Helping your clients with Medicare Part D coverage understand the mechanics of the Medicare Part D coverage gap can be a daunting task. We are going to cover a couple of the more difficult questions raised regarding the coverage gap in this segment.
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One of the more common questions agents get asked from their Medicare clients is "what is the Medicare Part D late enrollment penalty?" It is fairly easy to explain that if a Medicare member spends more than 63 consecutive days without having Part D or creditable drug coverage, they will be required to pay a late enrollment penalty should they choose to enroll in a Part D plan in the future. The typical follow-up question is "will I have a late enrollment penalty?" This is also usually pretty easy to answer, assuming the agent asks the proper questions of the client and the client responds with accurate answers about prior coverage.
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Earlier this week I read that our country’s spending on health care has been at historic lows for a third straight year. The conclusion was formed by comparing health spending growth rates to the overall growth of the economy, reasoning that it’s easier to keep up with the costs if the two are aligned, than if health spending surges ahead.
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You have been kind enough to receive emails from me for the last seven years about Humana's Medicare Advantage plans. Today I would like to share my personal experience from yesterday with enrolling into a Humana plan.
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Tags: Medicare choices, MAPD enrollment, MAPD and PDP membership, Health Reform Bill, MAPD, Medicare Health Plans, Medicare Advantage, Medicare Annual Enrollment Period, Medicare options, seniors choose Medicare Advantage, Medicare Advantage growth, marketing Medicare Advantage, Medicare Beneficiaries, AEP, Medicare AEP
As you know, selecting the correct election period for your client when facilitating an MAPD enrollment is an important step toward ensuring the beneficiary's enrollment form is processed for their proposed effective date. For 2013, there is a change in guidance of when to use IEP vs. ICEP. Let's take a closer look...
If you work in the Medicare Advantage business, some things are commonplace. If you facilitate MAPD and PDP enrollments, or support someone who does, it is almost certain you’ll have to deal with a commission audit at some point or another. Maybe you’ve recently joined a new agency and want to direct funds from the carrier to the agency in exchange for certain resources you gain. Perhaps you just set up an LLC and want your commissions paid to your new business, or have associates who will now be facilitating enrollments as an extension of your business. And of course, there will always be opportunities to assist your membership with an enrollment or billing issue they may encounter.
The concept of Humana's Guidance Centers has actually been around for nearly 20 years. In some circles it is known as the "Zephyrhills" or "Gulf Shore Mall” model. These were modest little retail storefronts where agents could get work done between appointments, new members could come for orientations on their plan, and existing members could stop by to address a customer service issue or ask a question.
In a recent conversation I had with Larry Bishop, the topic of getting value from Medicare entitlement came up. After 25 years of distributing Medicare Supplements as both an agent and MGA, Larry’s philosophy of health coverage shifted, from one of prepayment, to that of a “pay as you go” approach.
A LIS qualification also triggers a SEP, and can be validated by member attestation, redetermination letter, or SSA award letter. The SEP is continuous, as long as the beneficiary is eligible for the Part D subsidy.
For those recently losing their status, the SEPs are as follows:
- Loss of subsidy at the end of a calendar year yields an election period of January 1 through March 31.
- January 1 may be used as a proposed effective date in this case if the enrollment is done prior to the end of the year.
- Loss of subsidy occurring at any other time runs similarly to the loss of dual status, beginning in the month in which the beneficiary is notified of the loss, and ending two months following the month of notification.