Medicare Advantage | Changing the Way Health Care is Provided to, and Paid for by Seniors

Last week I had the privilege of attending the United Health Care kickoff meeting for Annual Enrollment Period for Medicare Advantage and Part D Prescription Drug Programs. This was a high level meeting held for the National Marketing Alliance’s,  and I felt fortunate to be able to attend. Much of the information looked like the following press release:

UHC Maintains Lead in Medicare MarketsMedicare Supplement market leader UnitedHealthcare (UHC) reported today it added 35,000 more lives in the 2nd quarter.

The UHC financial report features Standardized and Modernized policy in-force counts of 3,075,000 as of 2nd quarter 2012, a 35,000 increase over 1st quarter 2012 and a 215,000 increase over 2nd quarter 2011. The 215,000 policy count growth over the last 12 months is a 7.5% increase over the policy counts at 2nd quarter 2011.

As indicated in the following Exhibits–compiled by CSG Actuarial analysis using historical UnitedHealthcare financial reports–UnitedHealthcare’s Medicare Supplement policy in-force counts continue to grow at a faster rate than previous years.

UnitedHealthcare also remained in 1st place in the Medicare Advantage and Medicare PDP markets, reporting 2.6 million and 4.2 million lives respectively.

But with the acquisition of Care Improvement Plus and XL Health by UHC some things are starting to change. We’re all used to our companies providing the services and support that insurance has promised both us, the producers, and our clients. BUT WHAT IF THE COMPANY PROVIDED THIS TO ALL NEW MEMBERS???

• House Calls- In home visit with physician or nurse practitioner
• PharmAssit- Specialist Pharmacist provide personalized private counseling, Reviews medications, communicates with the members  provider where appropriate, and provides member follow up.
• Social Service Coordinators—Helps determine if member may be eligible for community programs that can assist with medical cost, prescription drugs, energy bills, heating cost, meals and more…
• Nurse Care Management-  24/7 Hot line, patient advocacy, Health care related coaching calls, and care coordination.

Would our clients receive better care? YES

Would our clients take more responsibility in managing their health and chronic conditions? YES

Would we and our clients feel better about the future of health care knowing that FINALLY the health care providers and the insurance companies paying the claims were all working together for a common goal, helping people live better, fuller, healthier lives? YES

Well, that is exactly what is happening as I write this. United Health Care, with the acquisition of care Improvement Plus,  is integrating this system and taking the leading role in; “Changing the Way Health Care is Provided to, and Paid for by Seniors”.

U.S. Medicare Chief Donald Berwick said in 2010;

“Those who wish to preserve status quo are not going to be contributors to our nation’s future. They can’t be effective partners. All of us will have to change the way we do business.”

I wonder… what should we do next???

(This article was written by Philip Warren of Senior Marketing Specialists.)

Medicare Advantage Certification | Challenge or Opportunity?

This time every year thousands of insurance agents across the country join their brethren in a common task; procrastinating on getting their MA certification done. Here’s what CMS says:

The Centers for Medicare & Medicaid Services (CMS) require that all sales representatives, agents, and brokers who are licensed and appointed to sell Medicare Advantage or Medicare Prescription Drug Products complete an annual certification program. You must be properly certified to receive commission for group Medicare Advantage and Medicare Prescription Drug Plan sales.

I know but it’s one more thing I have to do in a business that already has too much regulation. The companies keep pressuring me with new rules, advertising guidelines and changing things without notification. Sometimes I wish I’d listened to my grandfather and gotten a real job (that’s what my grandfather told my brothers when they entered the business in 1960. They became wealthy!).

Well everyone agrees it’s a hassle! But let’s look at what might motivate us this year so we can get the job at hand done. Here’s five good reasons:

1. We have to get certified in order to represent the plan provider for MA and PDP and get paid commissions. Okay, fair enough. Now that I think about it, my MA commissions last year during AEP were as much as my Medicare Supplement commissions during the previous quarter of the year.
2. Sixty percent of Medicare Supplement throughout the year is sold in the last quarter. Wow, my earnings so far this year are down over the same period from last year. That gives me an opportunity to bring those earnings up.
3. The companies participating in MA have shrunk in numbers and the plans are some of the best being offered with better networks, some on a regional basis. Really, now that you mention it that would make it easier to decide who I want to represent.
4. 14 million Medicare recipients have chosen Medicare Advantage in only seven years (that’s compared with 10 million Medicare Supplement policyholders). I guess that means we can actually increase the demographic base of people for prospecting who need help  supplementing their Medicare by as much as 30+% in some cases.
5. To truly be in the Medicare market you need to represent both Medicare Supplement and Medicare Advantage. You’re right, with everything that’s transpiring in our business and world, I should be able to give my clients what they need and deserve, respect and choices. It’s hard enough out here today, people are nervous and scared. Maybe I can help some of them!

Okay. I’m going to do it tonight!!!

This article was written by Philip Warren of Senior Marketing Specialists.

Pay No Attention to the Man Behind the Curtain | What This Means to Insurance Agents

From the book by L. Frank Baum, The Wonderful Wizard of Oz, comes one of my favorite quotes “Pay no attention to the man behind the curtain!”

In our age of sound bites, self-appointed pundits and mega-hype, we need to take heed to this sage advice. Let’s take the future of Medicare for example:

Medicare will go bankrupt in seven years unless drastic changes are made. So we were warned – in 1969.

Experts pegged the countdown to disaster at eight years in 1981 and four years in 1997. In fact, every report by the program’s Trustees, since the first one was issued in 1970, has projected pending bankruptcy. Some of those reports saw it coming in as little as two years.

Last week, the Trustees reported that insolvency is now due in 2024, five years earlier than they predicted a year ago.*

So, with every warning in the last 43 years the government has adjusted and maintained the solvency of the program, because to not do so would create havoc in the electoral body of representatives and cost them their jobs.

What does that mean to us in the insurance industry today? Well:

• Original Medicare Part A and Part B has remained fundamentally the same since 1965 with an actual increase in benefits due to medical technology while adjusting the program costs to keep up with medical costs and inflation.
• One change is that we have more creative ways to help more people supplement Medicare today than any time since 1965.
• The increasing number of Medicare enrollees will drive more than $3,000,000,000 of annualized new business premium in the Medicare Supplement market in 2012, and that number is projected to increase 50% in the next 3 years.
• Nine out of ten Medigap policyholders are satisfied with their coverage. **
• More than nine out of ten (91 percent) would recommend Medigap coverage to a friend or relative when they turn 65 and enroll in Medicare. **

Our opportunity in the Senior Market is unprecedented!!! Our next few posts will be highlighting this opportunity and how we at Senior Market Specialists, and you, can capitalize on this. Until then; “Pay no attention to the man behind the curtain!”

**http://www.philly.com/philly/blogs/healthcare/Is-Medicare-Going-Bankrupt-Not-Really.html#ixzz1yXgszBER

**AMERICANVIEWPOINT AHIP National Medigap Satisfaction Survey