Medicare Advantage Season Coventry

Medicare Advantage Season Coventry

Medicare Advantage VS Medicare Supplements (Medigap)

• Medicare Advantage plans offer coverage with little or no monthly premiums. In some instances the client can actually receive money back every month!

• When a client enrolls in a Medicare Advantage plan they are still part of the Medicare Program and retain all of their Medicare rights and protections.

• When joining a Medicare Advantage plan a client will continue to receive all their regular Medicare-covered services. With Medicare Advantage the client will also have access to additional services that neither Medicare Supplements nor Original Medicare can provide.

• Medicare Advantage plans can offer prescription drug coverage whereas Medicare Supplements do not.

• Medicare Supplement premiums continue to rise while the commissions continue to shrink. At the same time most Medicare Advantage premiums are at or near $0.

• Medical providers may or may not accept some Medicare Advantage plans. Agent and clients need to check with the client’s doctor prior to purchasing a Private Fee for Service (PFFS) plan. Some Medicare Advantage plans may have a published network of providers. Whereas most Medicare Supplements are universally accepted.

• Medicare Advantage plans require annual certification and strongly enforced marketing practices. Most Medicare Supplements are free of certification requirements and have less strict marketing guidelines.

• With a Medicare Supplement the client must pay a premium whether they use it or not! With a Medicare Advantage plan the client only makes a small co-pay when they use the services.

• With a Medicare Advantage plan the client only has to answer ONE health question; Do you have End-Stage Renal Disease (Kidney Failure)? Medicare Supplements may have multiple health questions.

Now as a top agent can you imagine how you can help your clients with their other product needs after you have freed up $1500-$2000 per person in a household? Up to $4,000 per couple?

AGENT USE ONLY. Not for use with the public.

NEW 2010 Medicare Deductible and Coinsurance Increases

(Click on table to enlarge)

Medicare Advantage – Make this Your Best Year Ever!

It’s the time of year that thousands of agents live for – the Medicare Advantage selling season. Just like the major box stores love the holiday season, insurance producers love the selling opportunity that comes with the Medicare Advantage season.

This is the fourth big year for Medicare Advantage. Medicare Advantage producers have developed a love/hate relationship for this season. Agents love the season, as it creates a buying frenzy by the public. The consumer has a very limited number of days to make a decision, so activity is very high and a tremendous number of sales are made in a very short time. On the other side, Medicare Advantage has another player, besides the insurer, agent and consumer. That other player is our federal government –led by The Center for Medicare and Medicaid Services (CMS). CMS has taken the lead on all aspects of Medicare Advantage plans, including: design of products, commission amounts, how/when commissions are paid, issuance of plans, and of course, when plans can be purchased. The involvement of CMS has totally changed how agents and insurers have intertwined. CMS has been known to change the rules as the game is played, thus causing the “hate” in an otherwise terrific product and selling opportunity.

Most agents recognize November 15 through December 31 as the “season of choice”. However the entire selling season is much longer than these coveted 46 days, in fact, the actual season can be year round.

Let’s look at the calendar for Medicare Advantage:

• November 15 – December 31: This is the “door buster”, called the Annual Enrollment Period by CMS. At this time consumers can buy anything and everything Medicare Advantage.

• January 1 – March 31: These three months, called the Open Enrollment Period, are ignored by a portion of agents, typically the ones that are new to Medicare Advantage. They simply don’t realize that the season remains in full swing. There are some definite guidelines during this time period that are not applicable in the Annual Enrollment Period. For example, one must be cognizant of the Part D. If a consumer owns a Part D element to their Medicare Advantage plan, they must not delete it from any new plan. However, they can switch to a new Medicare Advantage plan as long as it contains Part D. On the other, if a person does not have a Part D element to their Medicare plan, they cannot suddenly add Part D during this Open Enrollment Period. In summary, if a person has Part D, the agent must make sure the new plan also has Part D. If the consumer doesn’t have Part D, they can still buy a new Medicare Advantage plan; it simply can’t have Part D attached to it.Nearly all agents believe the Medicare Selling season is fully done on March 31. This is very unfortunate as the season continues, with limitations, year round. CMS has provided the following opportunities for the senior citizen to obtain a Medicare Advantage plan:

• Special Enrollment Period: there are no dates attached to this portion of the selling season. There are multiple ways a person can qualify for a Special Enrollment, including:

- Moving out of a service area
- Termination of the plan by the carrier
- Ageing-In: when a person turns age 65, they have 6 months prior to and 6 months after their birthday to join a Medicare Advantage plan
- Special Needs

Without question, the very best opportunity for the agent is the Special Needs Plans. These plans can be sold year round. The available prospects for a Special Needs plan is extremely large. This segment of the eligible Medicare population is the most underserved, thereby creating a unique opportunity for the agent.

There are several varieties of Special Needs plans (sometimes called SNiPs). SNiPs are for people who can qualify with:

- Low Income
- Dual Eligible
- Chronic Illness

According to an insurer in this Special Needs market, over 68% the senior population could qualify in one of these categories! So if you think the “selling season” is over on March 31 – think again.

In this fourth year of Medicare Advantage, it appears the rules are now mostly known – although all would likely agree that they may be changed at any time. The first few days of the season have begun as of the date this article is written and it appears that this will once again be a terrific opportunity for the consumer, agent, insured, and yes – CMS.