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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

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

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

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

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

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

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

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

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

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

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

  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

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

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 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 (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

We're on a mission to make sure your clients, get the most out of their Oscar plan . That's why we're shining the spotlight on the Oscar Essentials this month. And, first up is account creation! With an Oscar account, your clients can take control of their healthcare experience like never before. Imagine being able to search for in-network care, select a primary care physician (PCP), refill prescriptions with ease, and even pay bills with just a few clicks. The possibilities are endless! So, how can you help your clients take advantage of these amazing benefits? It's easy! Just follow these simple steps: Open your Book of Business Select a client and click on the "Engagement" tab on the right-hand side View your member engagement checklist Select account creation Send an email by clicking on the "Email client tutorials" button Hit "task complete" Repeat for each of your clients. Don't let your clients miss out on the essential benefits

Exciting news for healthcare consumers in Texas! Blue Cross Blue Shield of Texas has announced that Ascension, one of the largest non-profit healthcare systems in the country, will remain in their network. This means that patients who have health insurance through Blue Cross Blue Shield will continue to have access to Ascension’s vast network of hospitals and clinics across Texas. Ascension's non-profit commitment to providing high-quality, compassionate care to its patients is well known. With its extensive network of facilities, Ascension offers a wide range of services, from primary care to specialty care and everything in between. By keeping Ascension in their network, Blue Cross and Blue Shield is ensuring that its customers have access to the care they need, when they need it. This decision is a big win for Blue Cross Blue Shield customers, as well as for Ascension. It’s not just about having access to quality care, but also about ensuring that patients have access to the ca

By: Michelle M. Saavedra   On December 31st, millions of people around the world were eagerly counting down the hours to welcome the new year. But for insurance agents, the real countdown began when the ball dropped on Time Square. This action alone symbolized the impending end of the Open Enrollment Season for the year 2023. In other words, Insurance Agents now had 15 days left to contact potential clients and enroll them in a 2023 health insurance plan. Naturally, every effort would be geared towards promoting health insurance products through social media. But come January 16th, most of the messages and digital ads would cease to exist. And sadly, many insurance agents would go as far as abandoning their digital platforms until the next Open Enrollment Period comes along. Agility Agents understand that NOW is the time to start building their online reputation, not during OEP season. Why is this? Because building a rapport with an online community takes time, dedication, and consist

  The 2022-2023 Open Enrollment Season saw more than 16.3 million people sign up for healthcare coverage, a new record that signaled the continuing need for access to quality healthcare and the Affordable Care Act’s (ACA) continued success in providing that access. The enrollment period ran from November 1, 2022 to January 15, 2023, and was the fifth consecutive period in which more than 10 million people signed up for coverage. This year's record-breaking number also signals the success of the Biden administration’s efforts to promote healthcare access and increase the number of ACA enrollments. Thank you Agility Agents for making this Open Enrollment Period a success! Read the linked article to find out more about the 2022-2023 open enrollment period! Discover why thousands of health insurance agents have chosen to join the Agility family!

Dual eligible special needs plans (DSNP) are a type of Medicare and Medicaid coverage that are tailored to meet the specific needs of certain individuals. DSNPs provides access to a wide range of services and benefits designed to help individuals with long-term care needs and help them maintain their independence in the home or in a care setting. DSNPs cover all Medicare-covered services, plus additional services and benefits, and are available for individuals who are eligible for both Medicare and Medicaid. With DSNPs, individuals can obtain the coordinated care, services, and supports that are best suited to their needs, and access quality care at a lower cost. Knowing the difference between Aetna Medicare and Medicaid dual plans Aetna Medicare and Medicaid dual plans provide a comprehensive healthcare solution for those who are eligible for both Medicare and Medicaid. These plans combine the benefits of both programs and often include additional benefits such as dental, vision, and

The 1095 forms are tax documents used to report health insurance information to the Internal Revenue Service (IRS). They are part of the Affordable Care Act (ACA) and are used to determine eligibility for government subsidies and tax credits. 1095 forms are typically issued by employers, health insurance providers, and the Health Insurance Marketplace. What is Form 1095-A Form 1095-A is used to report health care coverage provided by the Health Insurance Marketplace. This form is sent to individuals who had a qualified health plan through the Marketplace during the year. It includes information about the insurance and the amount of any Advance Premium Tax Credit that was applied. What is Form 1095-B Form 1095-B is used to report health insurance provided by a health insurance company, such as an employer-sponsored plan. It includes information about the insurance and the names of the individuals covered. What is Form 1095-C Form 1095-C is used to report health insurance provided by an

During a  CMS National Stakeholder call , the omnibus spending plans were discussed as it relates to the recent spending plan proposed by Congress that would allow states to resume Medicaid continuous enrollment unwinding after the end of the first quarter of 2023. This post outlines a few key points about the unwinding of the Medicaid continuous enrollment requirement and the associated provisions in the bipartisan spending plan. The proposed law makes it clear that states can take up to a full year to initiate all renewals. CMS has previously issued guidance allowing states up to 14 months to resume routine eligibility and enrollment processes; 12 months to initiate renewals and an additional two months to complete the process. Extended federal funding will help states avoid the fiscal cliff. In the first quarter of 2023, states will continue to receive the 6.2 percentage point increase in the Federal Medical Assistance Percentage (FMAP). The increased FMAP is phased down for the re

The IRS just made a final ruling regarding the ACA “Family Glitch” . Here’s everything you need to know about it as a health insurance agent, and what this will mean for your customers. The Final Rule addresses the "family glitch" in the Affordable Care Act by basing the affordability of employer-sponsored coverage for a family member on the cost of family coverage, rather than self-only coverage.  This means that some dependents who have or have eligibility for a premium tax credit or for group health plan coverage may now be eligible for premium tax credits to purchase a subsidized Marketplace plan and may switch their coverage as a result, if permitted by plan rules.  Starting in 2023, family members who currently do not meet the qualifications for premium tax credits may become eligible when purchasing health insurance through the Health Insurance Marketplace. This change does not affect the employer mandate penalty.  Producers can help members who may be newly eligible