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Oscar Health Medicare Advantage

Oscar Health Medicare Advantage

Oscar Health Medicare Advantage

March 30, 2020

New to the senior market in 2019, Oscar Medicare Advantage has quickly made itself known amongst its competitors. Oscar’s plan of attack is simple, provide a concierge-like service and offering rewards and incentives, all while keeping their benefits among the best in the areas that they serve. They have implanted themselves into their markets by partnering with local health systems, like Montefiore Health System in NYC. While maintaining a robust network, integrating with Montefiore provides Oscar’s members Concierge services for more accessible, personalized care.

Oscar Medicare Advantage Service Area

The initial 2020 rollout for Oscar is in New York City and Houston, TX markets. In New York, the plans will be available in Orange, Rockland, Westchester and Bronx counties. All of the plan benefit information can be found on our Medicare quoting page. The plan in Bronx county is branded with the Montefiore name, but all of New York is covered by a large network of doctors and hospitals. Texas plans will be available in Fort Bend, Harris and Montgomery counties. The Houston network will be one of the strongest and includes Houston Methodist, VillageMD and Privia Medical Group.

Oscar Medicare Advantage Difference

Any plan can offer benefits comparable to each other when looking at copays and deductibles. Oscar combines those benefits while including several other unique plan designs. They utilize a partnership with Capsule Pharmacy to offer same-day delivery of prescription drugs and have prescription refills completed right over the phone. Every member of Oscar Medicare Advantage gets their very own Concierge Care Team that includes care guides and a nurse to help answer questions and save money. Oscar’s Rewards and Incentives program encourages members to take personal steps toward better health and adds value to being an Oscar member. As an Oscar member, you will receive gift cards as rewards for completing various health-related activities such as getting your annual wellness visit or breast cancer screening. Members can earn up to $250 per plan year in gift cards. All of this, along with no referrals, 24/7 access to telemedicine, and a free fitness benefit make Oscar an easy sale when in their service area.

How to sell Oscar Medicare Advantage

Like other Medicare Advantage plans, you must be licensed, certified and appointed to be eligible to sell Oscar. Get the process started by completing our one-page contract form. Once through contracting, you’ll need to upload or attach your AHIP certification, then complete the product training specific to Oscar’s plans. Once you are active, you can use their paper apps, or utilize our Connect4Medicare online application system, which includes almost all carriers in addition to Oscar. Check out our YouTube training video for more on the electronic application process.

Pinnacle Financial Services is here to help grow your business. We are not just your upline, but a partner in your journey to success. Not only can we help you get the top contract with Oscar, but with any one of the 130 plus companies we are partnered with. We are a full service, one-stop-shop for all of your senior insurance needs.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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Medicare Agent Training

Medicare Agent Training

Medicare Agent Training

January 28, 2020

The first rule in the Medicare industry is to always be compliant. Compliance shouldn’t be feared, but should come naturally as a second-nature. The only way to develop this, is to be constantly learning and increase your knowledge. The top priority for an independent agent is to find new prospects and close more cases. The more comfortable with the products, features, and rules around what you’re selling, the easier it will be to do the right thing by your clients. You can find help when you have the right partners however, ultimately you are responsible for seeking out that help. As a Medicare FMO, Pinnacle Financial Services is asked about training every day. Our team makes available a variety of tools to help our agents develop their second-nature compliance skills.

In-Person Medicare Agent Training Meetings

All Medicare carriers have training sessions throughout the year, especially once within certification season. The main benefits of the carrier meetings are getting in-depth information on local products and networks within a specific market. For example, one can look at a quote and see a side-by-side benefit comparison of copays in Independence Blue Cross’ Focus and Select plans. What you won’t see however, is that the Focus plan has a more defined network and won’t necessarily include all the doctors that clients typically associate with IBX. These meetings are also a great opportunity to pick up sales materials and promotional items when they become available.

Pinnacle Financial Services also holds similar meetings across the country and throughout the year. These meetings are typically focused on local updates in the general landscape of a selected area, and provide training on our state-of-the-art technology platforms. Coming up is our inaugural National Sales Summit, just outside of Philadelphia, Pennsylvania in King of Prussia. In attendance are the national carriers, to provide their view on the direction of Medicare, as well as  speaker John Greene, NAHU’s Vice President of Congressional Affairs.

Self-Learning and Medicare Agent Training

An agent’s schedule may not always accommodate in-person meeting times or agendas, therefore it’s important to spend some free time learning independently. Each carrier has webinars to attend that cover a variety of different topics. Pinnacle holds webinars through the month, that can cover product updates, technology, cross-selling, certifications, and more. One can also visit our website for updates in our news and blog areas. Join our email list to receive updates delivered via email in real-time. Don’t forget to also use the Medicare site as a resource!

For more information, contact a Pinnacle Representative today at 1-(800)-772-6881 x7731 or email sales@pfsinsurance.com.

Jeff Palo

Jeff Palo

Senior Sales Director - Health

1 (800) 772-6881 x7716
jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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Medicare Companies in Philadelphia

Medicare Companies in Philadelphia

Medicare Companies in Philadelphia

January 13, 2020

Philadelphia, like most cities, has Medicare plans and companies that are unique to their area. There are three different types of Medicare plans offered by private companies:

  • Medicare Supplement
  • Medicare Prescription Drugs
  • Medicare Advantage

As an agent, it’s important to know where to search for, and how to compare, plans to determine what will best fit the needs of your clients. Pinnacle Financial Services, a local FMO in the Philadelphia area, carries most of the companies unique to Philly, and has multiple specialists available to help answer any and all questions.

How to search for Medicare companies in the Philadelphia area

A number of different tools are available to assist agents in not only finding all of the companies available, but also comparing such plans to find what fits.

Pinnacle offers our agents access to these services at no cost.

Medicare Plan Finder had some major changes this past year, and has helped provide another way to run a quote.

Connect4Medicare.com provides agents a way to run quotes for individual clients based upon their medications and current financial statuses. The system also has a doctor and hospital look-up service to find if clients are covered at facilities, such as Lehigh Valley Hospital (Allentown,) or Novacare Rehab (South Philadelphia.)

Additionally, agents can also run a more generalized quote as well as find base pricing using Pinnacle’s CSG Quoting Tool.

There are several websites to show every single company within a specific ZIP code, although they may not be compliant to show a client.

When in doubt, reach out to our agent support team, based only 30 minutes outside of Philadelphia.

There is a large list of companies within and around Philadelphia, many of which will be attending the 2020 Sales Summit, (held in King of Prussia, March 10 & 11.) Below are a list of Pinnacle’s preferred carriers for each Medicare product line.

Preferred Companies offering Medicare Plans in Philly

Medicare Advantage
  • UnitedHealthcare
  • Aetna
  • Independence Blue Cross
  • Humana
  • Cigna
Medicare Supplement
  • UnitedHealthcare
  • Cigna
  • Aetna
  • Transamerica
  • Mutual of Omaha
Prescription Drug Plans
  • UnitedHealthcare
  • Silverscript
  • Envision
  • Wellcare
  • Humana

For more information, contact a Pinnacle Representative today at 1-(800)-772-6881 x7731 or email sales@pfsinsurance.com.

Jeff Palo

Jeff Palo

Senior Sales Director - Health

1 (800) 772-6881 x7716
jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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What Does MACRA Mean for Medicare Clients?

What Does MACRA Mean for Medicare Clients?

What Does MACRA Mean for Medicare Clients?

December 11, 2019

What is MACRA?

The Medicare Access and CHIP Reauthorization Act of 2015, (more commonly referred to as MACRA), has many components. One of which is a limit on first dollar coverage in certain Medicare Supplement insurance plans for individuals considered “newly eligible”, including a transition away from using Social Security numbers as identifiers. Additionally, MACRA changes way Medicare pays healthcare professionals. Currently, healthcare professionals are paid based on the number of services they perform. MACRA allows for healthcare professionals to be compensated on quality of care, as opposed to the number of services they perform.

Quality of care versus quantity of care.

Who is Considered “Newly Eligible”?

“Newly eligible” is defined as anyone who is turning 65 on or after January 1, 2020, or anyone who is eligible for Medicare benefits due to age or disability, (as defined by the Centers for Medicare and Medicaid Services- CMS), on or after January 1, 2020.

What does MACRA Require?

As of January 1, 2020, MACRA does the following:

  • Prohibits first dollar Part B deductible coverage on Medicare Supplement, so Plans C and F cannot be sold to those “newly eligible” for Medicare.
  • Makes Plans D and G the new guaranteed issue plans for those who are “newly eligible” within the guaranteed acceptance rules for Medicare Supplement plans.
  • Mandates that a Social Security Number can no longer be used as an identifier.

How are Enrollees in Current Plans C & F Affected by MACRA?

No change. Plans C and F can still be sold after January 1, 2020 BUT, only to Medicare beneficiaries who were age 65 PRIOR to 1/1/2020, or first became eligible for Medicare PRIOR to 1/1/2020, regardless of what plan they had previously. Plans C and F are NOT going away. Current policyholders can continue with their Plan C or Plan F beyond January 1, 2020. Example: A customer who bought Plan F, (or any other plan,) in 2018 can purchase any plan, including C and F, prior to January 1, 2020 or thereafter.

What does MACRA Mean to an Agent?

It will be necessary to make clear distinction between clients eligible for Medicare before and after 1/1/2020. This will decide which product options are available to your client. It will also be important to remember that with Plan F not taking any younger lives into their risk pool, those rates will have a higher chance of increasing significantly in future years. Be sure not to say “Plan F is going away” as it is incorrect and considered a scare tactic. Be sure to check out quotes and change effective dates to see updated rates and availability.

What can Clients Expect to See with MACRA?

Carriers hold the responsibility of education their members on the upcoming changes. This means they should expect to see increasing communication as the year goes on, including mailings, phone calls, guides and webinars. If they have not already, they will start to receive their new Medicare card.

Old Medicare Card

New Medicare Card

MACRA mandates the removal of Social Security Number (SSN), and based Health Insurance Claim Number (HICN), from Medicare Cards to address the risk of beneficiary medical identity theft and fraud.

  • New numbers are unique and randomly assigned.
  • The new number will be referred to as the Medicare Beneficiary Identifier Number (MBI).
  • Beginning April 2018, new cards will be issued and will continue through April 2019.
  • Review the new Medicare Card design and press release to learn more.

Next Steps with MACRA

The train is moving and all an agent can do is be informed and look for more information. Pinnacle Financial Services will be continually giving out information and holding webinars to keep you up to date. Be sure to always have the correct information to relay to your clients and inform your decisions.

<a href="https://pfsinsurance.com/about/partner/jeff-palo/" target="_blank">Jeff Palo</a>

<a href="https://pfsinsurance.com/about/partner/jeff-palo/" target="_blank">Jeff Palo</a>

Senior Sales Director - Health

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

What is MACRA?

What is MACRA?

What is MACRA?

May 31, 2019

The Medicare Access and CHIP Reauthorization Act of 2015 is more commonly referred to as MACRA. MACRA has many components, one of which is a limit on first dollar coverage in certain Medicare Supplement insurance plans for individuals considered “newly eligible”, and a transition away from using Social Security numbers as identifiers. It also includes a change to the way Medicare pays healthcare professionals. Currently, healthcare professionals are paid based on the number of services they perform. MACRA allows for healthcare professionals to be compensated on quality of care, as opposed to the number of services they perform.

QUALITY OF CARE VS QUANTITY OF CARE

WHO IS CONSIDERED NEWLY ELIGIBLE?

“Newly eligible” is defined as anyone who is turning 65 on or after January 1, 2020, or anyone who is eligible for Medicare benefits due to age or disability, (as defined by the Centers for Medicare and Medicaid Services- CMS), on or after January 1, 2020.

WHAT DOES MACRA REQUIRE?

As of January 1, 2020, MACRA does the following:

  • Prohibits first dollar Part B deductible coverage on Medicare Supplement, so Plans C and F cannot be sold to those “newly eligible” for Medicare.
  • Makes Plans D and G the new guaranteed issue plans for those who are “newly eligible” within the guaranteed acceptance rules for Medicare Supplement plans.
  • Mandates that a Social Security Number can no longer be used as an identifier.

HOW ARE ENROLLEES IN CURRENT PLANS C & F IMPACTED BY MACRA?

No change. Plans C and F can still be sold after January 1, 2020 BUT only to Medicare beneficiaries who were age 65 PRIOR to 1/1/2020, or first became eligible for Medicare PRIOR to 1/1/2020, regardless of what plan they had previously. Plans C and F are NOT going away. Current policyholders can continue with their Plan C or Plan F beyond January 1, 2020. Example: A customer who bought Plan F, (or any other plan,) in 2018 can purchase any plan, including C and F, prior to January 1, 2020 or thereafter.

WHAT DOES MACRA MEAN TO AN AGENT?

It will be necessary to make clear distinction between clients eligible for Medicare before and after 1/1/2020. This will decide which product options are available to your client. It will also be important to remember that with Plan F not taking any younger lives into their risk pool, those rates will have a higher chance of increasing significantly in future years. Be sure not to say “Plan F is going away” as it is incorrect and considered a scare tactic. Be sure to check out quotes and change effective dates to see updated rates and availability.

WHAT CAN CLIENTS EXPECT TO SEE WITH MACRA?

Carriers hold the responsibility of education their members on the upcoming changes. This means they should expect to see increasing communication as the year goes on, including mailings, phone calls, guides and webinars. If they have not already, they will start to receive their new Medicare card. MACRA mandates the removal of Social Security Number (SSN), and based Health Insurance Claim Number (HICN), from Medicare Cards to address the risk of beneficiary medical identity theft and fraud.

  • New numbers are unique and randomly assigned.
  • The new number will be referred to as the Medicare Beneficiary Identifier Number (MBI).
  • Beginning April 2018, new cards will be issued and will continue through April 2019.
  • Review the new Medicare Card design and press release to learn more.

NEXT STEPS WITH MACRA

The train is moving and all an agent can do is be informed and look for more information. Pinnacle Financial Services will be continually giving out information and holding webinars to keep you up to date. Be sure to always have the correct information to relay to your clients and inform your decisions.

For more information on MACRA, and how to join our email list, contact a Pinnacle Financial Services sales director today.

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail