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Home Posts tagged "Medicare" (Page 14)
UHC Jarvis login

UHC Jarvis login

By Ed Crowe | General Articles | 0 comment | 14 December, 2023 | 0

UHC Jarvis login

Agents who are appointed to offer UHC/AARP Medicare plans can access many helpful tools in the UHC Jarvis portal.  In order to access the Jarvis portal, you must have a writing number and a UHC Jarvis login.

Do you want to add UHC to your appointments, click here to contact online with Crowe

Once you are in the portal, you can either sign in with your One Healthcare ID or register for a One Healthcare ID .  You can also login through the One Healthcare mobile app.

To learn more about the mobile app, click here.

When you get to the Home page, you will see a menu at the top of the page.  If you hover over the items, you will see a drop-down menu with several options for each category.

Sales Tools

In this section you have the following options:

Sales Materials with this tab, you can order or download applications or enrollment guides.

Medicare Medicaid Eligibility lookup.

Plan Search with this tab, you have the ability to look up available plans in an area once you enter a zip code.

LEAN is an online enrollment HUB.  LEAN includes a scope of appointment and voice signature options for applications.  There are also tools to lookup providers and medications.

Marketing Resources includes forms for events including new event request and cancellation forms.  There are also a marketing sales event checklists as well as sample verbiage.

Application Status

This tab is pretty self-explanatory.  Once you are in this screen, you can view a list of clients and see details of their application and enrollment.  This includes their member ID.

Commissions

Commissions Search this tab is useful for both agents and agencies. Run a report by agent and date.

Statements and More use this tab to download statements by date.

Commissions Calendar view the calendar and to see when commissions are set to be paid each month.

Direct Deposit access your direct deposit information and update it when necessary.

Assignment of Commissions this tab allows you to download an assignment of commissions form as well as view a FAQ sheet.

Release view instructions for releases.

1099 instructions to get a copy of your 1099.

Successor Agent this area is used for the transfer of both members and commission payments.

Book of Business

Use this tab to view a complete list of your clients.  Agents can apply filters to narrow down their search by area, status or name.

The final tab is Knowledge Center

Medicare Product Portal view the UHC product portfolio and search for available plans in a specific market area.

Training and Certifications form here you will access the Learning Lab where you can view product training and continuing education resources.

Agent Guide this area provides rules, policies and procedures for marketing UHC products.

Portfolio Overview view all the plan types UHC offers.

Selling Resources from here, you can access resources and product guides to find out what’s new and what benefits members can expect.

Enrollment Resources here you will access LEAN (The Landmark Electronic Application Navigator).  This tool makes enrollments quicker and easier. LEAN supports all Medicare Plans, including Medicare Supplement. Agents can use LEAN as a website on either desktop or laptop as well as mobile app for iOS and Android tablets.

Agent News View special election periods as well as several other announcements.

Member Experience in this tab you can view examples of common communications members receive from the plan based on the plan type.

Compliance Access resources for CMS sales and marketing compliance information.

Forms agents can easily find forms for events, scopes, PTC, commissions or other forms pertaining to specific plan types.

Click here to watch a quick YouTube video on the scope of appointment rules

FAQs learn how to find anything you need in Jarvis.

The top of the Home page shows enrollment statistics

View at a glance, how many applications are pending, how many have been approved in the last 60 days and how many active members you have.  There are links to view clients in each one of the categories.

There is a scrolling news feed with recent information as well as a plan finder and application status tool.  The center of the screen provides quick links to tools such as:

Medicare & Medicaid lookup

LEAN

UHC Agent Toolkit

Book of Business

Prescription Drug Lookup cost estimator

Pharmacy Finder

Dental Provider lookup

Medical Provider lookup (Rally)

Renew Active Fitness locator shows locations of clubs, classes and provides information for members to join a Fitbit community etc.

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Humana Vantage login

Humana Vantage login

By Ed Crowe | General Articles | 0 comment | 11 December, 2023 | 0

Humana Vantage login

Medicare agents who contract to offer Humana Medicare plans should make sure they have a Humana Vantage login. Vantage provides access to several helpful tools that will make it easy to find answers to both agent and client questions.

How to access Vantage

You need to be contracted to sell Humana and have your writing ID before you can access Vantage.  Once you are ready to go, visit the Humana website.  Once you are on the site, click sign in on the top right corner of the screen and enter your username and password.  If you forgot your username or password, click the links below the sign in button and reset either one.

Contract with Crowe to offer Humana Medicare plans, click here

Are you a new to the Humana Vantage site

If this is your first time on the site, just click activate online profile to follow the prompts to get set up.

Vantage home page

Once you are signed into Vantage, you will see the menu on the top left of your screen.  You will also see options for Notifications, Agent Profile and more.

Click the 3 horizontal lines under the word menu to get quick access to the different areas in Vantage such as:

  • Favorites
  • Quote & Enroll
  • Commissions
  • Certifications & Training
  • Agent Portal
  • Connection Hub
  • Delegated User Access

Please Note: The menu appears differently based on the type of agent.

There are several sections on the Vantage home screen.

Notifications

Notifications shows both urgent and general messages for agents.  You can access the same notifications in the link at the top of the page.   You can see prior notifications by clicking on archives.

Urgent notifications will be displayed in a banner across the top of Vantage.

General notifications are found in the notification center.  These may include dates for events like recertifications or other general announcements.

Licensing, Certification and Contracts

Licensing, Certification and Contracts lets agents know what their current status is for all Humana licensing and certifications.

Education

Agents can find a link to the Humana MarketPoint University (aka HMU) in the Education section.  In MarketPoint University, agents can complete certifications and courses as well as find training webinars and job aids.

Sales and Marketing

Sales and Marketing provides agents an easy way to find marketing materials such as, sales presentation videos and more.

Quote and Enroll

Access all Humana’s enrollment tools in this area.  Some things Quote and Enroll includes are as follows:

  1. Enrollment Hub
  2. Fast App
  3. Scope of Appointment
  4. Upload Paper Applications
  5. Eligibility Verification
  6. Health Risk Assessment
  7. Digital Marketing Materials

Click here to watch a quick video on the 48-hour scope of appointment rule

Drug Cost Lookup

This tool allows agents to verify out-of-pocket costs for prescriptions drugs.  Agents can view several plans side-by-side to find out which one would best suit their client’s prescription coverage needs.  Both of the links in the Drug Cost Lookup area have the ability to import client drug lists from the CMS website.

This section of the portal provides the following tools:

Prescription Calculator

Medicare Drug List Search

Doctor & Pharmacy

This is a helpful tool that will help you find doctors, hospitals, vision or dental provider as well as pharmacies.   This helps ensure the client’s doctors are in-network with plan they are considering.

My Humana Business

Agents can use My Humana Business to check application status and submit customer service inquires for clients.  Service Inquiries is the best way to start a customer service request.

Some inquiries may include:

Client address changes

Billing questions

Verification of benefits

PCP changes

Commissions

Commissions is only available to Partner Agents; Humana employees cannot view this area.  Some of the things you can view in this area:

Commission Statement Portal

Create a Pay Audit Request

See Payment Assignments

Set up Direct Deposit

Complete the Delegated Commission Assignment Form

You can also view the Agent of Record Protection Pledge and the Agent of Record Change Policy.

Compliance

Compliance is a quick way to access policy documents as well as agent agreement documents.

As you can see, the Humana broker portal (Humana Vantage) provides all the information agents need to be successful.

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Anthem OTC catalog 2024

Anthem OTC catalog 2024

By Ed Crowe | General Articles | 0 comment | 5 December, 2023 | 0

Anthem OTC catalog 2024

The Anthem OTC catalog 2024 provides members of participating plans access to many useful items at no charge with their prepaid Benefits Mastercard.  Plan members have the choice to pick up items in store or have them delivered to their doorstep.

Download a copy of the 2024 Anthem OTC Catalog

Here’s what you can find in the catalog

  1. OTC benefit details.
  2. Details of all the different ways to shop for OTC items.
  3. Eligible items listed by category.

Members can call the number on the back of their Benefits Prepaid card for any assistance they need.  Members can also get answers to their questions by logging into their secure account in the Benefits Pro Portal at MyBenefits.NationsBenefits.com.

Here’s how to create an online account

Access your benefits when it’s convenient for you 24/7 at MyBenefits.NationsBenefits.com

First time users need to create an account visiting the Benefits Pro Portal or using the Benefits Pro mobile app.  Once you are on the Nations Benefits portal, just click the “register” button and follow the prompts from there.

If you need assistance, just call 866-413-2582 (TTY: 711)
Once your portal is set up you can log in and view your spending allowance.  Find participating stores nearby, view and track recent orders and look for eligible products.

How to shop for OTC products

Because there are many ways to shop for OTC products, you can easily find the one that works best for you.

In a participating store

Members can use their Benefits Prepaid Card to purchase eligible OTC products at one of the many participating stores.  TO find a store near you, visit MyBenefits.NationsBenefits.com and enter the area you want to shop in.  You will quickly find a list of local stores.  The OTC catalog provides an instore shopping guide with information on the available items.  You can also find eligible items in your member portal as well as by scanning the UPC code found on any product by using the Nations Benefits Pro app.

Once you finish shopping, place your benefits card into the card reader and choose “credit” when prompted.  You do not need a PIN to use the card.  You r eligible spending amount will apply to the purchase.  If you’re spending more than your available balance, you can use another form of payment to cover the remaining balance.

Have items delivered to your home

Members can order products for home delivery from the NationsBenefits catalog or by going to MyBenefits.NationsBenefits.com search by product type or UPC code.
Selected items are shipped to your home at no cost.

Download a copy of the 2024 Anthem OTC Catalog

Order through the Benefits Pro App

You can download the app either by scanning the QR code you find in the OTC catalog or by going to the App Store or Google Play
Once you have the app downloaded, you can choose the items you want to purchase and follow the instructions to pay and checkout.

Place an order by Phone

Find the items and the items number of the OTC products you want to purchase and call the number on the back of your NationsBenefits card.  Member Experience Advisors will assist you Monday through Friday from 8:00AM until 8PM local time.

To order by Mail

Find the items you wish to purchase and fill out the order form at the back of the OTC catalog.
Send your completed order form to:
NationsBenefits
1700 N. University Drive
Plantation, FL 33322
Mail your completed form no later than 12/20/24 to use your available spending allowance before it expires.

More information

The products in the OTC catalog are subject to change.  In some cases, an item, quantity or size may change depending on availability.  Some items may be added or removed without notice.

Visit our homepage for OTC catalogs from other Medicare carriers

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Medicare scope of appointment rules

Medicare scope of appointment rules

By Ed Crowe | General Articles | 0 comment | 3 December, 2023 | 0

Medicare scope of appointment rules

The Medicare scope of appointment rules are put in place by CMS.  The SOA (scope of appointment) is a form that clients or potential clients as well as their agent must complete before meeting to discuss Medicare plan options. The scope is mandatory if you are discussing either a Medicare Advantage or Part D prescription drug plan. Although, it is a good idea to collect a SOA before any client meeting to protect both the agent and the client.  The SOA form should be kept no less than 10 years and may be collected either physically, verbally or electronically.

Watch a quick video on the scope of appointment rules for 2024

Verbal scope of appointment

When the pandemic began, it was not advisable to host in-person meetings to discuss coverage options.  Because of this, many appointments took place over the phone.  That lead to the use of verbal scope of appointments which are recorded and saved.  Many carriers offer this option as well as quoting/enrollment tools such as Sunfire and Connecture.

Click here to watch a Sunfire enrollment demonstration on YouTube 

General information about a verbal SOA

  • If the client calls the agent (inbound call), the 48-hour rule does not apply.
  • The scope is good for 12 months from the date it is signed.  You must complete the appointment within that time or obtain a new scope. The scope is still good if the call drops and the same agent calls the client back.
  • If additional benefits are added to the discussion, a new scope is necessary.

How long is a SOA good for

As we mentioned above, a scope of appointment is good for 12 months from the date it is signed. It is important that you discuss only products that were agreed to and included in the scope.  If additional products are added, the beneficiary needs to sign a new scope.

If the client asks about Medicare Advantage plans during the 48-hour waiting period and they had not included them on the original scope, you will need to have them sign a new scope before your discussion.  This will restart the 48-hour waiting period and may move your meeting date out further.  This rule applies to any product regulated by CMS.

Need a SOA – Click here

CMS guidelines

In order to be complaint with CMS, agents need to have their clients complete a Medicare Scope of Appointment form. The 2024 CMS final rule went into effect September 30. 2023 and has added some changes to how agents obtain the SOA.

The SOA rules apply to agents and brokers who discuss Medicare coverage options and plans.  The 48-hour rule was put in place so beneficiaries could avoid the high-pressure sales tactics some agents use.  The 48-hour period provides beneficiaries time to consult friends, relatives or anyone they like to research their options. This time also provides agents time to prepare for the discussion.

Agents are able to contact the beneficiary once the SOA is completed for up to 12 months. It is essentially permission to contact until the meeting takes place.  The beneficiary has the option to opt out annually.

Please note, if the beneficiary does not select a coverage option on the SOA, Medicare requires the agent to avoid discussing that option without a new SOA where the option is clearly selected.

Find out about the proposed CMS rule 4205-P, see how it could affect agents!

Exceptions to the 48-hour rule

If the beneficiary is in the last four days of a valid election period, agents may collect a same-day SOA.

When the beneficiary walks into your office and initiates a conversation about coverage options, agents can take a same-day SOA.  This same rule applies to inbound call initiated by the beneficiary to the agent requesting advice.

How long do you need to keep a SOA

Agents must be able to access the SOA form for ten years. Clients have the right to request a copy anytime within that time frame without any issues.  The SOA can provide help in the event that an issue or dispute occurs.  The Scope is in place to protect the consumer, but it can also protect the agent.

 

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Aetna Medicare OTC catalog 2024

Aetna Medicare OTC catalog 2024

By Ed Crowe | General Articles | 0 comment | 3 December, 2023 | 0

Aetna Medicare OTC catalog 2024

Both current members and anyone considering enrollment in an Aetna MAPD plan should take a look at the benefits in the Aetna Medicare OTC catalog 2024.

Aetna has two separate catalogs for 2024.  The first one is for members of their participating MAPD plans, this catalog is called Over-the-Counter Health Solutions (OTCHS).  There are three ways to order products from the OTCHS.

Download the MAPD OTC catalog 2024

Order in a participating CVS pharmacy

Use the following link to find a participating store:  CVS.com/storelocator.

Please note:  CVS pharmacies inside either Target or Schnucks stores do not participate in the OTCHS program.

  1. Look in your OTC catalog to find items you would like to purchase.  It is important to know; only items in the catalog are available to purchase with this plan.
  2. Locate products marked with the blue shelf tag in the store.  Prices of in store items may not be the same as the catalog price.
  3. Use your benefit at any register.  Tell the cashier you have the OTC benefit and show them your member Id card to verify your eligibility.

Use the OTC Health Solutions app to access OTCHS benefits

Download the app from either the App Store (for apple devices) or from Google Play (for Android devices). Look below for three easy steps to use the app in stores.

  1.  Scan the item’s barcode to make sure it is an approved item (eligible items should have a blue tag).
  2. When you are ready to check out, show the cashier the digital barcode from your phone.
  3. Use the app to check on your remaining benefit balance or get answers to some FAQs.

Order items online

Create an account by visiting CVS.com/otchs/myorder.

  1. Click on the create account button and follow the prompts.  Please note:  you will need your member ID, birthdate, zip code and a valid email address.
  2. Sign into your account and view your available benefit amount as well as products.
  3. Add products to your cart and then click checkout.  Confirm your shipping address, review your items and place your order.
  4. You will receive an email with tracking information.  Items will arrive in about 14 days.

Order items over the phone

  1. To place an order, call 1-833-331-1573 (TTY:711).
  2.   You must enter your birthdate to verify your account.  You will also need to verify your name and address.
  3. Please have the code for the items you wish to order.  If the code is A10, just enter the numerical code 10.  After your items is located in the system, you verify it is correct.
  4. Once you finish your order, you can review items and submit the order.

The second catalog is for Aetna DSNP plan members:

Download the Aetna DSNP OTC catalog 2024 Nations benefits

The catalog for DSNP members is referred to as Nations Benefits.  There are 3 ways to order items from the Nations Benefits catalog,

order by mail

Members receive an order form in their Nations Benefits catalog.   Fill out the form provided and mail it to: NationsBenefits, 100 N. University Drive, Plantation, FL 33322.

Order online

Go to Aetna.NationsBenefits.com

  1. create an account by following the instructions on the page.
  2. Once you are logged in, you can search for items, read product descriptions and check your benefit balance.
  3. Place items in your cart.
  4. You will receive an email so you can track your items.  You should receive your order in about 14 days.

Order by phone

Call 1-877-204-1817 (TTY: 711).   Speak with a member experience advisor from 8AM – 8PM, local time 7 days a week, except for holidays.

Please note: Language support is available if needed.

All beneficiaries should be aware:

Because of the personal nature of the items, there are no returns or exchanges.  Please call OTC health solutions within 30 days of receipt if you receive a damaged item.

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Social Security retirement age

Social Security retirement age

By Ed Crowe | General Articles | 0 comment | 27 November, 2023 | 0

Social Security retirement age

The age that an individual can receive their full retirement benefits from Social Security is the Social Security retirement age. In the past, the full retirement age was set at 65.  Changes to the law have gradually increased the full retirement age.

The full retirement age is not the same for everyone.  It is based on the year the beneficiary was born.  For anyone born before 1938, the full retirement age is still 65. Although, anyone who was born after that, has to wait longer to reach their full retirement age due to the gradual increase of a few months for each birth year after that.  In other words, people born in 1960 or after will not reach full retirement age until they are 67.

What is the early retirement age

Although the full retirement age is 65 or older depending on what year you were born, individuals can decide to receive their benefits early.  Individuals can receive benefits as early as age 62. However, if they decide to do this, they will receive a reduced benefit amount which will be permanent and can be substantially less than the full benefit amount.

If you want to see an estimate of your Social Security benefits at different retirement ages. go to ssa.gov and create an online account to see what your monthly payment will be.

Click here for a few ideas on what to do when you turn 65

Taking Social Security benefits after full retirement age

Some individuals choose to wait to take their Social Security benefit for years after they reach the full retirement age.  This decision can lead to an increase in the monthly benefit amount they receive.  For every year delayed past the full retirement age, delayed retirement credits are earned. This results in a higher monthly benefit amount.

Learn about Medicare enrollment periods

Factors to consider

Financial factors

When a beneficiary claims their Social Security benefits can significantly impact their overall retirement income for the rest of their life.  Each person has to consider their entire financial situation including, savings, IRAs, 401k accounts and other investments. This will help determine if they take early retirement, full retirement or go past it to receive an increased benefit amount.

Personal health

Individuals need to consider their health and how long they expect to live.  Although this may be impossible to know, there are some factors that could help them decide especially if they are in poor health.  when that is the case, early retirement may be a good idea. On the other hand, people in good health with a family history of longevity may want to delay retirement benefits.

Employment Status

Individuals who want to work past their full retirement age need to know what that means if they decide to receive Social Security benefits as well as income form employment.  Any earned income received while claiming early Social Security benefits can have an impact on the amount of the benefits they receive.

Planning ahead

Evaluate Retirement Goals

Understanding personal retirement goals and financial needs is crucial. Individuals need to be clear about how they expect to live once they retire.  Do they plan to travel or downsize their home.  What sources of income can they count on?  There are many questions that must be considered.

Hire a professional

Meeting with a financial advisor, retirement planners, or Social Security expert may offer unbiased advice and may provide you with insights you may otherwise have not considered.

A few more thoughts

The age you decide to receive Social Security retirement benefits can make a huge difference in the financial well-being of retirees.  This decision should not be made without ample consideration.

If you are retiring from your job and taking Social Security benefits, you may need to sign up for Medicare coverage at that time.

Click here to learn about Medicare enrollment SEP rules

Although the age a beneficiary chooses to take Social Security benefits is an important aspect of retirement, there are many other things that come into play for a successful and happy retirement.

Medicare agents, subscribe to our YouTube channel to watch free training and informational videos.

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Medicare enrollment periods

Medicare enrollment periods

By Ed Crowe | General Articles | 0 comment | 26 November, 2023 | 0

Medicare enrollment periods

In order for agents to sell Medicare plans, one of the first things they need to understand are the Medicare enrollment periods.  There are many different enrollment periods available to beneficiaries. Each one depends on their personal circumstances.

If a beneficiary already receives Social Security benefits, they will automatically be enrolled in Original Medicare.  In other words, they do not need to sing themselves up for Medicare Part A or Part B.  Beneficiaries who do not qualify for automatic enrollment should enroll during the Initial enrollment period.

There are three enrollment periods available for Original Medicare

  1. The first and most commonly used is the IEP or initial enrollment period.
  2. Second is the AEP or annual enrollment period which can be used for a number of different reasons.
  3. Third is the GEP or general election period that beneficiaries use to enroll in Original Medicare if they missed their IEP for some reason.

Medicare IEP (Initial Enrollment Period)

The Medicare IEP (Initial Enrollment Period) is a seven-month window available to beneficiaries to enroll in Medicare Part A & Part B.  The IEP is based on either your 65th birthday or once a qualified beneficiary receives their 24th Social Security disability payment. This enrollment period starts 3 months before the qualifying event and continues through the month of the event.  The IEP ends 3 months after the month of the qualifying event.  If the beneficiary’s birthday falls on the first of the month, The IEP begins 4 months before the 65th birthday of the beneficiary and ends 2 months after the beneficiary’s birth month.

Coverage for beneficiaries who enroll in the months before their birthday begins the first day of their birth month.  If they enroll either during or after their birth month, coverage begins the first day of the month after they enroll.

During the IEP, beneficiaries can choose to either enroll in both parts of Original Medicare or they may choose to delay enrollment in Part B if they have other credible coverage such as from their own or a spouse’s employment.

Medicare AEP (Annual Enrollment Period)

The AEP starts each year on October 15 and runs until December 7.  AEP is an opportunity for anyone on Medicare to make changes to their Part C or Part D coverage.  Please note: changes made during this enrollment period will go into effect January 1 of the following year.

Click here to learn more about the AEP

Medicare GEP (General Enrollment Period)

If a beneficiary neglects to enroll during their IEP and does not have other credible coverage, they may need to use the GEP to enroll in Medicare.  The GEP starts January 1 and runs through March 31 each year. During the GEP, coverage begins the first day of the month after you enroll.  Beneficiaries who enroll during the GEP may have to pay a late enrollment penalty depending how long they have gone without credible coverage.

Other Enrollment Periods

There are still more enrollment periods available.  There are the Medicare Advantage Open Enrollment Period as well as the Medicare Supplement Open Enrollment Period. Each if these enrollment periods apply to the specified type of coverage.  Although some individuals qualify for one of the many SEPs (Special Enrollment Periods).

Medicare Supplement Open Enrollment Period

The Medicare Supplement Open Enrollment Period starts the day their Medicare Part B is effective and runs for 6 months. This enrollment period gives beneficiaries guaranteed issue right to enroll in any Medigap plan available to them. Several supplement carriers let beneficiaries apply for a plan up to 6 months before their Part B start date.  The supplement will not start until the day Part B benefits are in place.  If the beneficiary misses their Medicare supplement open enrollment period, they can apply for a Medicare supplement plan any time of year.  Keep in mind, they may have to go through underwriting and can be denied coverage.

Medicare Advantage Open Enrollment Period

When a beneficiary first enrolls in Medicare Part A and Part B during their IEP, they are eligible to enroll in a Medicare Advantage plan.  If they do not choose to enroll at that time, they have to wait until the AEP (Annual Enrollment Period) unless they have an SEP available to them.

There is a specific Medicare Advantage Open Enrollment Period available to those who are already enrolled in a Medicare Advantage change their coverage.  This enrollment period runs from January 1 through March 31 each year.

To learn more about the Medicare Advantage OEP, click here

Special Enrollment Periods for Medicare

The most difficult to understand enrollment period may be the Special Enrollment Period. This enrollment period can apply to several different circumstances and does not apply to all Medicare beneficiaries. SEPs may require the beneficiary to provide proof of eligibility.

The most common reason for enrolling during an SEP is loss of employer coverage due to the fact that many benficiares choose not to enroll in Medicare PArt B because they have employer coverage.

Find out the rules for SEPs

Ready to contract with Crowe – click here

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What's the Medicare GEP

What’s the Medicare GEP

By Ed Crowe | General Articles | 0 comment | 25 November, 2023 | 0

What’s the Medicare GEP

The Medicare GEP (general enrollment period) is a chance for eligible individuals to enroll in Medicare Part A and Medicare Part B.  The GEP runs each year starting January 1st and ending March 31st.  In years when the GEP ends on Saturday or Sunday, Social Security allows individuals to enroll the following Monday in one of their local offices.  If they receive a written request for enrollment with a stamp dated by the last day of the GEP, Social Security will honor it.

Who can enroll during the GEP

If individual is eligible for Medicare benefits and has to pay a Medicare Part A premium, they can use the GEP to enroll in Medicare.  If they are like most people and do not have to pay a Part A premium, they can enroll in Medicare Part A anytime.  Eligible individuals who did not enroll in Part B during either their IEP or an SEP can use the GEP to enroll in Medicare Part B.

Is there a penalty for enrolling during the Medicare GEP

Eligible beneficiaries who went a year or more without Part B or Part A, if they have to pay a premium for it, may pay a late enrollment penalty when they use the Medicare GEP to enroll. Penalties for Part A and Part B differ.  See below for details:

The penalty for Part A only applies to individuals who are not eligible for premium free Part A benefits.  If a penalty applies, 10% is added to the premium cost. The penalty lasts for twice the number of years the enrollee delays Part A enrollment.  For example, (If enrollment was delayed for 2 years, a penalty applies for 4 years).

Part B penalties add an additional 10% to the Part B premium each year the beneficiary delays Part B enrollment.  An example is (a delay of 2 years will equal a 20% penalty).  The Part B penalty lasts for as long as they have part B coverage.

Please note:

Those who did not enroll in Medicare Part B because they had insurance coverage through theirs or a spouse’s employment, do not pay an LEP.  There is also no penalty for beneficiaries who qualify for an MSP (Medicare Savings Program).

Before 2023, no matter what date beneficiaries enrolled in Medicare during the GEP, their coverage would start July 1.  Since the CMS rule change that began is 2023, there are no longer delays in Medicare effective dates for beneficiaries who enroll during the GEP.  In other words, coverage begins the first day of the month following the enrollment.

Our YouTube channel has many important guidelines and updated rules for Medicare sales – subscribe to our channel and take a look.

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Medicare sales cross selling

Medicare sales and cross selling

By Ed Crowe | General Articles | 0 comment | 24 November, 2023 | 0

Medicare sales and cross selling

If you are selling Medicare, you should think about how to meet all the coverage needs of your clients. That is why Medicare sales and cross selling go hand in hand.  Before you try and do this, be sure you have the necessary product knowledge on anything you intend to offer.

A great way to get insight into your client’s potential needs is with a client needs assessment.  Each agent should tailor the assessment to include the applicable product lines they are licensed to sell and have a good knowledge of.

If your client understands that you are able to offer them coverage for all their personal insurance needs, they will be inclined to call you when they decide to add to their current coverage.  It is best to take care of their most urgent concerns before talking about additional items.

Watch our quick YouTube video on cross selling during AEP

Medicare sales cross selling – be aware of underlying health issues

If you conduct a needs assessment or spend enough time speaking with your client, you will probably find out if your client has any illnesses that will prevent them for obtaining some types of coverage that they will not qualify for.  If you ask about any recent claims they have had, this may be an indicator if they are a good candidate for some types of coverage.

Some other things to find out from your client

Is the client or their spouse presently working?  If the answer is yes, do they have any employer benefits and if so, what are they?

Have they ever served in the military (are they a veteran)?  Sometimes veterans receive benefits.  You need to find out if they do and what those are.

Medicare sales cross selling – Cancer, Heart attack and Stroke coverage

Because many people have a family history of either cancer, heart attack or stroke, this product is not difficult to sell. This product is sometimes called critical illness insurance.  Be sure you understand the client’s budget before you show them quotes from companies that will fill their coverage need.

Cross selling – Long Term Care Insurance

Most people do not have long term care coverage. Although LTC has changed over the years, there are still some good coverage options available.  There are some short-term care policy options that include home health coverage.  There are also some life policies that include an optional LTC rider.  You can ask your client if anyone in the family has needed home health or nursing home care. If they have, ask them if they know how it was paid for. Do they have a way to pay for it if they need it?

Cross selling – Life Insurance

Life insurance is not like LTC coverage because many clients have at least some life insurance coverage.  If you want to start a discussion about life insurance, you need to find out if the client already has coverage and if so, how much.  Once you get the answer, you can ask questions to determine if they have enough to cover what they need it for.

Here are some reasons people purchase life insurance:

To replace income lost due to the death of a family’s financial provider.

If they want to cover their final expenses.  If they have a policy in place, it may not be enough to cover their final expenses.  This means they may want to consider purchasing a policy that provides a bigger benefit amount.

Policies can help pay any outstanding debts owed by the policy holder.

In some cases, the policy holder wants to leave a financial gift to their chosen beneficiary.

If they do not have a policy, you may be able to help them decide if a policy could benefit their loved ones.

Cross selling – Final Expense

Final expense insurance is a kind of life insurance.  If the client does not have life insurance in place, this type of policy can help family members pay for their final expenses and avoid leaving them with a large bill after you are gone.

Cross selling – Annuities

These days many people want a safe place to invest their savings due to low interest rates at banks and stock market volatility. Simply ask your client if they are happy with their current rate of return on investments. Let them know a fixed indexed annuity can provide a dependable place to invest savings and a better return rate than many CDs.  In many cases, you can offer them an annuity product that will provide a better return that what they currently have.

Now that we have given you a few products to consider adding to your portfolio, it is up to you to decide what will be the best value add.

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Medicare fact finder

Medicare fact finder

By Ed Crowe | General Articles | 0 comment | 24 November, 2023 | 0

Medicare fact finder

Each time a Medicare agent meets a new client a Medicare fact finder is a great way to address what they want and what they need.  This is a great tool to help you make personalized suggestions for coverage.

If you are in the senior market, your fact finder should focus on Medicare coverage.  It may also include additional options like hospital indemnity, life products or other relevant products you offer. You should design your fact finder to fit your client’s needs and the services that you have to offer.  The only way to know what the client is looking for is to ask questions.

We have a few examples of Medicare fact finder questions below:

1. Do you understand the different parts of Medicare

This question is very important to ask.  Clients need to understand the parts of Medicare and how they work to know what type of coverage they want and need.  Your job is to make sure they know about all the coverage options available and make an informed decision.  This includes what is covered by Part A, Part B, Part C and Part D.

2. Can you tell me what you like and don’t like about your current Medicare coverage

When you ask this question as part of your fact finder, you gain valuable insight into what type of coverage the client is looking for.  This will help sort out which benefits are important to them, and which are not. This can be very useful in sorting out MA/MAPD plan benefits as there are so many to choose from and they offer different benefit packages.

3. How often do you see a doctor or specialist

The answer to this question can help decide if a Medicare Supplement or a Medicare Advantage plan is a better option for your client. That is a reason to include it in your Medicare fact finder.  Many of your clients’ plan choices will come down to simple mathematics.  Medicare Advantage plans require a copayment for visits to either PCPs or specialists.  The amount of each copay can make a difference in your client’s budget.

4. Are there doctors and medical facilities that you like to use for your health care needs

If a client uses medical care from several providers on a regular basis, they may have a difficult time finding a Medicare Advantage Plan that all their chosen providers participate with.  It is your job to be sure they can continue to use the providers they want and are aware of the cost for each visit.  In some cases, an MAPD plan may not be the best option for the client.

5.  Find out if the client is currently taking any prescription medications and which pharmacy they like to use

Please be aware, it is up to the client if they want to disclose this information.  However, it is important to help them find the best coverage options for their needs and can be very costly if they make an ill-informed decision.   Each MAPD and PDP plan has a specific formulary.  This means they cover each medication differently. There can be very large differences in the cost for prescriptions that may place a burden on your clients when they are trying to maintain their health.

The cost of each prescription also depends on the pharmacy your client chooses to use.  This must be explained to them as well.  Carriers for Part D coverage often have preferred network pharmacies that can save the client money when they fill prescriptions there.

6. Does your client have any chronic health conditions

There are specific Medicare Advantage plans that provide coverage of certain chronic health conditions, such as ESRD.  Although they cannot enroll in most Medicare Advantage plans, these SNP plans cover their specific needs, and they cannot be denied coverage for pre-existing conditions.

7. Do they travel often or have a home in another state

This may be an important question to include in you Medicare fact finder.  Medicare supplement plans are good in any doctor’s office or facility that accepts Medicare assignment. On the other hand, Medicare Advantage plans have a local provider network and clients may not find an in-network provider when they spend months living out of their home state.  This can end up costing quite a bit out of pocket for care. It is important to check the benefits of each plan for travel and residency coverage.

8. Are they covered through a former employer or other organization

In some cases, client have retiree plans that work with Medicare to provide coverage for health care needs.  If this is the case, the client should check with their company’s benefits coordinator to see how a Medicare plan affects their retiree coverage and how they work together.

These are just a few possible questions to use.  It is important to decide which questions to add or subtract based on your personal preferences.

A few more thoughts

Let your client know what you are doing and why.  This will help them understand that you see each client as an individual and will do your best to fill their personal health coverage needs. It is best to finish the questions and go over the answers before you try and make any sales presentation to the client.  Making the suggestions at the end will let the client know you are listening to every answer and using all the information to make the most informed suggestions.

Click here for a SSA Medicare fact sheet

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