Capping Part D Costs Could Lead to Reduced Benefits
Discussions continue to ripple through the Medicare insurance community with the recent Centers for Medicare and Medicaid Services (CMS) announcement of rules and regulations changes for 2025. Sweeping alterations were released earlier in April that affect everything from agent commissions to Part D drug benefits. At first, the changes to Part D drug benefits were […]
New CMS Rule Limits Selling and Reselling Consumer Data
As part of the Centers for Medicare & Medicaid Services (CMS) recently released updates, brokers and agents will have to take stronger precautions with customer data, especially when it comes to using that information with marketing companies. According to CMS, some third-party marketing organizations have been selling and reselling personal beneficiary data, subverting rules that […]
CMS Finalizes 2025 Rate Increase For Medicare Advantage Plans
On Monday, April 1, the Centers for Medicare and Medicaid Services (CMS) finalized 2025 rates for Medicare Advantage (MA) and Part D prescription drug plans, with the CMS announcing a payment increase of 3.7 percent expected over 2024 for MA plans. There are concerns in the MA industry that the expected increase in payments will […]
Molina’s Medicare Advantage Network Now Includes Cleveland Clinic in Ohio
Molina Healthcare has announced that as of Jan. 1, 2024, Cleveland Clinic has joined its provider network!
1.7 million lose Medicaid in Texas, could be eligible for Marketplace
After the end of a pandemic-era policy, 1.7 million Texans have lost access to Medicaid. For health insurance agents and brokers, that could open enormous opportunities to enroll uninsured consumers in the Health Insurance Marketplace. Based on normal qualifying conditions for Medicaid, most of these consumers likely would be eligible for $0 premium plans. According […]
Bridging the Gap: Navigating Dual-Eligible Healthcare Coverage
In the United States, Medicare and Medicaid play a vital role in providing health coverage to 12.5 million individuals who are dually enrolled in both programs, often referred to as “dual-eligible individuals.” While Medicare serves as their primary source of health insurance, Medicaid complements it with supplemental coverage. Nevertheless, concerns have arisen about fragmented care […]
Demystifying ACA Network Adequacy Requirements
Are you struggling to navigate the world of health insurance networks and providers? As a health insurance agent, it can be challenging to help clients find the right plan that meets their needs. It becomes even more difficult to also work to ensure that they have access to quality healthcare providers. In today’s post, we’ll […]
North Carolina Medicaid Expansion: What Health Insurance Agents Need to Know
As a health insurance agent in North Carolina, it’s important to stay updated on the latest developments regarding Medicaid expansion in the state. Medicaid is a government-funded health insurance program that provides coverage for low-income individuals and families. In recent years, there have been discussions and updates on the status of Medicaid expansion in North […]
Medicaid Behavioral Health Coverage: Addressing the Mental Health and Substance Use Crisis
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 […]
What to Know About Extended Medicaid Coverage for Mothers
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 […]
The Benefits of Florida’s Children’s Health Insurance Program
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 […]
Updates About Temporary SEP Unwinding
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 […]
Tennessee Makes Strides to Reduce Redetermination Process for Tenncare Coverage
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 […]
Continuous Enrollment Unwinding
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 […]
How can agents assist consumers in underserved communities?
As a health insurance agent, you are in the unique position of being able to make a difference in the lives of the underserved. There is no shortage of these communities around the globe. But many of these communities in need of service are right here in your backyard. Who are the underserved communities that […]
Health Care Service Corporation Launches Biggest Expansion of Medicare Advantage Plans in Company’s History
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 […]