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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:
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      November 2013 Med Supp rate Outlines for VA. Learn More

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

Impact of Healthcare Reform on the Medicare Market

Posted by Guadalupe Cantu on Fri, Sep 06, 2013 @ 11:15 AM

Medicare SupplementsAs the Affordability and Accountability Act inches closer to the October 1st launch date, many insurers are anticipating major changes in the regulatory and funding under the new health care reform law. With all this anticipation going around, how will the Medicare Supplement and Medicare Advantage programs be affected by the changes?

For Medicare Supplement program, health care is hardly unaffected by the ACA. Under the new changes (Section 3210 of ACA), the National Association of Insurance Commissioners (NAIC) was required to add a minimal cost to the C and F plans. In December 2012, in a letter to Health and Human Services Director Kathleen Sebelius, the NAIC recommended a no cost sharing to the plans, stressing that that the additional cost would decrease usage. In May 28, 2013, the no cost sharing to plans C and F was accepted in a letter response by HHS Director Kathleen Sebelius.

The Medicare Advantage program has been affected the most by the changes. The ACA holds the Med Advantage program to an 85% minimum loss ratio. It further requires the funding levels to the plans to be restructured, removing 14% overpayment to Medicare Advantage, aligning it closer to the traditional Medicare program. This in spite of the 2012 demonstration program by Centers for Medicare & Medicaid Services, which expended payments to the Medicare Advantage program and regulates the funding and cuts of program.

With the regulations that the ACA has put in place for the health care reform, it has had a two-pronged road affect. The traditional plan seems to have gone unscathed, while the Med Advantage has an uphill battle adjusting it rates to the market, as well as, and being a hot topic for future political health battle grounds to come.


Please give us your feedback!
Does the health care reform hurt the Medicare insurance industry or will it make it more competitive and affordable?

 

Source: CSG Actuarial

Additional Updates:
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Tags: Senior insurance, Health Insurance, Medicare Supplement, Medicare News, health insurance industry, health care reform

Physicians Medicare participation on the rise

Posted by Guadalupe Cantu on Fri, Aug 23, 2013 @ 02:33 PM

Medicare SupplementsIn recent years, the numbers of doctors who have chosen to participate in Medicare program have risen. According to a Department of Health and Human Services, it rose by one-third from 2007 and 2011. The growth can also be seen in the 2011; about 1.25 million physicians billed Medicare, compared to the 925,000 of those who billed for their services in 2007, as reported by HHS Office of the Assistant Secretary for Planning and Evaluation.

According to Jonathan Blum, deputy administrator and director for the Center of Medicare, the trend "provides a more complete picture of how physicians choose to participate in the Medicare system."

The growth has continued despite the physicians complaints about Medicare payment caps, new paper work requirements, and Congress political delays of the payment of the Medicare beneficiary system, which could lower rates by 30% and is designed to ensure Medicare expenses do not exceed GDP growth.

However, in a Wall Street Journal article, it was reported that there was an increase in physicians opt out rate from the Medicare program, the number had risen from 3,700 doctors in 1997 to 9,500 in 2012, commissioning an investigation to the findings.

In spite of the WSJ article, Medicare Payment Advisory Commission (Medpac), reported that even though older doctors are opting out of the Medicare system, more new primary care professionals are opting into the system, according to Blum.

The researchers found that office based doctors made up 90% of those accepting new Medicaid patients, and Medicare patient found doctors in a timely manner. They also found 28% of the 7% of Medicare patients searching for new primary care doctors had a challenging time finding one that accepted Medicaid the year before. These are rates similarly aligned to those of private insurers, said Blum.


Please give us your feedback!
Do these findings raise awareness that agents and brokers make health insurance shopping more affordable?

 

Source: USA Today

Additional Updates:
  • Assured Life Association/Woodmen of the World: September 2013 Med Supp rate release for AZ, MS, PA and Med SELECT PA. Learn More
  • 2014 Certification with United Healthcare Learn More
  • 2014 Medicare Advantage / PDP Certifications Now Available Learn More
  • UnitedHealthcare Agents: 2014 Proposed Benefit Maps Now Available / Certification Reminder Learn More
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Tags: Insurance advisor, Senior insurance, Health Insurance, Medicare Supplement, Medicare News, health insurance industry, insurance companies

Proposed Bill would Pay Seniors to Say Healthy

Posted by Lauren Hidalgo on Fri, Jul 12, 2013 @ 09:06 AM

Medicare Supplements 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.


Please give us your feedback!
What are your thoughts? Do you think this bill would help improve wellness and reduce healthcare costs?

 

Source: The Hill

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Tags: senior market news, Medicare News, health insurance news, health insurance industry, Combined Insurance Medicare Supplement, Cigna Medicare Supplement, Baby Boomers

The HHS Agrees with the NAIC on Cost Sharing

Posted by Lauren Hidalgo on Fri, Jun 28, 2013 @ 09:09 AM

Medicare Supplements The U.S. Department of Health and Human Services (HHS) has taken the National Association of Insurance Commissioners (NAIC)'s advice not to impose a nominal cost sharing in Medicare Supplement insurance Parts C and F. Kathlee Sebelius, a former NAIC president herself, wrote in a letter to current NAIC President Jim Donelon "I value the NAIC's expertise on Medigap and other health insurance issues and the strong partnership between NAIC and the U.S. Department of Health and Human Services. This partnership has been instrumental in the effective implementation of numerous provisions of the Affordable Care Act."

The HHS had requested under PPACA that the NAIC revise the NAIC Medicare supplement insurance model to include a nominal cost sharing in Medigap Plans C and F to encourage the use of appropriate physician's services under Medicare Part B.

However, last December, the NAIC recommended against this nominal cost sharing and did not revise the standard benefit packages for these model plans. Besides studying the issue, the NAIC communicated caution with proceeding with nominal Medigap cost sharing because it could delay treatments that people really need. This would make the more vulnerable populations worse off in the long run with costly hospitalizations and emergency room visits. Also, when referencing the changes to Medigap's plan offerings that started in 2010, the NAIC stated "We are still learning the impact of these new offerings on both the Medigap market and to the Medicare program."

Despite the HHS agreeing to not go forward with these changes, the Medicare Trustee report has projected that the trust fund that finances Medicare's hospital insurance coverage will stay solvent until 2026, which is two years longer than it was projected last year. Additionally, Medicare Part B and Medicare Part D are both projected to remain funded into the foreseeable future because current law automatically provides financing each year to meet the next year's expected costs.


Please give us your feedback!
Are you glad the HHS has taken the NAIC's advice not the impose nomial cost sharing? Are you surprised by the decision or were you expecting it?

 

Source: LifeHealthPro

Additional Updates:

Tags: Medicare News, senior insurance market news, health care reform, Stonebridge Medicare Supplement

Medicare Supplement Market Projection

Posted by Lauren Hidalgo on Fri, Jun 21, 2013 @ 10:08 AM

Medicare Supplements The Medicare Supplement market continues to have long-term sustainability. By 2022, almost 68 million consumers are expected to be enrolled in Medicare. The recent growth in the Medicare Supplement market can be attributed to the number of Medicare enrollees growing by 11%, as well as a recent slowdown in the growth of Medicare Advantage enrollments. Additionally, employers have continued to remove Medicare-aged retirees from their employer health plans further supporting a growth in Medicare supplement sales. Medicare Supplement enrollments are projected to continue to grow over the next ten years, creating ample opportunities for insurance carriers, agents, and marketing organizations in the senior market.

Three factors contributing to Medicare Supplement’s growth:

  • Overall Medicare Growth: The ongoing growth in the Medicare market from Baby Boomers will increase the number of Medicare beneficiaries by 17 million over the next 11 years. The total number of Medicare beneficiaries in 2022 will be 34% higher than in 2012.

  • Medicare Advantage Funding Reductions: Over the past few years growth in Medicare Advantage enrollment has slowed. Predictions show that enrollment will plateau when additional bonus payments from the quality based demonstration programs end after 2014.

  • Decrease in Retiree Health Benefits: Companies and municipalities are eliminating or altering health care benefits for their retirees due to economic changes. Many are now offering those retirees a monthly stipend to purchase their own Medicare Supplement or Medicare Advantage coverage.

All these factors show a positive outlook for the Medicare Supplement market in the upcoming years. If you are considering getting into the senior market – now is the time! With 10,000 seniors becoming eligible every day the market is booming with no signs of slowing down.

To read the entire 2013 Medicare Supplement Market Projection by CSG Actuarial, please go here.


Please give us your feedback!
What do you think of CSG Actuarial's findings? Have you seen an increase in your Med Supp business as well?

 

Source: CSG Actuarial

Additional Updates:
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Tags: Medicare Supplement, Medicare News, insurance news, industry news, Stonebridge Medicare Supplement, Medicare Solutions

How Healthcare Reform will Affect Med Supp Products

Posted by Lauren Hidalgo on Fri, May 31, 2013 @ 09:26 AM

Medicare Supplements The largest portion of healthcare reform Affordability and Accountability Act "ACA" is set to go into effect in 2014. For the most part the Medicare Supplement market will be largely unaffected by ACA with most of the impact resulting indirectly from changes to Medicare Advantage.

Possible impact to Medicare Supplements:

Medicare Supplement::

  • Section 3210 of ACA required the NAIC to add a nominal cost sharing to plans C and F (however, the NAIC has recommended no cost sharing to plans C and F due to lack of evidence this would decrease utilization. This has not been decided upon.)
  • Mostly unaffected by ACA, as long as Plan F doesn't change

Medicare Advantage:
  • Medicare Advantage plans will be held to a minimum loss ratio of 85%
  • Restructures the funding levels to Medicare Advantage plans in order to reduce the payments closer to traditional Medicare
    • CBO estimates this will cut approximately $145 billion over the next 10 years
    • The payment restructuring was designed to be implemented over 3-6 years, which began in 2011

The changes to ACA may even prove positive for the Medicare Supplement market. Medicare Supplements will not be affected by minimum loss ratio changes or any major plan changes, whereas the Medicare Advantage market will most likely have a higher minimum loss radio requirement and continued political pressure on funding.

If there are any Medicare Supplement carriers you’d like to add to your portfolio, give your marketer a call at 1-800-998-7715; they can assist you with more information on all of the carriers PSM offers.


Please give us your feedback!
Do you think the ACA will affect your Medicare Supplement sales? Your Medicare Advantage sales?

 

Source: CSG Actuarial

Tags: senior market news, Medicare Supplement, Medicare News, Medicare Advantage News, Medicare Sales

Projected Hits for Medicare Advantage in 2014

Posted by Lauren Hidalgo on Fri, Mar 01, 2013 @ 11:11 AM

Medicare Supplements This week America's Health Insurance Plans (AHIP) warned that the potential 2.3 percent reduction in Medicare Advantage payments proposed by the Department of Health and Human Services (HHS) combined with PPACA's payment cuts will result in benefit reductions and premium increases of $50 to $90 on average. These cuts would affect 14 million seniors which is roughly 28 percent of all Medicare beneficiaries. An analysis prepared for AHIP states that the effect of the changes from both PPACA and the new payment cuts will result in an estimated 6.9 to 7.8 percent cut to Medicare Advantage plans in 2014.

The cuts were proposed last week by the Centers for Medicare & Medicaid Services (CMS). New rules will be published by CMS on April 1, 2013. Subsidies will be slashed and access to the report will be severely restricted, according to the AMAC industry analysts.

The analysis was made by actuaries at Oliver Wyman and was prepared for AHIP. The Oliver Wyman report states, "Virtually all of the 14.1 million Medicare beneficiaries are likely to be affected by these changes, either through increased premiums, reduced benefits, or plan exits from local markets."

The major impact of these changes will reduce Medicare Advantage in 2014 by more than eight percent or nearly $11 billion. Understandably, health insurance stocks reacted to the news negatively and took a hit. The costs per person for Medicare Advantage plans are a bigger drop than many analysts had anticipated.

So far in 2013, only four percent of PPACA's $200 billion in Medicare Advantage cuts have gone into effect. However, the Congressional Budget Office (CBO) projects that, after it's fully phased in, the cuts alone will result in three million less people in the program. The PPACA's new health insurance tax will begin in 2014 and Oliver Wyman has previously estimated that this tax alone will cause approximately $220 in higher out-of-pocket costs for seniors, reduced benefits for next year, and $3,500 in additional costs of the next 10 years.

AHIP contrasted the cuts by releasing projections for medical cost increasing three percent. Karen Ignagni of AHIP stated "The proposed changes to Medicare Advantage payments are a crushing blow to the millions of seniors and people with disabilities who count on this critically important part of Medicare."

Please give us your feedback!
How do you feel about these rate increases to Medicare Advantage? How do you think it will affect your business? Do you think this is positive for your Medicare Supplement business?

 

Source: LifeHealthPro

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Tags: Current Events, senior market news, Medicare News, Medicare Advantage News, Equitable Life Medicare Supplement, Gerber Life Medicare Supplement, Stonebridge Medicare Supplement

New Rates from Equitable Life Med Supp

Posted by Lauren Hidalgo on Fri, Feb 15, 2013 @ 09:29 AM

Equitable Life Medicare Supplement


We are pleased to announce that with Precision Senior Marketing, you now have the opportunity to offer Equitable Life's Medicare Supplement Plans. For over 75 years, Equitable Life has provided top-notch Life and Health insurance plans, backed by superior, friendly personalized service, to consumers and agents across this country.

Now is a great time to add Equitable Life to your senior portfolio and provide your senior clients with some of the most competitive plans in the market.

Equitable Life has New Lower Rates on their Medicare Supplement Plans

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More State Approvals Coming Soon:
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Please see the Equitable Life Med Supp Competitive Comparison for how Equitable’s rates stack up against the competition.

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Additional Updates:
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Tags: senior market news, Medicare Supplement, Senior Market, Medicare News, Equitable Life Medicare Supplement

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