha Insurance New Med Supp Outlines in Virginia
      November 2013 Med Supp rate Outlines for VA. Learn More

      - Med Supp Application for VA. Learn More
    • 2014 Medicare Advantage and Part D Certifications are now available! Learn More

Tags: Beneficiaries, Centers for Medicare & Medicaid Services, Medicare benefits, Medicare Part A, Medicare Part B, Medicare, Senior Market, Medicare News, Medicaid

Confusion lingers over Medicare benefits and the health care law

Posted by Guadalupe Cantu on Fri, Sep 20, 2013 @ 02:33 PM

Medicare Supplements 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.


Please give us your feedback!
Do you feel there is still a tough job ahead to inform seniors about what the Affordable Care Act is and how it impacts Medicare? Do you believe all the outreach efforts from advocates and federal health officials will help millions of uninsured people to sign up for coverage by the end of March or will just stir more confusion?

 

Source: LifeHealthPro

Additional Updates:
    • Omaha Insurance: New Med Supp release in Nebraska
      Med Supp Application for NE.Learn More

      Med Supp Rates for NE. Learn More

Tags: Medicare open enrollment, Medicare benefits, health care law, Health Insurance, health insurance news, Medicare Part D, Affordable Care Act, health care reform

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