Medicare Part B Premium and Deductible Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. Each year the Medicare Part B premium, deductible, and coinsurance rates are determined according to the Social Security Act.
The 2022 premium included a contingency margin to cover projected Part B spending for a new drug, Aduhelm. Lower-than-projected spending on both Aduhelm and other Part B items and services resulted in much larger reserves in the Part B account of the Supplementary Medical Insurance (SMI) Trust Fund, which can be used to limit future Part B premium increases. The decrease in the 2023 Part B premium aligns with the CMS recommendation in a May 2022 report that excess SMI reserves be passed along to people with Medicare Part B coverage. Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2023, the immunosuppressive drug premium is $97.10. Medicare Open Enrollment and Medicare Savings Programs Medicare Open Enrollment for 2023 will begin on October 15, 2022 and ends on December 7, 2022. During this time, people eligible for Medicare can compare 2023 coverage options between Original Medicare, and Medicare Advantage, and Part D prescription drug plans. In addition to the soon-to-be released premiums and cost sharing information for 2023 Medicare Advantage and Part D plans, the Fee-for-Service Medicare premiums and cost sharing information released today will enable people with Medicare to understand their Medicare coverage options for the year ahead. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices annually and decide on the options that best meet their health needs. To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help millions of Americans access high-quality health care at a reduced cost, yet only about half of eligible people are enrolled. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments for those who meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other vital needs, including food, housing, or transportation. People with Medicare interested in learning more can visit: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs. Medicare Part B Income-Related Monthly Adjustment Amounts Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 7 percent of people with Medicare Part B. Medicare Part A Premium and Deductible Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment. The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,600 in 2023, an increase of $44 from $1,556 in 2022. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2023, beneficiaries must pay a coinsurance amount of $400 per day for the 61st through 90th day of a hospitalization ($389 in 2022) in a benefit period and $800 per day for lifetime reserve days ($778 in 2022). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $200.00 in 2023 ($194.50 in 2022). ![]() |
Medicare Blog | Medicare News | Medicare Information
2023 Medicare Parts A & B Premiums and Deductibles
Posted by www.psmbrokerage.com Admin on Thu, Sep 29, 2022 @ 10:13 AM
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Tags: Medicare Part A, Medicare Part B, 2023
Sunfire: Telephony System is LIVE!
Posted by www.psmbrokerage.com Admin on Fri, Sep 23, 2022 @ 09:56 AM
YourMedicare SunFire users, Today is the day! Be sure to log in and establish your new virtual phone number. Here is a step-by-step guide:
To register for a webinar go to https://yourmedicareresources.com/webinars/ To register for the SunFire Platform, request details here.
New CMS Requirement
Effective October 1, 2022 Field Agents will be required to record all sales and marketing calls in their entirety. The recordings must be retained in a HIPAA compliant manner for 10 years. View details on the new CMS rule here.
This pertains to calling leads, scheduling appointments, collecting drug and provider lists and conducting phone enrollments. ![]()
Only in person, face to face appointments are excluded, however any follow up calls related to sales and completing the enrollment process must be recorded.
Additionally, a new disclaimer must be verbally conveyed within the first minute of a sales phone call.
Now is a great time to make sure you have access to Sunfire's enrollment platform and have a solution in place for the upcoming 2023 AEP.
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Tags: Medicare Advantage, CMS, AEP, SunFireMatrix, Compliance, 2023
Mutual of Omaha: The Annual Enrollment Period Buzz is Getting Louder
Posted by www.psmbrokerage.com Admin on Tue, Sep 13, 2022 @ 02:12 PM
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Tags: AEP, mutual of omaha, 2023
Coming Soon for AEP! YourMedicareSunFire Recording Capabilities
Posted by www.psmbrokerage.com Admin on Fri, Sep 09, 2022 @ 10:29 AM
On that day, the Centers for Medicare and Medicaid Services (CMS) released its 2023 Final Rule, and in this extensive document, there are two important guidelines we’d like to highlight in a more simplified manner. New Required Disclaimer
Aside from that, this disclaimer needs to be added to any previously approved materials and resubmitted to CMS for approval. Calls With Beneficiaries Must Be Recorded Agents making calls to beneficiaries must record ALL calls in their entirety. In addition, This includes calls that are part of the chain of enrollment into a Medicare Advantage or This rule applies to telephonic conversations only, not face-to-face meetings. The YourMedicare team was well aware of this change and immediately took action in
This is just the beginning of what is to come. As new information becomes available, we’ll keep you updated on all new enhancements, news and more specific details ![]() |
Tags: Medicare Advantage, Medicare Part D, Prescription Drugs, AEP, SunFireMatrix, Compliance, 2023, call recording
Set for Launch - Compliance Tips for AEP
Posted by www.psmbrokerage.com Admin on Thu, Sep 08, 2022 @ 12:39 PM
As you are well aware, agents will juggle vast amounts of activity during this time. Unintended actions may be a pathway to making compliance mistakes, which may derail the AEP application process. Before we lift off into a new AEP season, let's consider a few significant points related to compliance in order to remain on the right trajectory for a successful launch. Scope of Appointments detail the exact topics beneficiaries would like to discuss with an agent. CMS requires agents to have beneficiaries sign an SOA prior to discussing Medicare Advantage or Part D Prescription drug plans. Every appointment with a beneficiary requires an SOA and these forms must be kept on file for 10 years, even if the appointment doesn't result in a sale. Also, starting this year, a new CMS ruling requires agents to read a disclaimer to all potential clients at the beginning of a sales call. Reading this during the SOA process is an optimal time for this disclosure. These calls must be recorded and stored for 10 years.
Before agents can help a client with a Medicare plan, they must know the physicians and the specialists a client sees for their healthcare services. Many beneficiaries are happy with their healthcare providers and don't want to change. Compare their current providers with the providers in the plan's network to ensure there isn't a disruption in services. It's important to review a client's prescriptions in order to help them clearly understand the cost of drugs for a particular plan. An unexpected increase in drug prices can quickly turn an exceptional client experience into an unsatisfactory one. Make sure to review enrollment data with your clients, this way, if there is an error, you can fix it on the spot rather than having the application returned. Reviewing a client's prescriptions will ensure they are given options for the most comprehensive coverage for their individual needs. A Summary of Benefits must be provided to beneficiaries at the time of enrollment to provide clarity regarding coverage. Although beneficiaries will receive a hard copy of this document after enrollment, agents must summarize key features such as covered benefits and cost sharing. The Summary of Benefits needs to be thoroughly discussed prior to signature-collection and verification of intent-to enroll. Agents are certainly busy during AEP and sometimes put off submitting an application to a carrier. This can result in the application not being submitted in the required 24-48 hour time frame. An agent's primary responsibility is to ensure a clients' insurance needs are met. It's important to take the extra time and double check to make sure your clients' applications have been taken care of within this time frame. ![]() |
Tags: Medicare Advantage, Medicare Part D, Prescription Drugs, AEP, Compliance, 2023
Gearing Up for AEP - Compliance Bulletin
Posted by www.psmbrokerage.com Admin on Tue, Aug 23, 2022 @ 01:36 PM
As you'll recall, the annual enrollment period is a time when your clients can essentially make any change they are eligible for. Among other things, these changes may include enrolling in Medicare Advantage for the first time, switching from one Medicare Advantage plan to another, or joining a Medicare prescription drug plan. As you may know, AEP only lasts from October 15 through December 7th. This only gives you roughly seven and a half weeks to close on sales. With such a small window of time to enroll potential clients, it's important to take care of all your contracting, certifications, and training as soon as possible. Here are a few important points to consider before you can jump into AEP.
Now that we've gotten the general information out of the way, let's look into a few tips regarding what to avoid saying to current and potential clients in order to stay CMS compliant. "Free premiums!" "Is your spouse eligible for Medicare?" - "How about your friends?" - "Can I have their number so I can call them?" "If you're liking this Medicare plan, you should check out this life insurance plan." "Let me get your contact information so that you are able to come to my event." "While you're waiting for your doctor, let me tell you about your Medicare options." As you are well aware, there are many other requirements to consider in order to remain CMS compliant. Our aim today was to help you gear up as October 15th quickly approaches. Remember to complete your contracting and certifications, order your supplies, read up on any compliance changes, and set your goals. Thanks for tuning in, and we'll see you next month with some more compliance tips. We hope you find this information informative and we are always happy to assist with any questions. You can review a video summary of this information here. ![]() |
Tags: Medicare Advantage, Medicare Part D, Prescription Drugs, AEP, Compliance, 2023
Sunfire: Integrated Telephony for Field Agents
Posted by www.psmbrokerage.com Admin on Mon, Aug 15, 2022 @ 02:16 PM
REQUIREMENT
Effective October 1, 2022 Field Agents will be required to record all sales and marketing calls in their entirety. The recordings must be retained in a HIPAA compliant manner for 10 years. View details on the new CMS rule here.
This pertains to calling leads, scheduling appointments, collecting drug and provider lists and conducting phone enrollments. ![]()
Only in person, face to face appointments are excluded, however any follow up calls related to sales and completing the enrollment process must be recorded.
Additionally, a new disclaimer must be verbally conveyed within the first minute of a sales phone call.
Now is a great time to make sure you have access to Sunfire's enrollment platform and have a solution in place for the upcoming 2023 AEP.
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Tags: Medicare Advantage, CMS, AEP, SunFireMatrix, Compliance, 2023
Humana Medicare is expanding in 2023
Posted by www.psmbrokerage.com Admin on Wed, Jul 13, 2022 @ 08:23 AM
Have you heard? Humana Medicare is growing – And they’re expanding their footprint in 2023!
Subject to Centers for Medicare & Medicaid Services (CMS) approval. Confidential and proprietary. For internal/agent use only. Do not distribute. ![]() |
Tags: Humana, Medicare Advantage, AEP, 2023
Aetna Medicare is growing in 2023
Posted by www.psmbrokerage.com Admin on Tue, Jul 12, 2022 @ 10:49 AM
Have you heard? Aetna Medicare is growing – And they’re expanding their footprint in 2023!
Subject to Centers for Medicare & Medicaid Services (CMS) approval. Confidential and proprietary. For internal/agent use only. Do not distribute. ![]() |
Tags: Online Enrollment, Medicare Advantage, aetna, AEP, 2023
Compliant MA & PDP Enrollment Solution for the 2023 AEP
Posted by www.psmbrokerage.com Admin on Wed, Jul 06, 2022 @ 04:14 PM
Maximize Your Telephonic Efficiency
MyMedicareBot is proud to announce the carrier network expansion of its Telephonic Enrollment solution for field agents. Effective immediately, licensed Medicare agents can enroll beneficiaries telephonically into MA, MAPD, and PDP plans from CVS/Aetna, Cigna, Humana, United Healthcare, and soon WellCare.
"The platform's call recording and analytics capabilities are available now to help field agents prepare to comply and excel under the new CMS Final Rule. All of us at MyMedicareBot are excited to bring this CMS-compliant solution before the start of the 2023 AEP," Michael Cho, CEO.
⭐ Benefits include:
MyMedicareBot's Field Agent Portal with Telephonic Enrollment is a web-based tool that provides field agents with:
"Field agents can sell, service, and enroll members through a CMS-compliant process. With the Field Agent Portal, health plans can confidently rely on field agents to operate safely and compliantly and meet the increased CMS compliance regulations of AEP 2023." said MMB.
Need support or creative marketing ideas for AEP? ![]() |
Tags: Medicare Advantage plans, Online Enrollment, AEP, MyMedicareBot, 2023