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Medicare Part B Premium 2024

Although the Medicare Part B premium 2024 has not yet been announced, it is  projected to increase to $174.80.  That is an increase in cost of almost $10 per month compared to the 2023 standard monthly cost of $164.90.  This amount is based the Medicare trustees report released in March 2023.  Click this link to learn more about Medicare costs for 2024.

In 2024, both the Part B,  Medical coverage and Part D, prescription drug coverage premiums are expected to increase by 6%.

In some cases, Part B premiums may be higher or lower than the basic Part B premium:

Certain low income beneficiaries qualify to have their Part B premium paid for by their resident state DSS.

These individuals must apply for LIS in order to qualify. Medicaid recipients are also eligible to receive the Part B benefit at no cost.

In some cases, Medicare Advantage plans offer a Part B give back.  This amount varies but reduces the amount you pay for Part B Medicare premiums.. When this is the case, the private insurance company assumes responsibility for a portion of your premium and provides coverage for your medical benefits.

Medicare charges some beneficiaries an IRMAA in addition to the basic Part B premium.

An IRMAA is an income-related monthly adjustment amount.  The IRMAA applies to certain higher earning individuals and is determined by income reported (MAGI) on your income tax returns two years prior. In other words, your 2021 tax return is used to determine your 2023 Medicare premiums.  The Social Security Administration will send you a notice to inform you if you will receive an IRMAA.  The IRMAA applies to both Part B and Part D premiums as well as Medicare Advantage plans.

If your financial situation has changed, you can file an IRMAA appeal

Click here to download an IRMAA appeal form.

Take a look at the chart below to view the 2023 Part B premiums including the IRMAA amounts:

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Life Insurance for Lupus Patients

Some diagnoses carry more weight than others, particularly for those patients who are concerned about providing for their families. Lupus is one of those diagnoses. While whole life and term life insurance policies can be difficult to get for patients with a history of lupus, it is possible. Because there are increased risks associated with the disease, it may cost more for people with lupus to get coverage. Realistically, most lupus patients will pay more in premiums for their life insurance, but coverage is out there. Here’s how to find it:

First, patients will need to determine which of the two types of lupus they have. There are two main types of lupus.

1. Discoid Lupus

Discoid Lupus is a chronic autoimmune disease affecting the skin. It can lead to scarring, hair loss, and hyperpigmentation of the skin. It can go and return, although it is chronic. It is more common in women than men, and it is most common in women between ages 20 and 48. In about 10% of the patients with discoid lupus, it will progress to systemic lupus. Early recognition and treatment can improve the prognosis significantly.

2. Systemic Lupus

Systemic Lupus is a chronic autoimmune disease in which the immune system attacks its own tissues. While the symptoms do tend to come and go, this can cause widespread tissue damage and inflammation. Some typical signs of lupus can be painful joints, rash, major fatigue, and loss of circulation.

For patients with discoid lupus, finding a life insurance policy will be significantly easier than for those patients with systemic lupus. If a beneficiary has discoid lupus, or has lupus that has been dormant for many years, they can apply for a fully underwritten life insurance policy. This is a policy with the lowest premium rates, but discloses the applicant’s full medical history.

For patients with systemic lupus or lupus with other health concerns, a simplified issue or guaranteed issue life insurance policy is a reasonable way to go. Simplified issue life insurance policies ask far fewer questions about medical history, and guaranteed issue policies do not require any disclosure of medical history. Simplified issue premiums are more expensive than fully underwritten, and guaranteed issue policies are the most expensive overall. Despite having to pay higher premiums, access to these three different options for life insurance policies means that patients with lupus and their families do have the opportunity to benefit from a life insurance policy.

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Losing Medicaid benefits

Because of the recent Medicaid redetermination, many people are losing Medicaid benefits.

During the last 3 year period, Medicaid benefits have been automatically renewed for individuals who became eligible because of the public health emergency caused by COVID-19.  During this time, beneficiaries were not required to recertify annually for Medicaid coverage.

Because the public health emergency has ended or “unwinding” as of May 11, 2023, the requirement to recertify for Medicaid coverage is back in place.  This means there will not longer be any automatic renewal and Medicaid beneficiaries must prove the need for benefits.

In other words, beneficiaries will go through redetermination.

This process takes place each year and reviews each person’s need for health care assistance through their state government. It is important to reply to any valid communication you receive from your state’s department of Social Services or DSS.  If you fail to respond, you may lose your coverage even if you do qualify.

Each state has 1 year to begin the redetermination process starting on March 31, 2023.  All states must finish processing renewals within 14 months. In other words, beneficiaries may lose Medicaid coverage as soon as April 2023.

Millions of people will lose Medicaid coverage:

Although we do not know the exact number of people slated to lose coverage, it may be over 15 million.  For many employment is a main factor in their loss of Medicaid coverage.

Some individuals will lose coverage due to not confirming eligibility with their state’s DSS offices before the expiration of their coverage.  There also may be problems with a backlog of paperwork and a processing system that is simply overwhelmed.  This can cause delays and coverage loss.  This backlog has the potential to effect millions .  That is why it is best to be proactive and go into your Medicaid account to ensure you are still eligible and covered.

Click here to learn more about the unwinding of Medicaid’s continuous enrollment

What if I no longer qualify for Medicaid:

If you reapply for Medicaid and do not qualify, there are other low cost or even free healthcare choices available to you.  The choices depend on your personal circumstances.

1.  If either you or your spouse/partner has an employer that offers health insurance coverage, you may qualify to join during either their open enrollment period or with a special election period.
2. In the interim, if you are not yet eligible for employer based coverage, you can enroll in a short-term insurance plan while you wait to qualify.  There are several options for these types of plans.
3. You can also access healthcare through the healthcare marketplace.  In many cases, beneficiaries may qualify for a subsidy and pay a low monthly premium.   If you lose health coverage, you have a special enrollment period or SEP you can use to enroll in coverage.  To find the market place for your state go to healthcare.gov/marketplace-in-your-state.
4. College students may be able to purchase health coverage directly through a campus health plan. Students can get details from their registrar’s office.
5. If you are either 65 or older or have a qualifying disability, you may be eligible for health coverage through  Medicare.  Contact a licensed Medicare agent for help going over all your plan options.
6. Anyone who is either a veteran or an active duty service member may qualify for Tricare.  Use the following link to get more information: Tricare healthcare coverage.

It’s important to note that if you believe you qualify for Medicaid, you should reapply. We’ll discuss that next. But even if you do apply, you may need to explore some of the options above while you wait to be approved.

How do I reapply for Medicaid benefits:

If you have limited income/funds, you may be eligible to retain your Medicaid coverage.   If this is the case, Click here to for information on how to apply for Medicaid.  Contact your state DSS office for applications and guidance.

Medicare Card Scams

You may have gotten a phone call recently from someone claiming to be the IRS, or you may have gotten an email asking for your banking information to avoid a threat to your computer. Unfortunately, avoiding scams has become part of our daily lives in the past decade. The Medicare insurance industry is no exception. Many criminal endeavors tend to target older citizens, who may be less familiar with the technology that these Medicare card scams utilize.

With that in mind, the federal Centers for Medicare and Medicaid Services (CMS) sent every Medicare beneficiary a new Medicare card designed to better protect against identity theft. These new cards were sent out from April 2018 to January 2019 and had a different format. Where the previous version had shown the beneficiary’s social security number, they now feature the Medicare Beneficiary Identifier (MBI). The MBI is an individual, random assortment of letters and numbers that is unique to each beneficiary. During the rollout of these new cards, scammers used the new protocol to their advantage and made calls impersonating Medicare employees. Then, once the new cards were all sent out, they changed tactics and called beneficiaries telling them they had to upgrade or replace their IDs. With both of these scams, and most technology based scams in general, the objective is to obtain personal information from the targets and use their identity.

Medicare Card Scams Warning Signs

There are some basic precautions to take to try to avoid Medicare scams. Here are some things to keep in mind:

• You will never receive a call from Medicare employees unless they are returning a call from you or you have otherwise invited them to do so.

• You will never have to pay a fee to upgrade or change your Medicare ID card.

• If someone threatens to cancel Medicare coverage over the phone if you do not verify personal information, it is a scam.

• A hospital bill or bill from a service you did not receive is also a sign of a scam.

How to Protect Yourself from Medicare Card Scams

• If you receive a call from someone claiming to work for Medicare asking for personal information, hang up immediately.

• Destroy your old Medicare card – shredding it, for example.

• Only give your Medicare card to professional, trusted healthcare providers such as hospitals, doctors, pharmacies, and insurers.

• Do not share your Medicare information with anyone else, or your personal information with anyone you do not know.

• Remember that scammers may know some personal information about you if you are targeted. This does not mean they actually work for Medicare.

Scams may be a part of our lives, but that doesn’t mean we have to be willing victims. With these protective measures in mind, beneficiaries can be safer from scams than before. If anyone encounters a potential Medicare Card scam, they can report it to Medicare at 800-633-4227.

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Medicare Advantage Trial Rights

Sometimes, despite our best efforts, our clients need to update and change their coverage. Maybe their life or healthcare needs changed since enrolling, maybe they want to return to Original Medicare from a Medicare Advantage plan, or maybe they are just dissatisfied with their coverage. Regardless of the reason, there is a regulation in place for this situation called a Medicare Advantage Trial Right.

What are Medicare Advantage Trial Rights?

Medicare Advantage Trial Rights allow beneficiaries to update their coverage outside of the Annual Enrollment Period. Essentially, clients have a 12-month period to test out a MA plan. If they are satisfied with the plan and coverage at the end of the time period, they can keep the plan. If they are not satisfied, they can revert to Original Medicare and either return to their former Medicare Supplement or choose a new Medicare Supplement. What is permissible is dependent on some client-specific regulations and some state-specific regulations, as some places extend the Medicare Advantage trial right period or can offer additional guaranteed issue rights.

Who Qualifies for Medicare Advantage Trial Rights?

There are two types of clients who qualify.

1. MA clients who enrolled when they turned 65 (less than twelve months ago)

For example, if your client enrolled in Medicare Part A at the same time as their Medicare Advantage plan, they may switch to Original Medicare as long as that switch occurs within a year of enrollment. When the client uses this trial period, they can also choose a Medicare Part D plan (prescription drug) and a Medicare Supplement plan without having to pass any underwriting, depending on what is available in their area.

2. Medicare Supplement beneficiaries who switched to a Medicare Advantage plan for the first time less than twelve months ago

If the client chose a Medicare Supplement plan when they first turned 65 but then decided to try out a Medicare Advantage plan, they can still switch back to Original Medicare within the first year of the Medicare Advantage plan coverage. They have to return to their previous plan, however, and do not have the option to purchase a different one. If that insurance carrier no longer offers their previous plan, the client will be able to purchase a guaranteed issue plan offered by a different carrier.

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Medicare Connecture Comparison

Medicare Connecture Comparison:  Sunfire vs Connecture vs MyMedicarebot

There are many different quote and enrollment programs that agents and agencies can use to assist their perspectives and beneficiaries find plans, compare plans, enroll in coverage, and even find doctors and hospitals in-network. Three of the most commonly used are SunFire Matrix, Connecture, and MyMedicarebot.

What they have in common

All three of these online programs are free to use for agents with Crowe and Associates and can be accessed through connect4medicare.com. Additionally, all three platforms work in a similar manner. They allow agents to quote and compare plans and enroll clients without the need for a face-to-face meeting. Here are some of the features they have in common:

• Basic CRM functions that can save client information, applications, scope of appointment documents, drug lists, and plan history

• Ability to text or email plan comparisons to prospective clients

• To run doctor and drug lists against plans to see which has the most comprehensive coverage

• Record all phone calls in compliance with the CMS regulations (updated for 2024)

• Enroll prospects over the phone with text or email

• Ability to see and compare all plans even if the agent is not contracted with that carrier

Much of what these programs do is interchangeable, but they are different programs and thus have some individual features.

Medicare Connecture Comparison – Sunfire, Connecture, MyMedicareBot

SunFire Matrix

SunFire Matrix’s press says that they provide transformative and proven technology solutions to support the Medicare landscape. Their software has been used to secure coverage for over 50 million senior citizens. Due to their size, they can collect and distill data from more than 80 insurance carriers, offering a total of more than 1300 Medicare Advantage and Prescription Drug insurance plans. Like the other programs on this list, SunFire can save the prospective’s personal information in order to identify the ideal plan with the lowest annual cost for an agent to enroll them in.

Connecture (Medicare Connecture Comparison)

Connecture is advertised as the most personalized software for quotes and enrollment for agents and agencies. It is also referred to as Connect4Medicare. The idea behind this level of personalization is that it helps not only drive enrollment, but helps protect against dissatisfaction and plan disenrollment as well. Connecture is a commonly-used platform for small to mid-sized agencies. They are also the largest Health plan-FMO-Agent distribution network in Medicare and thus can provide access to more information than some of the smaller software companies.

MyMedicareBot

MyMedicarebot is yet another software program that can quote and enroll prospective clients. However, they are unique on this list in that they have the ability to record both sales and enrollment calls in compliance with the CMS regulations for AEP 2024 and have integrated call analytics for agent and agency usage. MyMedicarebot also offers a Portfolio Analytics and Consulting feature that can distill data from CMS, competitive marketing intelligence, and the unique user membership and identify the best markets and prospects. This level of personalization is meant to optimize sales and retention.

While all three of these commonly used software programs have the ability to do the basics of quotes and enrollment for agents and agencies, they all have certain individual features that may make one a better choice than another, depending on the agency’s needs.

Licensed Agents – Medicare Connecture Comparison

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Medicare Savings Programs FAQ

Connecticut is one of the states in the nation that offers access to financial assistance programs for eligible Medicare beneficiaries. Some of the services that the Medicare Savings Program (MSP) can help pay for are Medicare part B premiums, deductibles, and co-insurance. Depending on the beneficiary’s income, if they qualify for one of the three Medicare Savings Programs, the Department of Social Services will offer financial assistance for the Medicare Part B premium each month. Some seniors may also be eligible for financial assistance for Medicare deductibles and coinsurance. Connecticut’s Medicare Savings Program is funded by Medicaid. The following are some frequently asked questions about MSPs.

Can I have both MSP and Medicaid?

Yes, you can. Medicare Savings Programs and Medicaid are two separate programs and the medical coverage is different for both of them.

Can I see the provider of my choosing?

If you have traditional Medicare, then you can see any healthcare provider that is a participating provider in Medicare. Seniors on a Medicare Advantage plan are limited to a network of providers chosen by the insurance carrier. However, the MSP works with both of these plans.

Do I have to apply for MSP?

Yes, you must file an application in order to receive the assistance from a Medicare Savings Program. Enrollment in an MSP is voluntary, meaning you can stop at any time even if you still qualify financially for the assistance.

How do I apply for an MSP?

There is a short application form that must be sent to the Department of Social Services. There is no supporting documentation needed unless the DSS requests it from you. The application form is #W-1QMB or W-1QMBS (Spanish version).

Mail the application form to:

DSS ConneCT Scanning Center
PO Box 1320
Manchester, CT 06045-1320

You can also enroll online through https://www.connect.ct.gov.

It may take the DSS up to 45 days to review your application. However, if eligible,  benefits are backdated to the day the office received your application.

How often does the DSS review my eligibility?

Yearly. A month or so before the expiration date, beneficiaries receive a notice explaining that they are due for a review of coverage and a renewal form, which must be sent to the DSS scanning center.

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Selling Medicare Advantage plans from home

Selling Medicare Advantage plans from home is both a viable and rewarding career option for those passionate about helping beneficiaries find the right healthcare coverage. Because of the growing demand for comprehensive plans, Medicare advantage carriers are offering more and more benefits.  this gives agents a fantastic amount of options to fit their client’s needs.

If you stay up-to-date with industry trends as well as your education of plan options and compliance standards, you can build a thriving home-based business.  You can also make a positive impact on the lives of Medicare beneficiaries.

The healthcare industry is constantly evolving, and with an aging population, the demand for Medicare Advantage plans is on the rise. For individuals who want a flexible and rewarding career, selling Medicare Advantage plans from home is an attractive option.  We will discuss the benefits of selling Medicare Advantage plans remotely.

What are Medicare Advantage Plans:

Medicare Advantage (Medicare Part C), is a private health insurance option offered to Medicare beneficiaries. The insurance companies must have their plans approved by CMS.  This is an alternative way for beneficiaries to receive Medicare benefits.  Plans often include additional coverage for services not covered by Original Medicare.  The additional benefits include things such as; dental, vision, prescription drug coverage, OTC coverage.

Growing Medicare Advantage Plan Market:

The popularity of Medicare Advantage plans has been growing steadily in recent years.  Because beneficiaries are looking for comprehensive coverage and additional benefits, the demand for these plans has increased greatly.  As a result, selling Medicare Advantage plans is a great opportunity for anyone who wants to start a home-based business.

Reasons to Sell Medicare Advantage Plans from Home:

1. The ability to set your own hours

One important advantage of selling Medicare Advantage plans from home is the flexibility it offers. As an independent agent, you can create your own schedule.  This will allow you to balance your work and personal life as needed.

2. Reasonable start-up costs

Starting a home-based business selling Medicare Advantage plans requires a much lower initial investment compared to a traditional store front. You’ll need a computer, phone, internet connection, and the necessary licenses in place to start.

3. Freedom to work from different locations

Because you are working from your computer, you are not bound by a physical location.  In other words, you can reach clients wherever you go.  This can expand your market reach.

Getting Started as a Medicare Advantage Plan Agent:

1. Licensing and Certification

Before you start selling Medicare Advantage plans, you need to obtain the required licenses aa well as complete the necessary certifications. This usually involves passing state-specific exams and completing relevant carrier training programs.

2. Partner with Insurance Carriers

It is very helpful to create good relationships with your local insurance carrier reps. Carrier reps can offer you important services such as help with applications, marketing money and opportunities to represent their product.  It is a good idea to run quotes for the area you plan to sell in and find the most competitive carrier choices to add to your offerings.

3. Building a Book of Business

Both networking and marketing play a crucial role in building a book of business.  Online platforms, social media, and community events are all good ways to reach potential clients. Building trust and rapport with people is key.  If you prove to be approachable, helpful and informative, you can expect clients to recommend your services to others.

Learn more about how to become a Medicare agent

Compliance and Regulations:

In order to sell Medicare plans, you must adhere to all rules and regulations set by the Centers for Medicare & Medicaid Services (CMS). It is very important to stay up-to-date with changes in the industry, as non-compliance can lead to severe penalties.

Ongoing Support and Training:

Continuing education and training are essential to stay relevant in the ever-changing healthcare landscape. Many insurance carriers and organizations offer ongoing support and resources to help you succeed in your role.  This is one of the many reasons independent insurance agents may want to consider an upline.

Click here to begin a new contract with Crowe and Associates.

View our free training and informational videos on our YouTube Channel.

Medicare Call Recording

Online platforms where agents can get potential customers quotes, information about different carriers and insurance plans, and even enroll beneficiaries play a huge role in the Medicare business today. They are a vital tool for any agent. Three of the most commonly used quote and enrollment programs are Connecture, Sunfire, and MyMedicarebot. They are often used to enroll customers without the need for a face to face meeting. In order to be in compliance with the regulations from the Center for Medicare and Medicaid Services (CMS), all marketing calls between the agent and the potentials must be recorded.

Agents who work with Crowe and Associates have access to all three of these major enrollment tools for free and can watch a webinar on their use here.

Features in Common

Although the platforms are different in some ways, they have significant similarities:

• Basic CRM function that saves client information, applications, scope of appointment documents, drug lists, doctor lists, and plan histories.

• The ability to compare insurance plans and text or email them to prospective clients.

• Agents can run prescription and practitioner lists against plans to see which would include the prospective client’s preferred healthcare management

• Record all phone calls in compliance with CMS guidelines. Save calls for up to ten years if necessary.

• The ability to see and compare all plans even if an agent is not in contract with the company.

• Access to PURL links that allow clients to compare and ultimately enroll in their preferred plans. The PURL link is specific to the agent and has their contact information; it can be added to a website or sent as a link via email.

• Enroll perspectives over the phone using these Medicare call recording functions.

Medicare Call Recording Demonstrations

Watch the video instructions on how to record calls using Connecture.

For Sunfire, click for parts one and two of the instructions on how to record calls.

For MyMedicarebot, follow this link to learn how to record calls.

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