Protecting Your Clients from Medicare Flex Card Scams: A Guide for Health Insurance Agents

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As a health insurance agent, it’s important to be informed about potential scams and fraudulent activity that may affect your clients. One such scam that has been making its way around is the Medicare Flex Card scam. Understanding what the Medicare Flex Card is and how it can be used is crucial in helping your clients avoid potential scams.

Firstly, let’s define what Medicare Advantage plans are. Medicare Advantage plans are an alternative to traditional Medicare, where private insurance companies provide coverage instead of the government. These plans often offer additional benefits beyond what is covered under traditional Medicare, such as dental, vision, and prescription drug coverage.

Some Medicare Advantage plans also offer a “flex card,” which is a prepaid debit card that can be used to pay for certain health-related expenses not covered by Medicare. These expenses can include copays, deductibles, and even gym memberships.

Unfortunately, scammers have caught on to this and have begun creating fake Medicare Advantage flex cards. These cards are often used to steal personal data from seniors, such as their Medicare number and other sensitive information.

As a health insurance agent, it’s important to educate your clients about the potential for Medicare Flex Card scams. Encourage them to be wary of unsolicited calls or offers and to never give out their sensitive information unless they are sure the person or organization is legitimate. It’s also important to advise them to check their Medicare statements regularly to ensure that they haven’t been billed for any fraudulent services or equipment.

If your clients are interested in a Medicare Advantage plan with a flex card, be sure to do your research and only work with reputable insurance companies. Verify the legitimacy of the company and the plan, and never provide your clients’ data unless you are sure they are legitimate.

In addition to the Medicare Flex Card scam, there are other Medicare scams to be aware of. Some scammers will call seniors and claim to be from Medicare, asking for personal data, such as their Medicare number or Social Security number. Others may offer free medical equipment or services, only to bill Medicare for unnecessary or nonexistent treatments.

By staying informed about potential Medicare scams and educating your clients about the importance of protecting their sensitive data, you can help them avoid becoming victims of fraud. Remember to always protect your clients’ privacy and be wary of unsolicited offers or calls. By working together to prevent Medicare scams, we can help seniors access the healthcare they need without falling prey to fraudulent activity.

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Everything Your Customers Need to Know About How Employer-Sponsored Health Plans Compare to Medicare for Prescription Drug Costs

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When it comes to prescription drug costs, there can be significant differences between employer-sponsored health plans and Medicare. Understanding the differences between the two can help your clients save money and ensure you help them get the coverage they need. Here’s what your customers need to know about employer-sponsored health plans and Medicare.

Cost: 

Generally speaking, employer-sponsored plans tend to pay more for drugs than Medicare. This is because employers often negotiate discounts with drug manufacturers, allowing them to offer lower drug costs than Medicare.

Coverage: 

Employer-sponsored health plans may provide more comprehensive coverage for prescription drugs than Medicare. Some employer-sponsored plans may cover drugs not covered by Medicare.

Out-of-pocket costs: 

While employer-sponsored health plans may pay more for drugs than Medicare, they may also require higher out-of-pocket costs. Employer-sponsored plans may have higher co-pays, coinsurance, and deductibles than Medicare.

Formularies: 

Employer-sponsored health plans and Medicare may have different formularies, which are lists of drugs that are covered and excluded. Make sure customers check the formularies for both types of plans before making a decision.

Specialty drugs: 

Many employer-sponsored plans have higher copays and coinsurance for specialty drugs. Medicare, on the other hand, has lower copays and coinsurance for specialty drugs.

Prior authorization: 

Employer-sponsored plans may require prior authorization for certain drugs, while Medicare generally does not.

Step therapy: 

Employer-sponsored health plans may require step therapy for certain drugs, while Medicare does not.

Employer-sponsored health plans and Medicare can have significant differences as far as prescription drug costs. Understanding the differences can help customers make an informed decision about which plan is best for them. Make sure to emphasize to clients that they should compare the cost, coverage, and out-of-pocket expenses for each plan before making a decision.

Your next step as an agent is to learn how Medicare Advantage Plans (MAPD) and Prescription Drug Plans (Part D) play a role in helping your clients control their prescription drug costs. Work with Agility to learn more!

Are you contracted to sell Medicare plans yet? Contact us to get started today!

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How Robocallers Are Preying On Elderly With Fake Medicare Offers

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Robocallers are taking advantage of elderly people who may not be aware of how to protect themselves from scams, by offering fake Medicare plans. These calls are not only costing unsuspecting individuals large amounts of money, but they are also violating rules put in place by the Federal Trade Commission (FTC).

Robocallers are using fear tactics to convince elderly people to buy fake Medicare plans. They will tell the individuals that they are receiving a special offer and that if they do not take advantage of it right away, they might miss out on it. They might even pretend to be from a legitimate company.

Unfortunately, many elderly people will fall for these scam calls because they are not aware of the dangers of giving out personal information or credit card details over the phone. Even if the conversation does not involve money, the elderly person might still be vulnerable to identity theft.

The FTC has a few rules for robocallers, as well as other telemarketers. They must display their phone number and the name of the company they are working for. They must also tell you who they are calling on behalf of, and stop calling when you ask them to.

If you or someone you know has fallen victim to a robocall scam, it is important to report it to the FTC. You can also register your phone number with the National Do Not Call Registry. This will help to reduce the number of unwanted calls you receive.

It is important to be aware of the dangers of robocalls and to take precautions to avoid falling victim to one of their scams. There are a number of resources available to help educate and protect elderly people, such as the FTC and the National Do Not Call Registry. With these, you can help to ensure that elderly people are better protected from robocalls. As an agent, taking these measures becomes even more crucial.

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Medicare Patients Are Keeping the Telehealth Habit Post-Vaccines

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As the world slowly gets back to some semblance of normalcy in 2023, millions of Medicare patients are continuing to access telehealth services to manage their health and wellness. This is despite the fact that vaccinations against the Covid-19 virus are now available in the US.

The American Medical Association (AMA) recently conducted a survey of more than 2000 Medicare patients to better understand their telehealth habits in 2021. The survey revealed that a whopping 55% of respondents have used telehealth services in the past month, with an additional 8% planning to do so.

The survey also revealed that the primary reason for continuing to use telehealth is convenience. In fact, 43% of respondents cited convenience as a major factor in their decision to continue using telehealth services. Other popular reasons given included avoiding travel time (30%), comfort and privacy (20%), and affordability (17%).

The survey also revealed that the elderly are more likely to continue using telehealth services. Of the respondents aged 65 and older, 64% said they had used telehealth in the past month, with an additional 8% planning to do so.

The survey results are certainly encouraging, as they show that millions of Medicare patients are continuing to embrace telehealth even after vaccinations become available. This is likely due to the sheer convenience of telehealth, which allows patients to access medical care without having to leave the comfort of their own homes.

Overall, the survey results suggest that telehealth is here to stay, even after the Covid-19 pandemic has been brought under control. This is good news for the healthcare industry, as it means that patients will be able to continue accessing the medical care they need without having to worry about potential exposure to the virus.

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The Critical Role Agents Play in Medicare Plan Enrollment

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Medicare beneficiaries have the right to choose their own coverage, and this is where you come in. The help of a licensed agent or broker can be invaluable in guiding clients through the process. Agents and brokers possess the specialized knowledge to answer questions and provide advice on a wide range of Medicare plan options from private insurance companies, such as Medicare Advantage and supplemental plans.

Medicare contracted agents and brokers are trained to understand Medicare information and be able to explain it to clients in terms they can understand. They have access to real-time information about Medicare plan availability, premium costs, and coverage benefits. They can also help compare different plans and make sure consumers are enrolled in a plan that meets your needs.

Furthermore, agents and brokers are a great resource for seniors who are trying to make sense of the various Medicare programs. For example, they can help decide if a Medicare Advantage plan is right for an individual or explain the differences between a Medigap policy and a Medicare Part D prescription drug plan. Instead of trying to find the answers for themselves, people can rely on the expertise of an agent or broker.

Having the help of an agent or broker is especially important if someone is nearing the end of an Initial Enrollment Period and need to make sure they are enrolled in the right plan. Agents and brokers can help make sure people don’t miss critical enrollment dates. They can also help individuals get the most out of their benefits by applying for low-income subsidies or other assistance programs.

In short, agents and brokers are an important part of the Medicare landscape. Agents and brokers have the knowledge, experience, and resources to help people make informed decisions about their Medicare plan. 

Are you contracted to offer Medicare Plans yet?

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How to Increase Your Medicare Sales

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As an insurance agent, you may have a certain goal to reach, and you wonder how you can come close to meeting that goal. There are some tried-and-true ways to step up your marketing game. Start learning now so when open enrollment rolls around next year, you will be ready.

Stay up-to-date

One way to increase your Medicare sales is to stay up-to-date on the latest Medicare regulations and policies. This will not only help you provide accurate information to potential clients, but also make it easier to identify potential sales opportunities.

Build relationships with your clients

Another way to increase your Medicare sales is to build relationships with your clients. This can be done by providing personalized service and being a reliable source of information for your clients. By building trust with your clients, you will be more likely to retain their business and potentially generate referrals.

Educate your clients on the options available to them

In addition to building relationships, it is important to educate your clients about the different Medicare options available to them. This can help them make informed decisions and will also increase the likelihood of them purchasing a policy from you. You can do this through one-on-one meetings, group presentations, or informative seminars.

Research and target specific groups

Another effective way to increase your Medicare sales? Target specific groups of individuals who are likely to be in need of Medicare coverage. For example, you may want to focus on individuals who are approaching retirement age or those who have recently lost their employer-sponsored health insurance. By targeting specific groups, you can tailor your sales approach to their needs. Subsequently, you increase the likelihood they will purchase a policy from you.

Utilize social media

Additionally, using social media and other online platforms can be a great way to reach potential clients and promote your services. You can use these platforms to share educational content, answer frequently asked questions, and provide updates on changes to Medicare regulations. This can help you establish yourself as a trusted source of information and increase your visibility in the marketplace.

Increasing your Medicare sales as an insurance agent requires staying up-to-date on industry developments, as well as building relationships with clients and educating them. You should make time to target specific groups, and use online platforms to promote your services. By implementing these strategies, you can increase your sales and grow your business.

If you plan to sell Medicare insurance, Agility Insurance Services has a broad network of insurance providers to get contracted with:

UnitedHealthcare Medicare (MAPD + PDP + Medigap)

Humana Medicare (MAPD + PDP)

Aetna Medicare (MAPD + PDP)

Aetna Senior Supplemental (Medigap)

Devoted Health (MAPD)

Wellcare (MAPD + PDP)

Cigna Medicare (MAPD)

Cigna Supplemental Benefits (Medigap)

BCBS of Texas (MAPD + Medigap)

Oscar Health (MAPD)

Molina Medicare (MAPD)

Amerigroup (MAPD)

Care N’ Care (MAPD)

CHRISTUS Health (MAPD)

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Announcements regarding star ratings for Medicare plans

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Medicare Part D Star Ratings have been released for 2023 by the Centers for Medicare and Medicaid Services. 

57 of the plans earned 5 stars, but this shows a huge drop since last year, which was 74 five stars plans. 

This year, 67 contracts earned 4.5 stars, but this is lower than last year by 96!

136 of these contracts earned 4 stars, whereas last year 152 contracts earned four stars.

116 earned 3.5 stars; last year, 122 earned 3.5 stars. 

Finally, only 90 earned three stars, but this is a 25 increase from last year. 

Kaiser Foundation Health Plans and UnitedHealth Group led in earning five stars. 5 of Kaiser’s plans earned five stars, while 9 plans by UnitedHealth Group earned five stars.

Humana and Highmark also boast several plans that earned five stars.

These star ratings are annually announced, used to gauge the experiences of those using these companies to enroll in healthcare insurance. 

Those using Medicare can use this rating system to determine which plan is best, and which plan has the most positive reviews.

Thus, these star ratings are perfect if you are a Medicare insurance agent, as you can refer to this rating system to sell plans effectively to consumers. 

Just keep in mind that CMS did slightly alter the star rating system for 2023. Pandemic guardrails for these plans were removed; these safeguards created a hedge of protection during the height of the COVID-19 outbreak. Now these ratings will affect only 5% of bonus payments that are made to plans.

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Health Care Service Corporation Launches Biggest Expansion of Medicare Advantage Plans in Company’s History

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Health Care Service Corporation Launches Biggest Expansion of Medicare Advantage Plans in Company’s History

Medicare-Eligible Beneficiaries Have Greater Choice Of Medicare Products Through Expanded Footprint in Over 90 New Counties


CHICAGO — Health Care Service Corporation (HCSC), which operates health plans in Illinois, Montana, New Mexico, Oklahoma and Texas, announced the company is increasing its footprint in the Medicare Advantage market to serve more than 90 new counties, increasing access to new coverage options for more than 1.1M additional Medicare-eligible individuals. The expansion is the company’s largest service area and product expansion in its history, particularly in rural and underserved areas.

HCSC’s Medicare Advantage plans allow Medicare eligible individuals greater flexibility and choice in coverage, offering enhanced benefits and greater value. Premiums can vary by geography, including some $0 premium HMO and PPO plan offerings. Medicare Advantage plans may also provide additional benefits beyond traditional Medicare, including (or the option to purchase) dental, vision, and hearing coverage at a variety of price points in a simple and easy to understand plan design.

“We are delighted to be offering Medicare plans in more counties than at any point in our history; bringing greater access to care than ever before to more Medicare beneficiaries across our five states, with some gaining access to such plans for the very first time,” said Christine Kourouklis, president of Medicare, HCSC. “For more than 90 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care. This expansion continues our focus on that longstanding commitment by broadening our Medicare footprint.”

Through this expansion, HCSC is focusing beyond major metropolitan areas to provide needed access and choice to the rising population of those aging into Medicare– projected to increase to nearly 80 million people nationwide over the next decade, according the Centers for Medicare & Medicaid Services (CMS).

“We’ve chosen expansion markets very carefully to select areas where we are confident we can successfully leverage our strong reputation and the strength of our relationships with doctors and hospitals, as well as offering coverage for new potential customers,” said Nathan Linsley, senior vice president, Government Programs, HCSC. “Our Medicare Advantage plans will continue to provide greater choice, emphasize affordability, and are designed to help Medicare beneficiaries meet their health, lifestyle, and financial goals.”

To accommodate the expansion, HCSC significantly increased its broad network, adding 19,000 physicians and 2,800 hospitals and other medical facilities across its five states.

HCSC is in the process of seeking all necessary regulatory approvals in its targeted states for 2022. The Medicare Advantage and Prescription Drug Plan Annual Election Period (AEP) starts October 15, 2021 and ends December 7, 2021. For more information, visit www.medicare.gov.

Press release by: Jori Fine, Health Care Service Corporation

MEDICARE CONTRACTING & MORE >

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Aetna & CVS Health to enter the Affordable Care Act (ACA) Marketplace in 2022

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Aetna, CVS Health to enter the Affordable Care Act (ACA) individual insurance marketplace in Texas for January 1, 2022

This combines the health coverage of Aetna®, a CVS Health company, with local care at CVS Pharmacy®, MinuteClinic® and CVS® HealthHUB™ locations to deliver a quality, affordable health care experience.

 

WOONSOCKET, R.I., Aug. 4, 2021 /PRNewswire/ — Aetna and CVS Health (NYSE: CVS) will enter the individual insurance marketplace in Texas (specifically in select counties in the Austin, El Paso, Houston and San Antonio
markets) with the first Aetna CVS Health hybrid-branded insurance
product, providing access to health care for more Texans. Aetna and CVS
Health bring together quality along with convenience and expanded
services to meet consumer health needs, simply and affordably. 

“With the combined strength of Aetna and CVS Health, we’re uniquely
positioned to provide greater value for consumers, particularly the
millions of Americans who are uninsured or underinsured,” said Dan Finke,
Executive Vice President, CVS Health, President, Aetna. “We are taking a
human-centered approach to health care by connecting people to the
services and support they want – in their neighborhood, home and
virtually anywhere they need us.”

With these plans, members will have access to Aetna’s high-quality
network of health care providers and telemedicine services.
Additionally, the plan provides members with unique and convenient
health care offerings at MinuteClinic, HealthHUB and CVS Pharmacy
locations across the country.

Along with an enhanced direct enrollment experience via Aetna’s website, the plans feature:

  • No-cost or low-cost visits at any of the more than 50 MinuteClinic locations in Texas and over 1,100 MinuteClinic locations across the country.
  • Access to a Care Concierge at CVS HealthHUB locations, who is
    available to assist members by helping them navigate health care
    services and products.
  • 20% off select CVS Health Brand health and wellness products at any one of the 10,000 CVS Pharmacy stores. 
  • 90-day refills members can have delivered directly to their door for free.
  • Simplified member experience that lets members pay their premium at the store and manage their account with our mobile app or through the web.

“A key priority is providing people with access to the care they
need – simply, easily and affordably,” said Neela Montgomery, Executive
Vice President, CVS Health and President, CVS Pharmacy. “Whether it be
through our health plan, MinuteClinic, CVS HealthHUB, CVS Pharmacy or
any of our virtual care options, we are committed to helping simplify
health care and enable healthier outcomes.”

Additional CVS Health services include:

  • Added convenience with access to virtual care, including through MinuteClinic
  • Quality guidance and treatment for maternity care, as well conditions such as diabetes, hypertension, kidney disease
  • Help staying on track to better health with Pharmacy Advisor counseling and data-driven Next Best Actions or health nudges
  • Convenient, total health support with Destination Behavioral Health
  • Care in the comfort of the member’s home with Coram Home Infusion

The select Texas counties this new offering will be available in include Bexar, Brazoria, Comal, El Paso, Fort Bend, Galveston, Guadalupe, Harris, Hays, Kendall, Montgomery, Travis, and Williamson.

In addition to Texas, CVS Health is entering the individual exchange market in Arizona (Banner | Aetna), Florida, Georgia, Missouri, Nevada, North Carolina, Northern Virginia (Innovation Health) and Virginia.*

*Filings in each state are complete. Final approval to entry is pending state and federal reviews/certifications. 

About CVS Health

CVS
Health is the leading health solutions company, delivering care in ways
no one else can. We reach more people and improve the health of
communities across America through our local presence, digital channels
and our nearly 300,000 dedicated colleagues – including more than 40,000
physicians, pharmacists, nurses, and nurse practitioners. Wherever and
whenever people need us, we help them with their health – whether that’s
managing chronic diseases, staying compliant with their medications, or
accessing affordable health and wellness services in the most
convenient ways. We help people navigate the health care system – and
their personal health care – by improving access, lowering costs and
being a trusted partner for every meaningful moment of health. And we do
it all with heart, each and every day. Learn more at www.cvshealth.com.

About Aetna

Aetna,
a CVS Health business, serves an estimated 34 million people with
information and resources to help them make better informed decisions
about their health care. Aetna offers a broad range of traditional,
voluntary and consumer-directed health insurance products and related
services, including medical, pharmacy, dental and behavioral health
plans, and medical management capabilities, Medicaid health care
management services, workers’ compensation administrative services and
health information technology products and services. Aetna’s customers
include employer groups, individuals, college students, part-time and
hourly workers, health plans, health care providers, governmental units,
government-sponsored plans, labor groups and expatriates. For more
information, visit www.aetna.com and explore how Aetna is helping to build a healthier world.

 

ACA Contracting Available Here > 

 

News provided by


Aetna


Aug 04, 2021, 08:30 ET

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Oscar Brokers: Oscar’s Houston 2022 First Look and Training

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Certifications are open!

Plan year 2022 certifications are now open! To complete your certification today, please:

  1. Log in to your Oscar Broker Account at business.hioscar.com
  2. Click on “Get certified to sell Medicare Advantage”
  3. Click on “2022 Medicare Advantage Certification”

 


Complete the six-step checklist, including transmitting AHIP and passing the Oscar certification assessment

First Looks
Please
see attached Oscar’s Houston 2022 First Look — including a sneak peek
at our new plan with the O-Card, a $1,000 Visa card for medical, dental,
vision, and hearing services!

Download the Houston 2022 First Look Here

 

Oscar Contracting Available Here > 

Oscar Medicare Certifications & More >

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