Use of the Medicare Name

This time of year we get a lot of questions regarding advertising and the use of the term “Medicare”. Below are the regulations on its use:

Medicare Marketing Guidelines

30.11 Use of the Medicare Name

Section 1140 of the Social Security Act

CMS reminds all plan sponsors that under section 1140 of the Social Security Act, 42 U.S.C. 1320b–10, it is forbidden for any person to use words or symbols, including “Medicare”, “Centers for Medicare and Medicaid Services”, “Department of Health and Human Services”, “Health and Human Services”, in a manner that would convey the false impression that the business or product is approved, endorsed, or authorized by Medicare or any other government agency. This rule extends to downstream contractors who may be directly or indirectly involved in marketing Medicare plans. Plan sponsors should assure that their subcontractors are not using the Medicare name in a misleading manner.

CMS MARKETING REGS Q&A

CMS released this 2014 Medicare Marketing Guidelines Questions & Responses back in July of 2013, but is a great reference tool for agents.

You can view the report HERE.

Here are some agent highlights:

  

Q: How should a Plan/Part D Sponsor

handle a request to enroll at an

educational event?

R: If a beneficiary requests to enroll at an

educational event, the Plan/Part D Sponsor

representative may provide a business card.

Please refer to MMG section 70.8.

Q: Are seminars for current members to

inform them about their benefits and

plan services considered

educational?

R: Section 70.8 states that educational events

should not discuss plan specific premiums

and/or benefits or distribute plan specific

materials. CMS recognizes the need for

Plans/Part D Sponsors to educate their current

members about their benefits and plan services.

Although these member events discuss plan

specific information, CMS does not consider

them to be true marketing/sales events.

Therefore, these events can be considered

educational. However, it is the responsibility of

the Plan/Part D Sponsor to ensure the event

conforms to all other aspects of 70.8.

Q: Can we attend events (like a Senior

Expo) where there is food available

for the attendees as long as we (the

health plan) are not the ones

providing the food?

R: Yes. As long as Plans/Part D Sponsors are not

the ones providing or subsidizing the meals.

Q: Are non-health care related products

required to be documented on a

scope of appointment?

R: Yes. Non-health care related products must be

documented on a scope of appointment form.

Plans/Part D Sponsors must follow section 160.

Q: Does the scope of appointment have

an expiration date?

R: No. The scope of appointment does not have an

expiration date, but the meeting must remain

specific to the agreed upon scope.

More great information is in the CMS report.

(This article was written by Mike Gattorna of Senior Marketing Specialists.)

Using the Medicare and You 2014 Handbook

NOTE: If you do not have a copy of the 2014 Medicare and You book, CLICK HERE to view how to order and / or download your copy from Medicare.gov.

The Medicare and You publication is a great tool for agents to use in the field.  This is a Medicare approved piece, and many prospects and relate to it since they are used to getting them annually.

We recommend that you not only get a copy, but you also use it to help answer your clients questions.  

Below are some key pages in the 2014 book.  Of course, you may find other pages useful depending your clientele, but these are some great starting points when using the book:

Page 14 - Medicare and the Health Insurance Marketplace

Page 16 – Medicare Choices (Medigap / MA Flowchart)

Page 24 – Other insurance and Medicare

Page 58 – Medicare.gov plan finder

Page 59 – Medicare Choices plan chart

Page 67 – 71 – Medigap plans

Page 73 – MA plan types

Page 78 – How MA plans work

Page 80 – MA enrollment

Page 93 Part D Layout

Page 100 – Other programs and Part D

Page 110 - Medicaid

You cannot mark on CMS approved pieces and leave them behind.  If you have a copy where you take notes (as you should) write OFFICE COPY on the front with black marker so clients do not ask to keep yours.

(This article was written by Mike Gattorna of Senior Marketing Specialists.)

OEP/AEP 2014 - Same Benefits….BUT NEW SERVICES???

As the Medicare Advantage program matures we are experiencing a flattening of the various benefits offered by carriers. Why? A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.* The amount of money paid to the carriers is generally a set amount and the benefits they provide only have so much flexibility based on the carrier’s negotiated payments to the various medical providers.

What we at Senior Marketing Specialists are seeing is a true uptick in the services (not to be confused with Part A and Part B benefits) designed and provided by the carrier to help the Medicare recipient stay healthier and give agents a competitive advantage. This includes items like: Silver Sneakers, 24 Hour Nurse Hotline, Vision and Dental Discounts. The one service that stands out is UnitedHealthCare’s HouseCalls. UnitedHealthCare’s HouseCalls program is allows the carrier and the Medicare recipient to:

• ·      review the member's health conditions
• ·      answers health-related questions,
• ·      identifies potential health issues,
• ·      and suggests specific topics the member may want to discuss with their primary care physician.

Call Senior Marketing Specialists today to find out how UnitedHealthCare’s HouseCalls program can help your clients and increase your sales this 2014 OEP.

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

*http://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/medicare-advantage-plans.html

Important Reminder:

Updated Enrollment Materials
You can continue to use 2013 Enrollment Kits until 2014 enrollment materials become available. Additional information will be provided. 

You should also continue to collect 2013 premium amounts until 2014 rates are finalized and communicated to you. Insured members will be billed or credited for any difference, if applicable.

Remember, it is important to let consumers know that AARP Medicare Supplement Insurance Plans will cover any changes in Medicare copayments and deductibles for 2014.

Source: UHC Focus 09/18/2013

Medicare Advantage & AEP 2013 Facts vs. Rumors

UPDATE: Did you miss the webinar? Good thing we recorded it!

If you have any questions after the webinar give us a call at 1-800-689-2800.

 

 

Having just returned from one of the major companies Medicare Advantage kickoff meetings some things are becoming clear, change is in the wind and we need to be prepared. However rumors, some false, some true, abound. Here’s a taste of what we’re seeing at Senior Marketing Specialists:

Rumor: ObamaCare opponents have been warning for several years now that Medicare Advantage, the private plan option that seniors can pick instead of traditional fee-for-service Medicare, would fail because of the healthcare law's impact on the program.*
Fact: Advantage plans, which combine Part A (hospitalization), Part B (outpatient services) and usually Part D (prescription drugs) are on a big-time roll. Enrollment has jumped an impressive 10 percent in each of the past three years.*
Rumor: Medicare Advantage plans will be cutting benefits and increasing costs.

Fact: In 2013, the outlook for the Medicare Advantage program looks very similar to the marketplace in 2012.  Over the longer term, companies offering Medicare Advantage plans may respond to payment changes in several different ways, depending on the circumstances of the company.**

BUT:

·       Since inception over 14,400,000 Medicare recipients have enrolled in a Medicare Advantage Plan.

·       Medicare Advantage has grown the market share, of companies and their agents that supplement Medicare, exponentially in only SEVEN YEARS!!!

·       Medicare Advantage has allowed more agents to sell more plans and receive more commission dollars than any other change in Medicare since 1965.

·       Companies benefits are all looking the same, BUT….WHAT THEY DO FOR YOUR CLIENT MAY BE THE COMPETITIVE EDGE YOU NEED???

Join us for a very special webinar August 22, 2013 at 10:00 AM CDT as we discuss upcoming issues and solutions for AEP.  

*http://www.reuters.com/article/2013/07/18/column-medicare-advantage-idUSL1N0FO1N620130718

**http://kff.org/medicare/fact-sheet/medicare-advantage-fact-sheet/

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