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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

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