how to market medicare advantage legaly in nc

by Ronaldo Larkin Published 2 years ago Updated 1 year ago

Do North Carolina Medicare Advantage plan beneficiaries have PPO plans?

In 2022, 97% of North Carolina Medicare Advantage plan beneficiaries have access to at least one local PPO plan. Private Fee-For-Service (PFFS) plans allow members to receive care from any provider who agrees to the terms and conditions of the plan and who accepts Medicare. PFFS plans are much less common in North Carolina than HMO and PPO plans.

What is a Medicare Advantage plan?

A Medicare Advantage Plan is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare.

What do the new guidelines mean for Medicare Advantage Marketing materials?

The guidelines allow organizations offering both Medicare Advantage and Prescription Drug Plans the ability to reference one document when developing marketing materials.

What is it like to sell Medicare Advantage plans?

The unique thing about selling Medicare Advantage plans is that you don’t get to sell a product unless you’ve passed tests and meet knowledge requirements. LM: Correct. Further, you may have face-to-face training requirements before selling. You’ll be in a room of other new agents.

Is Medicare Advantage available in North Carolina?

Types of Medicare Advantage Plans in North Carolina There are four types of plans available in North Carolina's Medicare Advantage program: Health maintenance organization (HMO), preferred provider organization (PPO), private fee-for-service (PFFS), and special needs plan (SNP).

What are some of the unique rules for marketing and selling Medicare plans?

Medicare has rules for how plans can contact you in different situations: By mail, radio, and print advertisements: Plans are allowed to market themselves by any of these means. They cannot, in these advertisements or in any other marketing situation, suggest that they are endorsed or preferred by Medicare.

Can you advertise for Medicare?

Medicare private plans are allowed to conduct certain activities. For instance, companies can market their plan through direct mail, radio, television, and/or print advertisements. Agents can also visit your home if you invite them for a marketing appointment. Never feel pressured to join any plan.

What is CMS marketing rule?

Marketing Rules CMS also regulates marketing and plan presentations, including when you're allowed to market, and how you market. Agents must wait until October 1 to begin marketing next year's plans to potential beneficiaries and cannot enroll members until October 15.

Can you solicit Medicare Advantage prospects through email?

The only caveat: If you are initiating contact via email, you're required to include an opt-out opportunity. Direct unsolicited contact, such as text and direct messaging over social media, falls into the same category as unsolicited phone calls and door-to-door solicitation. This means it is not permitted.

Can you sell Medicare door-to-door?

MA/PD PLANS May not market to beneficiaries door to door, including leaving materials at a beneficiary's doorstep. May call a beneficiary they enrolled in a plan to discuss plan business, as well as discuss the availability of other plan options/types within the same parent organization.

Can social media be used to advertise Medicare Advantage plans?

Brokers can post any type of marketing material on social media as along as it meets CMS guidelines. Disclaimers are not required on generic social media posts, but the material you're sharing may require a disclaimer.

How do I target Medicare patients?

Here are five ways on how to attract Medicare patients to your clinic to grow your market share in the Medicare space.Home Health Care. If your clinic offers home health services, promote them. ... Health Screenings. ... Mental Health Services. ... Telehealth. ... Patient-Provider Matching.

How do you market Medicare on Facebook?

Use these tips to make sure you're taking advantage of Facebook in the best way to market to the Medicare-eligible community.Post the content they want. ... Post frequently. ... Promote your posts. ... Run an ad. ... Follow these compliance tips.

Does CMS regulate Medicare Advantage plans?

The Centers for Medicare & Medicaid Services (CMS) released a regulation that clarifies the payment of compensation to agents and brokers who enroll beneficiaries in Medicare Advantage and Prescription Drug Plans. Copies of the new regulations and related documents can be downloaded from below.

What are the marketing guidelines?

So, here are some very basic, simple rules of marketing which I think we can ALL benefit from.Rule #1: Make Yourself Known. ... Rule #2: Taking The Competition Seriously. ... Rule #3: Relate To Your Audience. ... Rule #4: Progress At The Speed Of The Audience. ... Rule #5: Making Your Customers Happy. ... Final Thoughts.

What is considered marketing material by CMS?

CMS Model Marketing Materials Model marketing materials include: the standardized Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) templates and instructions, ANOC/EOC Errata, and Provider Directory.

What Is Medicare Advantage?

DD: I’d like to start with the basics, Luis. I’m sure there are a lot of people who have heard about Medicare, maybe they’re brand new agents or so...

Is Medicare Advantage A Tough Sell?

DD: When I started in final expense sales, I saw many Medicare Advantage prospects, but I never sold any Medicare Advantage plans.Why? Because agen...

How To Get Certified To Sell Medicare Advantage Plans?

DD: What’s the process for somebody who wants to learn how to become a Medicare Advantage insurance agent?You have to do more than getting your ins...

What Happens After AHIP?

Once you get that AHIP done then you’ve done about 70% of your required certifications.Each carrier that you’re appointed with wants to make sure t...

What Are The Long-Term Benefits Of Selling Medicare Insurance?

DD: What would you describe as the long-term advantages selling Medicare Advantage plans as your primary line of business?LM: When you’re doing cro...

Commission For Selling Medicare Advantage Plans?

DD: A lot of agents are looking at this like we’ve talked about it from a final expense standpoint.They’re used to getting pretty high first year c...

How Long Would It Take To Write 500 Sales?

DD: How long do you think it would take to write 500 pieces of business? Somebody who’s serious about this business, they’re full-time, they really...

Can You Cross Sell?

DD: When we look at new Medicare Advantage clients, ones that we found or wrote from maybe one of these referral partners, what’s the guidelines on...

When Can You Sell Medicare Advantage?

DD: A lot of agents look at the Medicare Advantage business and think they can only sell these products when the person turns 65 and then if not, o...

How many Medicare Advantage plans are there in North Carolina?

There were 63 Medicare Advantage plans in the state of North Carolina in 2019. Compare NC Medicare Advantage plans that are available near you and find a plan that fits your needs.

What is an HMO plan?

A Health Maintenance Organization (HMO) plan features a network of participating doctors, pharmacies and other health care providers.#N#With a Medicare HMO plan, you typically choose a primary care physician (PCP) who coordinates your health care and provides a referral when you need to see a specialist.

What are the Medicare marketing guidelines?

The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423).

Can Medicare Advantage and Prescription Drug Plans use one document?

The guidelines allow organizations offering both Medicare Advantage and Prescription Drug Plans the ability to reference one document when developing marketing materials.

What is the difference between Medicare Supplement and Advantage?

As long as you’ve done that you’ve done your CYA. The other difference between a Supplement and an Advantage plan is you have a prescription portion. So you’ve got to sell a prescription drug plan with a Medicare Supplement.

What is the certification test for Medicare Advantage?

Selling Medicare Advantage plans, you get a contract with a carrier, but once you’re contracted with that carrier every year that you are in Medicare Advantage sales, you’re going to have to take a certification test called AHIP. A lot of people freak out, “Oh, it’s so hard.”. Well, it’s Medicare 101. You need to know the product that you’re ...

What is the age limit for Medicare?

LM: When somebody has Medicare they’re normally 65 and over. You do have a segment of the population under 65 that get Medicare who are usually disabled. Once someone is on Medicare they have two options – Medicare Advantage or Medicare Supplement. There’s not a good or a bad option, there is simply two options.

Can you door knock Medicare Advantage?

Now in the Medicare Advantage world if you don’t have permission to contact you’re not supposed to contact. You can’t door knock for Medicare Advantage, so you’ve got to wait for it to come to you, but you can put a lot of honey out there to attract the bees.

Does Medicare Advantage include prescriptions?

For Medicare Advantage a prescription plan is included. The copays per carrier are probably different, but they function the same way. All you’ve got to do is pull up the formulary, which is usually in a PDF and just do the search for the medications and make sure they’re in there.

Can you make a ton upfront selling Medicare Advantage?

Selling Medicare Advantage insurance, you don’t make a ton upfront.

Can you sell Medicare Advantage plans?

How many Medicare Advantage enrollees will be in 2021?

Nearly one in five Medicare Advantage enrollees (19%) are in group plans offered to retirees by employers and unions in 2021. Nearly 4.9 million Medicare Advantage enrollees are in a group plan offered to retirees by an employer or union. While this is roughly the same share of enrollment since 2014 ...

Why is it important to monitor Medicare Advantage?

It will also be important to monitor how well beneficiaries are being served in both Medicare Advantage and traditional Medicare, in terms of costs, benefits, quality of care, patient outcomes, and access to providers, with particular attention to those with the greatest needs.

What percentage of Medicare beneficiaries are in 2021?

The share of Medicare Advantage enrollees varies across the country: in 26 states and Puerto Rico, at least 40 percent of Medicare beneficiaries are enrolled in Medicare Advantage plans in 2021, and at least 50 percent in Florida, Minnesota and Puerto Rico. In a growing number of counties, more than half of all Medicare beneficiaries are in ...

How many people will be enrolled in Medicare in 2021?

In 2021, more than four in ten (42%) Medicare beneficiaries – 26.4 million people out of 62.7 million Medicare beneficiaries overall – are enrolled in Medicare Advantage plans; this share has steadily increased over time since the early 2000s. Between 2020 and 2021, total Medicare Advantage enrollment grew by about 2.4 million beneficiaries, or 10 percent – nearly the same growth rate as the prior year. The Congressional Budget Office (CBO) projects that the share of all Medicare beneficiaries enrolled in Medicare Advantage plans will rise to about 51 percent by 2030 (Figure 2)

What is SNP enrollment?

SNPs restrict enrollment to specific types of beneficiaries with significant or relatively specialized care needs, or who qualify because they are eligible for both Medicare and Medicaid. The majority of SNP enrollees (88%) are in plans for beneficiaries dually eligible for Medicare and Medicaid (D-SNPs).

What states have Medicare Advantage plans?

At least 50 percent of Medicare beneficiaries are enrolled in Medicare Advantage plans in two states (MN, FL) and Puerto Rico. Puerto Rico has the highest Medicare Advantage penetration, with 80 percent of Medicare beneficiaries enrolled in a Medicare Advantage plan.

Which company has the largest Medicare Advantage enrollment?

UnitedHealthcare and Humana have consistently accounted for a large share of Medicare Advantage enrollment. UnitedHealthcare has had the largest share of Medicare Advantage enrollment since 2010. Its share of Medicare Advantage enrollment has grown from 19 percent in 2010 to 27 percent in 2021. Humana has also had a high share ...