what is the date you can share medicare information with client

When does Medicare coverage start?

The start of your Medicare depends on your specific situation and when you enrolled. Below, we’ll go over what you need to know about when Medicare coverage starts. When Does Medicare Start? For most people, Medicare coverage starts the first day of the month you turn 65.

How do you inform potential enrollee of other Medicare plans?

Similarly, if a potential enrollee expresses interest in just one plan, you must inform them that other plans are also available to them. Avoid using absolutes and superlatives to describe Medicare plans and benefits. CMS puts a large focus on agent transparency.

How do I get Started with Medicare?

How to Get Started with Medicare. 1 Enter Zipcode. Enter your zip code to pull plan options available in your area. 2 Compare Plans. 3 Get Quote.

Can health care providers share patient information with other providers?

However, health care providers generally can't share personal medical information and records with providers who aren't involved in the patient's care, unless all personal identifiable information is removed. Thank you for subscribing! The email address cannot be subscribed. Please try again.

What is the 60 day rule for Medicare?

A benefit period begins the day you are admitted to a hospital as an inpatient, or to a SNF, and ends the day you have been out of the hospital or SNF for 60 days in a row. After you meet your deductible, Original Medicare pays in full for days 1 to 60 that you are in a hospital.

How does Medicare determine eligibility date?

The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month. If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

What are the rules for Medicare?

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medicare Insurance).

What is permission to contact guidelines for Medicare?

What Does it Cover? Specifically, the Medicare Permission to Contact (PTC) rule outlines when it is okay to contact a current or potential Medicare beneficiary, the specific products they are giving you permission to contact them for, how you can approach them, and when you can contact them.

What is initial enrollment period?

Initial Enrollment Period – a 7-month period when someone is first eligible for Medicare. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65.

What is initial election period?

The Initial Coverage Election Period (ICEP) is the period when you can enroll in a Medicare Advantage Plan for the first time.

What are the CMS mandates?

Since we first explained the CMS vaccine mandate (the Interim Final Rule (IFR) from the Centers from Medicare & Medicaid Services (CMS) that requires COVID-19 vaccinations for all staff at covered facilities), the mandate has survived numerous legal challenges and is being implemented across the country.

What is a CMS Final Rule?

Today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for the Medicare Advantage (MA) and Part D prescription drug programs that will improve experiences for dually eligible beneficiaries and provide greater transparency for the MA and Part D programs.

What is CMS policy?

The CMS oversees programs including Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the state and federal health insurance marketplaces. CMS collects and analyzes data, produces research reports, and works to eliminate instances of fraud and abuse within the healthcare system.

When can telephonic contact with a Medicare eligible consumer be made?

Once contact is made or 9 months from the date the consumer provided permission (e.g. consumer signature date on BRC) or 90 days if on federal do not call list, whichever comes first.

What is permission to contact?

Permission to Contact (PTC) is permission given by the consumer to be called or otherwise contacted by a representative of UnitedHealthcare for the purpose of marketing a UnitedHealthcare Medicare Solutions product, including any Medicare Advantage (MA), Prescription Drug Plan (PDP), or Medicare supplement insurance ...

What is Medicare compliance?

The Medicare Compliance Program is specifically designed to prevent, detect, and correct noncompliance as well as fraud, waste, and abuse.

When does Medicare start?

For most people, Medicare coverage starts the first day of the month you turn 65. Some people delay enrollment and remain on an employer plan. Others may take premium-free Part A and delay Part B. If someone is on Social Security Disability for 24 months, they qualify for Medicare. Those with End-Stage Renal Disease will be immediately eligiblee ...

When do you sign up for unemployment benefits?

It includes your birth month, and it ends three months after your birth month. If you want your benefits to start at the beginning of the month, you turn 65, be sure to sign up at least a month before your birthday. ...

Can you get Medicare if you have ALS?

Those with End-Stage Renal Disease will be immediately eligiblee for Medicare with a diagnosis. When Medicare starts is different for each beneficiary. People with disabilities, ALS, or End-Stage Renal Disease may be eligible for Medicare before they’re 65. If you qualify for Medicare because of a disability, there is no minimum age ...

Is group coverage better than Medicare?

In this scenario, delaying enrollment would make sense, especially if the coverage is better than Medicare. Although, group coverage better than Medicare isn’t the typical scenario. Many people work for small employers;

Can you have Cobra if you don't have Medicare?

So, if you don’t have Medicare, and you only have the group plan, the employer plan won’t pay until your Medicare is active. Further, COBRA is NOT creditable coverage for Medicare. When you delay Part B without creditable coverage, a late enrollment penalty could be coming your way.

Important Medicare Guidelines Update

Before we get into the do’s and don’ts, it’s important to note that the Medicare Communications and Marketing Guidelines (MCMG) has undergone some changes. You can now find the Medicare Advantage and Part D Communication Requirements on the Federal Register site.

Permission to Contact

Every interaction with a potential client has a starting point. Due to a change reflected in the 2019 MCMG and now in the Medicare Advantage & Part D Communication Requirements, agents are permitted to make unsolicited direct contact with potential enrollees via email. However, the email must have an opt-out option in order to remain compliant.

Scope of Appointment

Scope of Appointment means just what it says. It’s a form outlining exactly what you’ll be presenting to a client during a meeting. The SOA ensures that potential enrollees will not be pitched plans other than those they originally requested.

Marketing Rules

CMS also regulates marketing and plan presentations, including when you’re allowed to market, and how you market.

Events & Appointments

The types of presentations you host throughout the year typically fall under one of three categories; educational events, sales events, and individual appointments.

Secret Shoppers

Staying compliant should be a year-long objective for every agent. Annual Enrollment is the culmination of revised CMS Medicare Advantage & Part D Communication Requirements, new 2022 plans, and all kinds of potential enrollees, some of which could be secret shoppers.

Websites

Consumer-facing websites that promote a specific carrier or a group of carriers’ Medicare Advantage or Part D products must be submitted to CMS for approval. This is typically accomplished through the carriers. You may refer to the specific carrier’s policy regarding website review.

How long is the initial enrollment period for Medicare?

Initial Enrollment Period – a 7-month period when someone is first eligible for Medicare. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65. For those eligible due to disability, this period begins three months before their 25th month ...

How long do you have to enroll in Medicare?

However, the law only allows for enrollment in Medicare Part B (Medical Insurance), and premium-Part A (Hospital Insurance), at limited times: 1 Initial Enrollment Period – a 7-month period when someone is first eligible for Medicare. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65. For those eligible due to disability, this period begins three months before their 25th month of disability payments, includes the 25th month, and ends 3 months after. By law, coverage start dates vary depending on which month the person enrolls and can be delayed up to 3 months. 2 General Enrollment Period – January 1 through March 31 each year with coverage starting July 1 3 Special Enrollment Period (SEP) – an opportunity to enroll in Medicare outside the Initial Enrollment Period or General Enrollment Period for people who didn’t enroll in Medicare when first eligible because they or their spouse are still working and have employer-sponsored Group Health Plan coverage based on that employment. Coverage usually starts the month after the person enrolls, but can be delayed up to 3 months in limited circumstances.#N#People who are eligible for Medicare based on disability may be eligible for a Special Enrollment Period based on their or their spouse’s current employment. They may be eligible based on a spouse or family member’s current employment if the employer has 100 or more employees.

How long do you have to wait to get Medicare if you have ALS?

People under 65 are eligible if they have received Social Security Disability Insurance (SSDI) or certain Railroad Retirement Board (RRB) disability benefits for at least 24 months. If they have amyotrophic lateral sclerosis (ALS), there’s no waiting period for Medicare.

What is a SEP in Medicare?

Special Enrollment Period (SEP) – an opportunity to enroll in Medicare outside the Initial Enrollment Period or General Enrollment Period for people who didn’t enroll in Medicare when first eligible because they or their spouse are still working and have employer-sponsored Group Health Plan coverage based on that employment.

Additional Information

Medicare-Medicaid Enrollee Categories (PDF): People who are dually enrolled in both Medicare and Medicaid, also known as dually eligible individuals or Medicare-Medicaid enrollees, fall into several eligibility categories. This document explains the different enrollee categories.

Other Programs That Can Help

State Health Insurance Assistance Programs (SHIP): This program may help you with general questions related to Medicare.

What is scope of appointment in Medicare?

Updated on July 15, 2021. The form is a Scope of Appointment is a paper you fill out before an agent comes to your home. This form lets the agent know beforehand which coverage options are open for discussion.

How long does a scope of appointment last?

Agents must document their meetings with potential and current beneficiaries. The form goes on file for ten years and protects all parties. Sadly, many people have used a sales approach to profit from misunderstandings of the insurance world.

Does Medicare cover dental and vision?

Medicare Supplement plans work hand in hand with Medicare to pick up the out-of-pocket costs that Medicare doesn’t cover. Vision, Dental, and Hearing plans are separate insurance policies that offer routine care. Hospital Indemnity plans are the insurance plans that cover your hospital visits and stays. Long-Term Care Insurance comes in handy ...

Can an insurance agent talk about a plan?

You’ll select each box that you choose to discuss with the agent, and they legally can’t talk about plans ...

Can insurance agents save SOA forms?

Insurance agents can obtain the information, search for their SOA forms, and save all documents. They can even perform quotes for you within this program. The previous Scope of Appointment documents can also be uploaded into the electronic system to maximize proficiency.

What does it mean when a post meets CMS' definition?

A post would meet CMS’ definition if it is a retention-based marketing tactic, meaning the content pushes a specific brand or plan toward enrollees.

What can you share on social media?

Videos. Brochures, fliers, infographics, etc. Electronic marketing materials you can share on social media can come from your field marketing organization (FMO) or carrier, yourself, or a third-party.

What is generic information?

Generic information includes your business contact details, the types of products you sell (e.g. Medicare Advantage, Medicare Part D Prescription Drug Plan, Medicare Supplements, etc.), and posts that don’t provide specific details about Medicare plans. Here’s an example of how a generic post should be written to comply with ...

What is generic content?

Generic content stays away from naming specific products (e.g. Golden Medicare Advantage Plan) and giving plan details (e.g. plan benefits and premiums).

What percentage of seniors use Facebook?

The senior market is growing in number and in the use of social media. Sixty-two percent of Americans 65 and older use Facebook, according to a Pew Research study. As an agent, what you post and how you connect with seniors through social media matters. CMS’ guidelines for social media have greatly changed for 2019.

Can you save an infographic from an article?

You can save an infographic from an article and upload it to your social media post. If you do this, be sure to include the link for the third-party article that has the infographic in your post to credit the original source.

Can a broker respond to a social media post?

Brokers can respond to social media statements but not beyond the scope of comment. If you want to give an individual more information, you can respond by providing a phone number where they can contact you. Brokers can post generic, self-created marketing materials without CMS approval.

Why does CMS take Medicare monitoring seriously?

CMS takes the monitoring of Medicare agents seriously in order to protect seniors and the elderly from unscrupulous agents trying to take advantage of seniors.

Does CMS have compliance rules?

CMS mandates compliance rules for everyone, but each carrier has additional and different guidelines and protocols an agent must follow. Knowing how each company differs will save you time so you don’t duplicate any unneeded steps.

Important Medicare Guidelines Update

Permission to Contact

Scope of Appointment

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. In the CMS MA & Part D Communication Requirements, CMS differentiates between materials that ar...

See more on ritterim.com

Events & Appointments

Secret Shoppers

Websites