You guys that are mailing T65

[Travis Price]

In my area, if you drop out the Medicare folks I don't believe the 92% of people with health coverage is anywhere close

So the Census says it's 68% with private, 31% with public. I would assume public would include the exchange, Medicare and Medicaid, but I'm not entirely sure..

Still 68% is still pretty significant.

The bigger issue, for Medicare people, is the fact that double the amount of people are staying in the workforce after 65 and even at 55% carrying insurance at work, that's still a significant number.. especially because it's expected to rise another 10% over the next 5 years.

Calls I get are usually tied to the increase in SS age.

Not to rib on Vic, but he's getting leads from people looking for Medicare coverage enough to fill out a form. Not from people that you've sent a letter to contact you. That means, likely, you're getting people that are already in the buying cycle, not a shotgun blast..

Don't quote me on that, because that's more opinion than fact.

 

[Travis Price]

If you get a possible green light, the only other 2 things that rock the boat are (a) IRMAA and (b) Rx's. I've learned to add these ?s early on as well (rather than at the end - wasting time)

I've been telling people just sign up for Part A if not on HSA and premium free and wait on Part B.

I do think that's solid advice, BUT I could do better with the additional questions.

 

[Bill_Kiray]

One other thing to consider here is that insurance companies are beginning to deal with Medicare Secondary Payor policies differently than they did before. If the insurance companies continue to adopt a stance that they'll process claims for those on Under 20 groups as if the member has Medicare (whether they enrolled or not), those individuals won't be able to wait until 66 to enroll. They'll have to take it at 65 to avoid massive claims exposure.

I have a number of agents who work with us that have been mailing Turning 66's over the last year plus. I'll reach out to see if I can get some feedback that would be meaningful.

 

[somarco]

One other thing to consider here is that insurance companies are beginning to deal with Medicare Secondary Payor policies differently than they did before. If the insurance companies continue to adopt a stance that they'll process claims for those on Under 20 groups as if the member has Medicare (whether they enrolled or not), those individuals won't be able to wait until 66 to enroll. They'll have to take it at 65 to avoid massive claims exposure.

I have a number of agents who work with us that have been mailing Turning 66's over the last year plus. I'll reach out to see if I can get some feedback that would be meaningful.

I am under the impression the MSP rules only apply to original Medicare and a supplement plan.

If so, it would seem to me that OM is the one who decides if they are primary or secondary.

Medigap plans receive claims that are adjudicated and pre-approved from Medicare. Frankly, I don't believe the Medigap carrier has a right to deny payment on a Medicare approved claim.

(EDITED) Also, if the EGH is under 20 then Medicare is primary, EGH is secondary. If the person has only the "free" part A then B claims are not paid by Medicare OR a Medigap OR the group plan

 

[Travis Price]

I am under the impression the MSP rules only apply to original Medicare and a supplement plan.

If so, it would seem to me that OM is the one who decides if they are primary or secondary.

Medigap plans receive claims that are adjudicated and pre-approved from Medicare. Frankly, I don't believe the Medigap carrier has a right to deny payment on a Medicare approved claim.

Also, if the EGH is under 20 then the group plan is primary, Medicare is secondary. There is no reason to have EGH + Medicare + Medigap.

I thought egh under 20 makes Medicare primary..

 

[LostDollar]

I am under the impression the MSP rules only apply to original Medicare and a supplement plan.

If so, it would seem to me that OM is the one who decides if they are primary or secondary.

Medigap plans receive claims that are adjudicated and pre-approved from Medicare. Frankly, I don't believe the Medigap carrier has a right to deny payment on a Medicare approved claim.

Also, if the EGH is under 20 then the group plan is primary, Medicare is secondary. There is no reason to have EGH + Medicare + Medigap.

I think he is saying that until recently, some group insurance carriers have chosen to treat themselves as the primary health insuror for client company employees of medicare eligibility age, even though they have not been legally required to do so. But that now, more insurance companies are choosing to apply MSP rules for Medicare eligible employees more strictly than they have done in the past.

 

[somarco]

I thought egh under 20 makes Medicare primary..

You are right.

Sometimes multi-tasking isn't my friend.

I edited my reply.

Thanks.

 

[Travis Price]

, if the EGH is under 20 then Medicare is primary, EGH is secondary. If the person has only the "free" part A then B claims are not paid by Medicare OR a Medigap OR the group plan

I got confused by this, but I think I understand.. I'll reiterate so I learn something new today.

If Medicare is the primary under MSP and they don't elect Part B, the egh plan won't pay Part B claims that would have ordinarily went to Medicare? Am I understanding that correctly?

I haven't dealt with a lot of MSP people... so it's a bit confusing.

 

[kgmom219]

I got confused by this, but I think I understand.. I'll reiterate so I learn something new today.

If Medicare is the primary under MSP and they don't elect Part B, the egh plan won't pay Part B claims that would have ordinarily went to Medicare? Am I understanding that correctly?

I haven't dealt with a lot of MSP people... so it's a bit confusing.

Correct.

If the employer is under 20 employees (combined FT and PT, the rules follow the COBRA guidelines), then they need to get Part B during their OEP.

And groups under 50 are required to report this information to the carriers annually, who are required to report it to CMS.

Marketing tip: 99% of the time, they need to hold. I just ask if I can add them to my Mid-September email for Medicare Open Enrollment and of course they say yes. Then when the retire, they remember me

 

[Travis Price]

Correct.

If the employer is under 20 employees (combined FT and PT, the rules follow the COBRA guidelines), then they need to get Part B during their OEP.

And groups under 50 are required to report this information to the carriers annually, who are required to report it to CMS.

Marketing tip: 99% of the time, they need to hold. I just ask if I can add them to my Mid-September email for Medicare Open Enrollment and of course they say yes. Then when the retire, they remember me

That's 100% what I do.. email on every call. Even if they don't buy from me, they'll still get my monthly newsletter. Eventually they'll need to change.. and here I am.