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Protecting Personal Data in Healthcare: The Importance of Cybersecurity Measures

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As a health insurance agent, you play a critical role in ensuring the protection of the personal data of your clients. Consumers share a vast amount of important information when enrolling for health insurance. This includes social security numbers, citizenship papers, passport info, and banking numbers. However, the ongoing threat of cyber attacks in the healthcare industry highlights the need for increased cybersecurity measures to safeguard such sensitive information of Medicare beneficiaries. The recent CMS ransomware attack and subsequent data leak in 2022 is a clear example of how serious this issue is. Unfortunately, this is not the first time such an attack has occurred. In 2015, HMS Medicare suffered a data breach that exposed the personal data of nearly 400,000 beneficiaries. In 2018, a CMS data breach compromised the personal information of nearly 75,000 individuals on the Healthcare.gov website. The potential consequences of these data breaches are significant, and the lo

The Biden-Harris Administration Celebrates the 13th Anniversary of the Affordable Care Act

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Thirteen years ago, the Affordable Care Act (ACA) was signed into law with the goal of expanding access to affordable and quality healthcare for all Americans. Since then, the ACA has been a cornerstone of the American healthcare system, providing coverage to millions of previously uninsured people. This year , on the 13th anniversary of the ACA, the Biden-Harris Administration is celebrating the law’s achievements and highlighting the record number of people who have signed up for health insurance through the ACA's marketplace. One of the most significant achievements of the ACA is the creation of the Affordable Care Act insurance Marketplace. The Marketplace provides a platform for individuals and small businesses to compare and purchase health insurance plans that meet their needs and budgets. Over the past 13 years, the Marketplace has helped 16 million people gain access to affordable health insurance, and this year’s open enrollment period saw record-high enrollment numbers.

Medicaid Behavioral Health Coverage: Addressing the Mental Health and Substance Use Crisis

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Mental health and substance use disorders are pervasive in the United States, affecting millions of people each year. In fact, poor mental health is the leading cause of disability worldwide. According to the National Institute of Mental Health, an estimated 1 in 5 adults in the United States experience a mental illness in any given year, and 1 in 12 adults experience a substance use disorder. These statistics underscore the vital importance of access to quality behavioral health services, including substance use and mental health treatment. Fortunately, Medicaid provides coverage for many individuals with low incomes, including those with mental health and substance use disorders. Medicaid is the largest payer for behavioral health services in the United States, covering a range of services, including mental health counseling, substance use disorder treatment, and medication-assisted treatment. However, the extent and quality of Medicaid behavioral health coverage vary significantly

Exploring the Utilization of Preventive Services by Individuals with Private Insurance Coverage: A Closer Look at Healthcare Prevention

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The Affordable Care Act (ACA) brought many changes to the healthcare industry, including provisions that require most private health plans to cover preventive services at no cost-sharing for their enrollees. This means that individuals with private insurance coverage can receive important preventive services without having to pay out of pocket. The ACA mandates that private health plans cover in-network preventive services at $0 cost-sharing for enrollees. This includes a wide range of preventive services, such as cancer screenings, vaccinations, and counseling for tobacco use. These services are crucial for maintaining good health and preventing serious illnesses. According to a report by the Kaiser Family Foundation, the use of preventive services among people with private insurance coverage has increased significantly since the ACA's implementation. The report found that in 2018, 71% of adults aged 18-64 with private insurance coverage received at least one preventive service.

How the Medicare Prescription Drug Inflation Reduction Act is Tackling Rising Drug Prices

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The Centers for Medicare and Medicaid Services (CMS) recently announced the implementation of a new program called the Medicare Prescription Drug Inflation Reduction Act. This program aims to reduce the rising cost of prescription drugs covered under Medicare Part B. The new program will reduce coinsurance rates for 27 Part B drugs , with savings expected to start from April 1. The rising cost of healthcare is a growing concern for many Americans, particularly seniors and those with disabilities who rely on Medicare for their healthcare needs. Prescription drugs are a significant component of healthcare costs, and the cost of these drugs has been on the rise for several years. The new program is part of a broader effort by CMS to address the issue of rising drug prices and make healthcare more affordable and accessible. The Medicare Prescription Drug Inflation Reduction Act is an important initiative that is expected to benefit millions of Americans. The savings from reduced coinsuran

Moderna to Provide Free COVID Vaccines to Uninsured Individuals Once State of Emergency Conclude

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As a health insurance agent, you may be wondering about the latest updates on COVID-19 vaccination coverage for uninsured individuals. In recent news, Moderna has announced that they will be offering free COVID-19 shots to those who are uninsured once the state of emergency ends. This is great news for those who may not have access to health insurance or may be struggling to pay for medical expenses. With the ongoing pandemic, it's important to ensure that everyone has access to the necessary resources for staying healthy and protected. As an insurance agent, you can inform your clients about this development and advise them on how to take advantage of this opportunity. Encourage them to stay up-to-date on local news and guidelines regarding the vaccination process, and remind them of the importance of getting vaccinated to protect themselves and those around them. Additionally, this news highlights the ongoing need for comprehensive health insurance coverage, especially during tim

What to Know About Extended Medicaid Coverage for Mothers

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Health insurance agents, we have some great news to share with you that can benefit your clients. Several states have extended their Medicaid coverage program for postpartum care, allowing new mothers to access crucial healthcare services after giving birth. As you know, the Affordable Care Act (ACA) provides states with the option to expand their Medicaid coverage for new mothers up to a year after childbirth, instead of the usual 60-day limit. Currently, 17 states (plus Washington, D.C.) have implemented the expansion program, and more states are expected to follow suit in the near future. As an agent, it's important to be aware of the expanding postpartum Medicaid coverage program and inform your clients of this option. Many new mothers may not be aware of this extension and could miss out on the opportunity to receive necessary medical attention during the first year of their child's life. Under the extension program, new mothers have access to services such as routine chec

Agility Partners with Ameritas Dental and Vision!

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Are your customers looking for a stand-alone dental and vision carrier that offers simple plans, a wide range of benefits, and a large network of providers? They need not look further than Ameritas, now partnered with Agility Insurance Services. Ameritas has been offering dental coverage since 1959 and vision coverage since 1984. With $400 million in individual dental and vision plans available in all 50 states, Ameritas has become a trusted name in the industry. But what sets Ameritas apart from other carriers? First and foremost, Ameritas focuses on simplicity, ease of enrollment, and member value. They offer a variety of plans that include implant coverage, teeth whitening, LASIK, hearing care, and Preventive Plus. With online enrollment and next-day benefits, consumers will immediately start enjoying the advantages of these benefits. Ameritas also has an extensive network of providers. Their dental network boasts over 582,000 access points, 131,000 providers, and 93,000 locations

A Guide To High vs Low Deductibles for Health Insurance Plans

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Regarding health insurance plans, one of the most important things for your customers to understand is the difference between high and low deductibles . Understanding this difference between high and low deductibles can help your clients make an informed decision when selecting a health insurance plan. Here are 8 things for your customers to consider when comparing high vs low deductibles: Cost:  High deductibles generally mean lower monthly premiums, while low deductibles typically mean higher monthly premiums. Depending on your budget and healthcare needs, customers need to weigh the pros and cons of higher and lower deductibles to determine what's best for their situation. Coverage:  High deductible plans tend to have higher out-of-pocket costs and fewer covered services, while low deductible plans may have more comprehensive coverage but with higher monthly premiums. Maximum out-of-pocket expenses:  High deductible plans tend to have higher maximum out-of-pocket expenses, while

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 deduc

Understanding the Biden Administration's Medicare Advantage Cuts as an Agility Agent

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The Biden Administration has proposed reductions in spending for Medicare Advantage plans, intending to redirect funds towards other healthcare initiatives. These cuts could have significant implications for Medicare Advantage customers, the future of Medicare Advantage plans, and the entire Medicare Advantage market. The Administration’s proposal would reduce spending for Medicare Advantage plans by 1.25% in 2022. This would translate to an estimated $8.3 billion in cuts for Medicare Advantage plans. The Administration hopes that these cuts will fund other healthcare initiatives, such as expanding home health services and expanding access to long-term care and hospice services. The proposed cuts would primarily affect the Medicare Advantage market, which is already facing a period of uncertainty due to the pandemic. These cuts may lead to fewer plans being offered, higher premiums, and reduced benefits. This could create particular hardships for Medicare Advantage enrollees, especiall

Special Enrollment Periods: Understanding Aetna Medicare Options in Texas

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Your Texas clients need to understand your options when it comes to health insurance. With the changing landscape of healthcare, it’s essential for consumers to know if they are eligible for a Special Enrollment Period (SEP). It’s also important for your customers to understand their Aetna Medicare options in Texas. A special enrollment period is a window of time outside of the annual Open Enrollment Period when a customer can enroll in a health plan. A qualifying event, such as the birth of a child, a move, or a change in employment typically triggers the SEP period. The following are specific SEPs in Texas: Disaster SEP: If a customer is affected by a major disaster declared by the President, they may be eligible for a Disaster SEP. Medicaid/CHIP SEP: Medicaid and CHIP provide free or low-cost health coverage to eligible children in Texas. If a consumer is eligible, they may enroll in a Medicaid/CHIP SEP all year round. SEP for Indian tribes: If your client is a member of a federall

Medicare Advantage Marketing: Understanding CMS Guidelines

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The Centers for Medicare and Medicaid Services (CMS) recently announced new restrictions on marketing for Medicare Advantage Plans and other health care policies. With the new rules, it is more important than ever for Agility agents to understand the Medicare Advantage marketing guidelines and the policies associated with them. In this blog post, we’ll explore what the new rules mean for agents selling Medicare Advantage plans and the strategies available to stay compliant with these plans. Under the new CMS guidelines, agents selling Medicare Advantage plans can no longer use promotional materials that could mislead, confuse, or exaggerate the benefits of their plans. This means that all marketing materials must be clear, and accurate, and not promote any plans inappropriately. Additionally, agents selling Medicare Advantage plans must provide consumers with detailed information about each plan, including out-of-pocket costs, services covered, and formulary information. In addition t

The Benefits of Florida's Children's Health Insurance Program

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Your customers want to keep their children healthy, and one of the best ways to do this is by providing them with access to affordable health care. Fortunately, the state of Florida is committed to helping parents provide their children with this essential service through its Children’s Health Insurance Program (CHIP). This program offers benefits to qualifying families and helps them to secure the medical care their children need. In this article, we’ll look closer at the CHIP program, its benefits, and how you can guide your client to enroll their child in this vital program. What is Florida's CHIP Program? Florida’s CHIP program is an initiative that provides free or low-cost health insurance to qualifying children in the state. It is funded by the federal and state governments and administered by the Florida Healthy Kids Corporation. The program is designed to provide comprehensive healthcare coverage to children that are not eligible for Medicaid or have other health insuranc

Updates About Temporary SEP Unwinding

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The Temporary Special Enrollment Period (SEP) is a crucial aspect of healthcare for consumers who have lost their Medicaid or Children’s Health Insurance Program (CHIP) coverage. With the unwinding of the Medicaid continuous enrollment condition, many people are losing access to these important programs, putting their health and well-being at risk. The Temporary SEP provides a lifeline to these consumers by allowing them to enroll in a new health insurance plan outside of the standard enrollment period. This gives them the opportunity to secure the coverage they need, even if they have missed the regular deadline for enrollment. To be eligible for the Temporary SEP, consumers must have lost their Medicaid or CHIP coverage due to the unwinding of the Medicaid continuous enrollment condition. They must also be seeking new health insurance coverage through an insurance service like Agility Insurance Services. The Temporary SEP is a time-limited opportunity, and consumers should act quickl

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 dis

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 teleh

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

Tennessee Makes Strides to Reduce Redetermination Process for Tenncare Coverage

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Tennessee has long been a leader in providing quality healthcare coverage through its Tenncare Medicaid program. Recently, the state has taken steps to make sure that their citizens are receiving the most up-to-date coverage and the best possible service. In this blog post, we'll explore how Tennessee is working to reduce the redetermination process for Tenncare coverage, and what it means for Medicaid health plans in the state. Tennesseans have long relied on Tenncare as their source of health coverage. However, there have been issues with the redetermination process, with some patients not receiving the coverage they need in a timely manner. This is especially true for those who are already struggling financially and have limited access to healthcare. Fortunately, Tennessee has recently made strides to reduce the redetermination process. They have implemented an automated system too quickly and accurately assess a patient’s eligibility for Tenncare coverage. This system allows Te

Medicare Advantage Denied 2 Million Prior Authorization Requests in 2021

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Medicare Advantage (MA) plans received more than 2 million prior authorization requests in 2021, of which about 6% were denied. This statistic, sourced from the Kaiser Family Foundation (KFF) , illustrates the challenges MA users face in receiving the necessary treatments and medications. Prior authorization is a practice used by health insurance companies to control costs by ensuring that procedures, treatments, and medications are medically necessary and prescribed for the right reasons. The process often requires the patient’s doctor to submit an authorization request beforehand, and the insurance company reviews it to decide whether or not to approve the procedure. The KFF report found that the denial rate for prior authorization requests is much higher in MA plans than in traditional Medicare. The percentage of denied requests increased by 10% between 2020 and 2021. While the reasons for the increase are unclear, they may be related to new requirements that MA plans have implemen