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Senior Markets

Medicare Advantage: What Is Changing For Beneficiaries with End-Stage Renal Disease (ESRD) in 2021?

ESRD, or kidney failure, affects more than 500,000 Medicare beneficiaries. These individuals are not currently eligible to enroll in the MA program but may be covered by an MA plan if they developed ESRD after enrollment or were grandfathered through employer-sponsored coverage. Currently, 130,000 people with ESRD, or 25% of this population on Medicare, have coverage through an MA plan.

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Lower Out-of-Pocket Insulin Costs For Medicare's Seniors

Today, under President Trump’s leadership, the Centers for Medicare & Medicaid Services (CMS) announced that over 1,750 standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs through the Part D Senior Savings Model for the 2021 plan year. Across the nation, participating enhanced Part D prescription drug plans will provide Medicare beneficiaries access to a broad set of insulins at a maximum $35 copay for a month’s supply, from the beginning of the year through the Part D coverage gap. The model follows on the Trump Administration’s previously announced 13.5% decline in the average monthly basic Part D premium since 2017 to the lowest level in seven years.

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It's official - SEP for COVID-19

CMS has officially announced an SEP is available for individuals affected by the COVID–19.  This SEP is available nationwide to residents of all states, tribes, territories, and the District of Columbia.  The SEP can be used until June 30, 2020 under the following circumstances.

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MACRA Update

New rules took effect on New Year’s Day. The Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) was signed into law on April 16, 2015. MACRA prohibits the sale of Medigap policies that cover Part B deductibles to “newly eligible” Medicare beneficiaries. Those affected by the change must pay the $198 Medicare Part B deductible themselves. ThinkAdvisor has an article you’ll find helpful. Click here to read it.

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Important Reminder From Aetna

********** New Requirement for applications**********

As you're completing applications with your clients, be sure to include the correct Medicare ID number, which is now the Medicare Beneficiary Identifier (MBI).

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SEP Announced For North Carolina

FEMA has provided an update to the declared Special Enrollment Period (SEP) for those affected by hurricane Dorian, in the event they were unable to make an election during another qualifying election period. 

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CMS Change To LIS/Dual SEP Effective January 1st

In 2019, the Center for Medicare and Medicaid Services (CMS) will make an important change to the ongoing Special Enrollment Period for Low Income Subsidy or Dual Eligible beneficiaries (LIS/Dual SEP). Current policy allows eligible customers to change their Medicare & Medicaid Advantage Plan, or Part D Prescription Drug Plan every month if they so desire.

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