Educational Events As of 2019, you can now distribute business cards and/or contact information to encourage beneficiaries to initiate contact when you are at an educational event. Business reply cards are also allowed.
What is an educational event for Medicare?
Educational events are intended to inform people about Medicare and Medicare programs. This can include Medicare Advantage, Medicare supplement and Part D plans. It cannot be plan specific or intended to steer or sell someone something.
What is the Medicare Advantage disenrollment period for 2019?
The Medicare Advantage Disenrollment Period (MADP) which would normally take place from January 1 through February 14 is being replaced with the Medicare Advantage Open Enrollment Period (OEP). The new OEP will occur between January 1 and March 31 annually beginning in 2019.
Can I present Medicare plan information at a marketing event?
This can include Medicare Advantage, Medicare supplement and Part D plans. It cannot be plan specific or intended to steer or sell someone something. If you are going to be presenting any company specific plan information, you are holding a marketing event and not an educational event.
What is the new Medicare Advantage outcome period (OEP)?
The new OEP will occur between January 1 and March 31 annually beginning in 2019. During this time, clients who are enrolled in a Medicare Advantage plan (and those who are newly eligible for MA plans) will be permitted to choose a different MA plan or return to Original Medicare, with or without a prescription drug plan.
Which activities are permitted at an educational Medicare event?
You may do the following at the conclusion of your educational event: Distribute business cards and contact information so beneficiaries can contact you at a later date. Complete and collect Scope of Appointment (SOA) forms. Set up marketing appointments.
Can you display and distribute Medicare Advantage enrollment guides at an educational event?
During educational events, you may not discuss any specific plans, or benefits, and you may not distribute any enrollment forms or carrier marketing materials.
Do agents have to report educational events to United Healthcare?
According to CMS regulations and UnitedHealthcare policy, agents are prohibited from conducting a marketing/sales event immediately following an educational event. There must be at least one hour separating the conclusion of an educational events and the beginning of a marketing/sales event.
Can sales representatives answer beneficiary initiated questions at educational events?
Of course, there are more detailed guidelines to protect attendees from dealing with an unwanted sales presentation. Guidelines for the Agent at the Education Event: May answer beneficiary initiated questions.
Can food be provided at a Medicare educational event?
Educational events are the exception to the “meals” part of the rule above. You can still provide food and snacks at educational events, but you are also allowed to provide meals. If you'd like to provide meals at an educational event, here are a few additional rules you must follow.
What is the purpose of an educational event for Medicare?
Educational events are intended to inform people about Medicare and Medicare programs. This can include Medicare Advantage, Medicare supplement and Part D plans. It cannot be plan specific or intended to steer or sell someone something.
What types of events must be reported to UnitedHealthcare?
UnitedHealthcare policy requires that all events, educational and/or marketing/sales (including formal and informal), be reported to UnitedHealthcare prior to any advertising and no less than 7 calendar days before the date of the event.
What is a Medicare informal event?
There are two types of sales events: formal and informal. Here's what sets them apart: Formal Sales Events: Agent presents plan-specific information to an audience invited to the occasion. Informal Sales Events: Agent offers plan info upon request only while at a table, booth, kiosk, or RV.
During which type of educational event are agents allowed to discuss plan-specific information?
The agent can set up a sales/marketing appointment with a member, and pass out business cards. It is okay to complete SOA forms and collect them at an educational event. At a sales event, marketing activities and lead generation can take place, including discussing plan-specific information and collecting applications.
What must all Medicare Advantage sponsors have in place in order to meet CMS compliance guidelines?
Medicare Advantage Plans Must Follow CMS Guidelines In the United States, according to federal law, Part C providers must provide their beneficiaries with all services and supplies that Original Medicare Parts A and B cover. They must also provide any additional benefits proclaimed in their Part C policy.
What is considered unsolicited contact?
Unsolicited direct contact with a consumer that was not requested or initiated by the consumer is prohibited and includes in-person (e.g., door-to-door marketing), telephonic (e.g., outbound telemarketing), electronic (e.g., email, voicemail messages, text messages) solicitation.
What is bundling at a sales event?
Bundling is a marketing strategy where companies sell several products or services together as a single combined unit. The bundled products and services are usually related, but they can also consist of dissimilar items which appeal to one group of customers.
When will Medicare take effect?
Here are seven improvements to Medicare that will take effect in 2019. Some of the changes will affect all beneficiaries while others will apply just to individuals who select Medicare Advantage plans.
Why won't Medicare pay for outpatient therapy?
Beneficiaries of original Medicare won’t have to pay the full cost of outpatient physical, speech or occupational therapy because Congress permanently repealed the cap that has historically limited coverage of those services.
How long can you test drive Medicare Advantage?
Plan test drives. New regulations will let people try an Advantage plan for up to three months and, if they aren’t satisfied, they can switch to another Medicare Advantage plan or choose to enroll in original Medicare.
Is Medicare getting better?
En español | Now 53 years old, Medicare has higher rates of satisfaction from its 60 million members than almost any other form of health insurance. It is about to get better. Here are seven improvements to Medicare that will take effect in 2019. Some of the changes will affect all beneficiaries while others will apply just to individuals who select Medicare Advantage plans.
Does Medicare cover meals delivered to the home?
Beginning in January, Medicare Advantage plans have the option to cover meals delivered to the home, transportation to the doctor’s office and even safety features in the home such as bathroom grab bars and wheelchair ramps. To be covered, a medical provider will have to recommend benefits such as home-safety improvements and prepared meals.
Does Medicare Advantage cover home delivery?
Lifestyle support. Beginning in January, Medicare Advantage plans have the option to cover meals delivered to the home, transportation to the doctor’s office and even safety features in the home such as bathroom grab bars and wheelchair ramps.
Does Medicare cover telehealth?
Medicare is steadily broadening the availability of telehealth programs that let patients confer with a doctor or nurse via telephone or the internet. In 2019, it will begin covering telehealth services for people with end-stage renal disease or during treatment for a stroke.
When did Medicare start reporting QPP?
Beginning in 2017 , all eligible clinicians who may have previously participated in the Medicare Promoting Interoperability Program are now required to report on Quality Payment Program (QPP) requirements. For more information on the QPP, visit this website.
When does CEHRT have to be implemented?
The 2015 Edition CEHRT did not have to be implemented on January 1, 2019. However, the functionality must be in place by the first day of the EHR reporting period. The eligible hospital or CAH must be using the 2015 Edition functionality for the full EHR reporting period.
How long is the EHR reporting period?
The electronic health record (EHR) reporting period for new and returning participants attesting to CMS is a minimum of any continuous 90-day period in CY 2019.
When is CEHRT required?
The 2015 Edition CEHRT did not have to be implemented on January 1, 2019. However, the functionality must be in place by the first day of the EHR reporting period. The eligible hospital or CAH must be using the 2015 Edition functionality for the full EHR reporting period. In many situations the product may be deployed, but pending certification.
Can you apply for hardship exception for 2019 EHR?
If your EHR vendor is unable to offer 2015 Edition CEHRT for the 2019 EHR reporting period, you can apply for a hardship exception to avoid a payment reduction.
What changes are there in Medicare 2019?
2019 Medicare changes include increases to certain Medicare deductibles, coinsurance or copayments and certain Medicare premiums.
How many people will be on Medicare in 2019?
According to CMS, 2019 Medicare Advantage enrollment is expected to reach 22.6 million, which would represent an 11.5% increase from 2018.
What is Medicare Part D?
Medicare Part D is a form of private Medicare insurance that provides coverage exclusively for prescription medications.
How much of the Medicare donut hole will be paid in 2019?
In 2019, the Medicare donut hole reached the final phase of its reduction for brand name drugs. Part D beneficiaries will now pay 25% of the cost of their brand name drugs during the coverage gap in 2019.
What is Medicare Part D coverage gap?
The Medicare Part D coverage gap, or “ donut hole ,” is a temporary limit on how much your prescription drug plan will pay for your covered drugs.
How much is Medicare Part B deductible?
The Medicare Part B deductible went up from $183 per year in 2018 to $185 per year in 2019.
What is the extra Medicare premium called?
Higher income earners may pay higher Medicare Part B and Part D premiums than the standard amount. This extra amount is called the IRMAA, or the Income-Related Monthly Adjusted Amount.
When is Medicare Advantage Open Enrollment Period?
The Medicare Advantage Disenrollment Period (MADP) which would normally take place from January 1 through February 14 is being replaced with the Medicare Advantage Open Enrollment Period (OEP). The new OEP will occur between January 1 and March 31 annually beginning in 2019.
How does CMS determine the category?
CMS determines the category that the material falls into by reviewing both the content and the intent of the piece. What does it say and what is your intention? Let’s look at an example from the MCMG:
How to advertise Medicare educational events?
You are allowed to advertise educational events through most of the usual methods such as flyers, newspapers, radio, email and direct mail. When marketing them it needs to say meetings will be for “educational” purposes.
Is Medicare Advantage plan specific?
This can include Medicare Advantage, Medicare supplement and Part D plans. It cannot be plan specific or intended to steer or sell someone something. If you are going to be presenting any company specific plan information, you are holding a marketing event and not an educational event. Medicare Educational event rules: advertising.
Is Medicare a straight forward event?
Medicare educational event rules are fairly straight forward. There has not been many modifications of them from 2020 to 2021 which makes things a bit easier. We will go over the basics below and point out the key things you need to be aware of when hosting one.
Do all carriers require an educational event registration?
The short answer is “yes”. Not all carriers require educational event registration but many of the do. As a result, it would be wise to register them either through your FMO or directly with the carrier. Online Enrollment- Enroll prospects online without the need for a face to face appointment.
When will Medicare final rule be published?
The final rule will be published in early November.
How much is a single payment for E and M?
Single payment for all E and M services (Levels 2 through 5), for a New Patient would be $135 and for an Established Patient, $93. The payment will be the same regardless of which method of documentation you choose to use.
Is a physician billable for a non-face-to-face visit?
This service would be billable when a physician or other qualified health care professional has a brief non face-to-face communication with a patient via technology, which is not accompanied by a surrounding office visit.