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Prepare for Medicare AEP

It may not feel like it now, but summer is almost over. Before you know it, Fall will be here.  And, with it the Annual Enrollment Period (AEP) for Medicare and Medicare Advantage insurance plans. Now is the time to prepare for Medicare AEP.

The AEP runs from October 15th through December 7th. This is the time when beneficiaries can choose to re-enroll in their existing plan, switch from Original Medicare to Medicare Advantage, add a Medicare Part D or prescription drug coverage plan.  Or opt to stay with Original Medicare and purchase a Medigap policy. Comparing plans can save beneficiaries significant money in premiums as well as make sure that their basic needs for their changing health status are covered. According to a survey conducted by Deft Research, over 44% of seniors shopped around during the Annual Enrollment Period of 2020. Whatever the changes will be, here are five ways you can start getting ready to make informed choices for your healthcare and medical insurance needs:

Read your ANOC

An ANOC is a Plan Annual Notice of Change, and insurance carriers are required to send them out to their beneficiaries each year. Its purpose is to inform members of a plan as to what changes will be coming to that plan in the following year. Some possible changes might be raising the premium, your healthcare team no longer being in-network, or adding or discontinuing extras like dental or vision. There have even been cases when an insurance plan was completely gotten rid of, and those beneficiaries had to choose a new one regardless of whether they had planned to switch. The ANOC will have all the information you need to know about what will be different next year.  Begin preparing for Medicare AEP by understanding what you currently have.

Stay aware of the timeline

The timeline for Annual Enrollment goes like this: on October 1st, new plans are released.  This gives people time to peruse and compare before the enrollment starts on October 15th. December 7th is the deadline for making a choice in coverage. The more research you do, the more informed you’ll be.

Work with a broker to Prepare for Medicare AEP

Brokers work with multiple insurance companies.  They are uniquely suited to help you compare and contrast the ins and outs of  plans. Doing this process with a broker may help you save significant time on research.  They are in the business of knowing all the details you would be looking for.  A reputable broker is a must to prepare for Medicare AEP.

Make a list of your important questions

You have to know what you need and want in a healthcare plan before making a choice – otherwise you may end up with a plan that doesn’t suit your needs at all. Some questions to ask might be: Is my doctor in-network? Is this prescription that I need to take covered? Will there be vision and dental coverage or is that extra?  Make note of this when preparing for Medicare AEP.

Review the logistics of enrollment

There are several options for enrolling in a new plan: you can meet with an insurance representative face to face, fill in and mail all the paperwork yourself, or enroll directly with a broker who will walk you through the process. And, although it’s normal to be hesitant to make any big changes in healthcare coverage, remember that, whichever plan you choose, it’s only for the next twelve months. Annual Enrollment Period will be back next year.

Licensed Agents – Prepare for Medicare AEP

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Devoted First Look 2024

The Devoted first look 2024 includes an expansion in 12 of the 13 markets Devoted is available in!  Devoted provides an excellent team of 100% U.S.-based support for both agents and Members.

Devoted Agent support statistics:

Nearly 96% of agent calls are answered within 30 seconds.  This is very important when you do not have time to waste.  Over 90% of all issues are resolved on the first call.  The average case resolution is 1.4 days.  Devoted provides bilingual support with expanded weekend hours during AEP.

The Member guides:

On average 92.5% of all member calls are answered in 30 seconds, although wait times may vary somewhat during some enrollment periods.  Almost 92% of issues are resolved on the first call this helps cut down on member frustration.  During the busy seasons of both AEP and OEP, Devoted provides extended weekend hours to be sure all member’s questions are answered.

General information about the 4 plan groups of the Devoted Plans for 2024:

HMO and PPO Giveback Plans –

These plans provide high Part B giveback values.  This is offset by less rich medical benefits as well as fewer supplemental benefits as compared to other Devoted plans.  However, all giveback plans provide a dental benefit.

$0 HMO ands PPO Plans –

These plans are Devoted’s anchor product lines. They provide an equal balance between medical and supplemental benefits.  Every $0 PPO plan, except in Chicago, is now a passive design with equal in and out of network cost sharing on most benefits.  Please note; there are some market exclusions.

Premium HMO and PPO Plans –

These plans are a great option for members who want strong supplemental benefits.  All premium products are no-cost to individuals who receive 100% LIS(Extra Help).

DSNP and CSNP HMO Plans –

All SNP plans provide members with a Food & Home card as well as comprehensive dental coverage. In the states of AL, CO, FL, NC, OH, both Dual and partial D-SNP products are available.
Additionally, Devoted has renewed four C-SNP products in Arizona and Tennessee.

To view plan details by state, just click here

Download the First Look for all markets, click here

Comparing Life Insurance Products

One of the most common issues that faces people as they age is this question: how can I provide for them after I am gone? The answer for many has historically been by purchasing a life insurance policy.   For many beneficiaries as they age, they take comfort in the knowledge that their families will receive a sum of money to cover things like funeral costs, any outstanding debts, and even life essentials like groceries while they are mourning. Agents need to be well versed in all the different options for life insurance in order to present their clients with a cohesive picture of their options.

Much of the time, people think of life insurance as two-fold: people are either able to purchase term life insurance or whole life (permanent) insurance. However, there are three different options for the type of policy that is available. The following presents a comparison of these three types: fully underwritten, simplified, and guaranteed issue life insurance policies. Each one has their benefits and drawbacks.

What are the Three Types?

Fully Underwritten – Comparing Life Insurance Products

Fully underwritten policies are typically for term life insurance, meaning that coverage is for a certain time frame, such as ten years, and then the beneficiary has to reinstate the coverage when that time is up. This is a policy in which the beneficiary’s medical history is completely disclosed, and most often requires a visit from a doctor, nurse, or other healthcare professional in order to have the application accepted. The approval process for fully underwritten policies is the longest; it can take up to several weeks to get approved. However, there is no specified maximum coverage amount. These policies are recommended for individuals in good health.   They have no complex medical history.

Simplified Issue – Comparing Life Insurance Products

Simplified issue policies are also typically for term life insurance. The largest difference in the application process between simplified issue and fully underwritten is that the simplified issue application has far less medical history disclosure required. There is no visit or exam necessary by the medical professional, and, as a result, the premiums are often higher than fully underwritten policies. Approval of applications is quicker because of this, as well, with approvals in several hours to several days. The maximum amount of coverage differs by carrier, but is typically up to a million dollars in coverage.

Guaranteed Issue – Comparing Life Insurance Products

Guaranteed issue life insurance policies are for whole life, or permanent, policies. These are the most expensive premiums by far.  No medical questions.   (Hence the “guaranteed” part.) Approvals can come within a few hours. Because of the guaranteed aspect of the policy, the coverage is usually limited to between $25,000 and $50,000 per policy. These policies work best for people with a complex medical history.  These individuals may not receive coverage otherwise.

Knowing the basics of which situations require which policies can help agents successfully enroll more clients and maintain more working relationships.

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Medicare and working after 65

As people approach the age of 65, many consider retiring and accessing their Medicare benefits. However, a growing number of individuals are choosing to continue working after turning 65.

Navigating Medicare and working after 65 requires an understanding of how these systems interact. By exploring your options, enrolling during the appropriate periods, and considering your retirement plans, you can make informed decisions that optimize your healthcare coverage and financial security. It is also be a good idea to consult with a licensed Medicare agent as well as a financial advisor to be sure you make the best choices for your unique situation.

Medicare Eligibility:

Most people become eligible for Medicare at age 65. If they or a spouse have worked and paid Medicare taxes for at least 40 quarters/ten years, they usually qualify for premium-free Part A.  Enrollment in Part B has a premium for most people. 

Here are the 4 parts of Medicare and what they cover:

1. Part A: Is Hospital insurance and it covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health services.
2. Part B: This coverage is called Medical insurance and it provides coverage for doctor visits, preventative care, outpatient services, and medical equipment.
3. Part C: Not everyone needs to have Medicare Part C.  This is another name for a Medicare Advantage plan.  These plans are offered by private health insurance companies and take the place of Medicare Part A & Part B coverage (although you still have to pay the Part B premium even with a Part C plan).  In most cases, they include Part D prescription drug coverage.
4. Part D: This is prescription drug coverage that helps pay for your medications.  These plans are offered by private insurance companies.

Working After 65:

Many seniors choose to work past 65 for various reasons.  These reasons may include; financial security, personal fulfillment, and maintaining social connections. If you continue working after 65, consider the following:

Employer Coverage vs. Medicare:

If you have health coverage through your employer or your spouse’s employer, you can delay Part B enrollment without facing penalties. You should look at the coverage and cost of each option before you make a decision.  This is a perfect time to consult a Medicare agent so they can go over both plans and help you make the best choice.  However, if your employer has less than 20 employees, Medicare becomes your primary coverage.  This means you should enroll in both Part A and Part B to avoid potential late enrollment penalties.

Enrolling in Medicare While Working:

If you want to access Medicare benefits while working, make sure you sign up during your IEP or Initial Enrollment Period. The IEP begins three months before your 65th birthday and ends three months after your 65th birthday.  Just be sure you understand how your Medicare coverage works with your employer plan if you have both.  You may drop employer coverage and to join a Medicare plan.  If you choose this option, you will need additional coverage such as a Medicare Advantage plan or a Medicare Supplement plan and a Medicare Part D plan.

No matter which plan you choose, be sure you have Creditable prescription drug coverage.  If you do not, you can end up with a life-long penalty for late enrollment once you decide to purchase a Part D plan.

Medicare and Part-Time Work:

Even if you work part-time, you may be eligible for Medicare benefits. The rules for Medicare and employer coverage will vary.  It all depends on your situation which includes the size of your employer.  It is best to check with your employer’s HR department and your Medicare agent to see what your options are.

Click here for more information on working past 65

Medicare and Retirement Plans:

Working after 65 can impact your retirement plans, especially if you have retirement accounts like a 401(k) or an Individual Retirement Account (IRA).  Check with your financial advisor for contribution limits and rules.  You should also consider the following points:

The main rule for contributing to either a traditional or Roth IRA is, you or your spouse need to have earned income during that year.

Please be aware; IRA contribution limits apply based on your adjusted gross income amount.

1. Earned income includes wages, salaries, tips, bonuses, commissions or earnings from self-employment.
2. What is not counted as earned income cannot be deposited into your IRA include; dividends, interest, capital gains or distributions from retirement accounts.

Note;  Social Security does not qualify as earned income, and can’t be contributed to an IRA.

Medicare and HSA Contributions:

If you have a Health Savings Account (HSA), contributing to it can provide significant tax benefits. However, once you enroll in Medicare, you can no longer contribute to an HSA.

RMDs and Retirement Accounts:

Once you reach either  72 or (73 starting in 2023) ,  you must begin taking Required Minimum Distributions (RMDs) from your retirement accounts. Make sure to plan for this additional income in retirement.

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Advanced Diabetes Supply: Agent Support Program

There are multitudinous programs available to agents through agencies and other partners that they work with. Some of these features come in the form of agent support programs. One of the organizations that works with Crowe and Associates is Advanced Diabetes Supply, a trusted supplier of diabetes supply products since 2002. They are a leading national distributor of Durable Medical Equipment (DME) and specialize in supplies for clients handling their diabetes diagnosis. Because of their national presence and range, they are able to provide efficiency, payor coverage, and flexibility.

In addition to this, Advanced Diabetes Supply provides a free agent support program. This is a personalized retention service in which they work with the agent to provide excellent care to their clients with diabetes. Nearly one third of the beneficiaries on Medicare are diabetic, and therefore this agent support program can help ensure retention of up to a third of an agent’s business book. Additionally, 26.4 million people over the age of sixty-five are pre-diabetic, which is a considerable 48.8% of that group. An account executive from ADS (Advanced Diabetes Supply) works with the agent to provide sales and retention support for their clients living with diabetes.

While working with the agent to provide retention, Advanced Diabetes Supply can also provide supplies to their beneficiaries. These supplies include blood glucose meters, test strips, lancets, lancing devices, and control solution. Also available are continuous glucose monitors, insulin pumps and supplies associated with those, including Medtronic and Tandem pumps, infusion sets, reservoirs, and cartridges. ADS is also in a position to supply clients with necessities that fall under Medicare Part D, such as Omnipod dash/5, insulin syringes and pen needles, and alcohol wipes.

Using the Service

It is very simple for an agent to take advantage of this free support service. The first thing to do is check if their client has diabetes. If they do have diabetes, the agent can then forward their client’s contact information to the account executive from ADS at point of sale – there is a secure “refer a client” link for this purpose. The account executive will then call the client and help them set up easy home deliveries for any supplies that they may need with free shipping. This makes the beneficiary’s life easier and helps the agent provide them with excellent service, increasing retention through ADS’ free agent support program.

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Medicare marketing ideas

What is MACRA?

There are many acronyms in the Medicare insurance industry. So much so, that it can be hard to keep them all straight. It is helpful to focus on the vitally important ones. MACRA is one of those acronyms that any informed agent needs to know about in order to best serve their customer base.   What is MACRA stand for?

MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015. This bipartisan piece of legislation was signed into law on April 16, 2015. It created what is known as a Quality Payment Program (QPP). The Quality Payment Program is an incentive program that replaced the Sustainable Growth Rate (SGR) formula that Medicare was using. The Sustainable Growth Rate would have made payment rates for participating Medicare physicians go down significantly, which would have caused problems in the industry. Instead, the Center for Medicare and Medicaid Services (CMS) is now using the Quality Payment Program.

There are two different ways that physicians can choose to participate in the Quality Payment Program.

1. The Merit-Based Incentive Payment System (MIPS). This means that physicians would be reviewed and their payment would be based on how well they perform.

2. Advanced Alternative Payment Models (APMs). For physicians who choose this route, they may earn Medicare Incentive Payments by participating in an innovative payment model rather than have their rate based on their reviewed merit.

Other things that MACRA accomplished, other than implementing the Quality Payment Program and doing away with the Sustainable Growth Rate, are as follows:

• It changed the way that Medicare rewards physicians, which puts the onus on quality of service rather than volume of service.

• Under the Merit-based Incentive Payment System (MIPS), many quality programs are streamlined.

• Rewards physicians for participating in Advanced Alternative Payment Models (APMs).

• MACRA also required CMS to remove social security numbers from Medicare ID cards by 2019, in an effort to prevent identity theft and increase security for their beneficiaries.

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Things to do when you turn 65

If you are turning 65 in the near future, it is probably a good time to find a knowledgeable Medicare agent to provide insight into some of the things to do when you turn 65.

Decide if you want to retire or keep working

In most cases, you have thought about long before you turn 65.  This is a good time to go over your financial health and see if you need to keep working or if you have had enough. You may have quite a bit of savings and are ready to travel the world.  On the other hand, you may truly enjoy your work and couldn’t imagine what you would do without it.  That is entirely up to you.

If you are considering retirement:

Check in with Social Security and see what your benefit amount will be if you retire and look at what it will change to if you wait a year or two.  You should be aware of when you will reach your full retirement age and how much higher your benefit amount will be if you wait until then to claim it.

Take advantage of available catch-up contributions to IRAs & 401ks:

Once you are over 50, you are allowed to contribute an extra $1,000 to your IRA annually.   If you have a 401k, you can contribute an additional $6,000 annually.  If you opted to keep working, this is an opportunity to add to your retirement savings.

Important healthcare coverage decisions:

Before a person turns 65, their IEP (initial Enrollment Period) for Medicare starts.  The IEP is a seven-month window around your birthday that you can use to sign up for Medicare coverage.  It includes the three months before, the month of your birthday, and three months after.

Even if you have health insurance coverage through your employment or a spouse’s, you may want to sign up for Original Medicare during your IEP.  Find out when to enroll in Medicare Part A & Part B.  This is a great time to enlist the advice of a licensed Medicare agent who can explain all your options.

Do you have medical coverage through yours or your spouse’s employment:

If this is the case, you should speak with the employer several months before your 65th birthday to see what their policy for Medicare eligible employees is. Once you have an answer, you should go online or contact a licensed Medicare agent and learn about the Medicare options available to you.

You should contact Social Security and confirm your eligibility for Medicare Parts A & B.  Even if you decide to stay on your employer plan, you may want to at least enroll in Part A.  If you qualify for free Part A coverage.  Because there is a cost to enroll in Part B, You might want to wait to enroll, as long as you have coverage through employment.  Be sure you will not be charged a penalty if you do decide to wait.

If you do not have health coverage through an employer or spouse:

Make sure you enroll in both Medicare Part A & Part B before the month you turn 65.  This will provide enough time have your enrollment processed and get your card to you.  Normally your coverage starts the first day of the month you turn 65.  If your birthday is on the first day of the month, your coverage starts on the first day of the previous month.

You will need to look at all the Medicare coverage options available to you.  Again, this is a great time to get help for a licensed Medicare agent.  The agent should take a list of your current doctors and medications.  That will make it easier for him to find the best coverage for you. There are several choices available including Medicare Advantage plans, Medicare Supplement plans and Medicare Part D( prescription drug plans).  Whatever plan you choose, be sure you have credible prescription drug coverage (Part D).  If you neglect to purchase Part D coverage, you may end up paying a late enrollment penalty once you decide to add this coverage.

Learn about the Medicare Part B premium

If you have an HSA and enroll in Medicare:

Once you enroll in Medicare, you are no longer eligible to contribute to your HSA. However, you can contribute to an HSA after 65 if you chose not to enroll in Medicare Part A or Part B and maintained coverage through a high deductible health plan.

Click here to learn more about HSAs

Have a complete physical exam:

Because we all get busy and tend to put things off,  we can forget to take care of ourselves.  This is a great time to make sure you are in top shape so you can enjoy the years to come and address any concerns with routine exams and screenings.

Make sure your legal documents are in order:

I know this doesn’t sound fun, and in most cases at 65, you are in good health, but this is a good time to get this out of the way.  Once this is taken care of, you can get it off your plate and move on.

Consider making a legal will. Be sure you make any health care choices known to family members. You can also make a living will or advanced medical directive.  This can save family and friends a lot of stress later on if you become ill, they will not be faced with difficult choices. It can also protect any assets you have.  You should also organize your finances and have important papers filed properly so they are easy to locate should the need arise.

Remember to have fun:

Do not forget to enjoy yourself.  Take that trip or go out with friends/family.  You have worked hard your whole life; now it’s time to stop and smell the roses.

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Medicare SEP Rules – Medicare Part B Special Enrollment Period Rules

Every agent knows about the Annual Enrollment Period (AEP). It’s often the busiest time of the year and it is when the majority of prospective clients are enrolled in insurance plans. There are, however, exceptions. Special Enrollment Periods, often known as SEPs, are periods of time outside of the AEP when someone can enroll in health insurance. These SEPs are usually prompted by a specific change in personal circumstances. For Medicare Part B, or medical insurance, SEPs are necessary because Medicare Part B is optional, while Part A (hospital insurance) is not. What are the Medicare SEP rules?

When Does It Start?

The Part B Special Enrollment Period starts when a person has coverage from their employer (called job-based insurance) and is simultaneously in their first month of eligibility for enrollment in Part B. The SEP ends eight months after the person loses coverage from that employer, either by end of coverage or unemployment. If they enroll in Part B coverage during their Special Enrollment Period, then the beneficiary can avoid paying the Late Enrollment Penalty (LEP), as well.

In most cases, it would be recommended to enroll in Medicare before the person loses their job-based coverage in order to avoid gaps in healthcare.  It is important to understand the SEP rules.

How Do I Enroll? – SEP Rules

There are two steps to enrolling in Medicare Part B during the SEP.

1. Contact the Social Security Administration (SSA)

The SSA can be reached at 800-772-1213. The prospective beneficiary can then request forms. The forms they will need to fill out are CMS 40B (application to enroll in Medicare) and CMS L564 (request for employment information). Both of these are needed to complete the process.  However,  the beneficiary should fill out CMS 40B and their employer should fill out CMS L564. If there are multiple employers, each one should receive a copy of the CMS L564 to fill out.

2. Submit all forms to the SSA

Once all the information has been gathered, the forms must be dropped off either at a local SSA office or they can be sent to the mailing address. Locating a local SSA office or their mailing address can be done at their website.

Licensed Agents – Medicare SEP Rules

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