New Marketing Rules for Medicare Plans

Medicare has enacted several new rules regarding marketing techniques during Medicare Open Enrollment. These rules further define the steps insurance agents are allowed to take to market and enroll beneficiaries. Important changes are as follows:

Absolutely No Cold Calling. All contacts with prospects must be pre-approved by the beneficiary. Don't allow anyone initiate contact without a senior asking for it.

Plans and agents can't provide full meals at seminars. Refreshments are permitted, but full meals were being used to "buy" contracts.

Prospect meetings are to be limited to one topic. Discussions of other topics, like annuities, during an Medicare Advantage appointment should not happen until another time at least 48 hours later.


While these rules are very limiting to the sales of Part D and MA plans, agents who are honest and customer-focused will continue to do well. Dishonest agents hopefully will leave the industry. Seniors will be better served.

Increased Growth In After-Hours Clinics

Competition, patient demand are fueling growth in after-hours clinics. Doctors are expanding hours to accommodate the demands of busy, informed patients—and combat competition from retail health clinics popping up in drugstores such as Walgreens and CVS. "Given the choice, most patients who have a regular physician would prefer to see them on extended hours than go elsewhere for treatment," said Doug Henley, CEO of the American Academy of Family Physicians. "It’s moving to a more patient-centric (business) model rather than a physician-centered model," Henley said. Read the full article from the Kansas City Star.

State Specific Report Shows Increasing Health Insurance Costs

Families USA has released a series of state-specific reports showing the rising cost of health insurance premiums compared with median family income. In Alabama, for example, annual premiums for employer-sponsored family coverage rose 79% between 2000 and 20007, while median worker earnings rose 17%. The reports’ findings are based on data from the U.S. Census Bureau and departments of Labor and Health and Human Services.

New Treatments Drive Up Spending On Diabetes

Annual U.S. spending on prescription drugs to treat diabetes rose 87% between 2001 and 2007. A study in the Oct. 27 Archives of Internal Medicine revealed total annual expenditures for diabetes medications rose from $6.7 billion in 2001 to $12.5 billion in 2007, while the average drug price per prescription rose from $56 to $76. Estimated patient visits to office-based physicians for type 2 diabetes grew from 37 million in 2000 to 45 million in 2007.

New Approach to Medical Costs

Americans spend more than $265 billion a year out of pocket on healthcare and pile up medical debt, struggle to pay it off and sometimes end up in financial ruin. Now Haddam, CT-based Criterion Ventures is creating a new approach to dealing with those costs. Criterion's idea is to weave together private and public sources of payment, negotiate discounts on hospital and doctor care, and load it all onto a hybrid debit-credit card. Criterion believes the project will help people avoid drowning in medical debt and could also reduce bill collection hassles for care providers. Read the full article from the Hartford Courant.

Are Alternative Medicare Plans Reducing Costs?

Private Medicare Advantage plans will be paid an average 12.4% more per enrollee in 2008 than the same enrollee would have cost in the traditional Medicare fee-for-service program, according to a new report from the Commonwealth Fund. I wanted to post this report to inform the public of the continued debate over the course of Medicare. In any study, one should question the calculations that are used to determine the results. I, personally, like the fact that seniors have a choice in receiving their healthcare insurance. The Medicare Modernization Act of 2003 has attempted to bring Medicare into today's behaviors and mindset. As the financial impact is calculated and debated, continue to be aware of these issues. Seniors can have a louder voice when informed about the issues. Take time to educate yourself or risk allowing others to make your decisions for you.

Study of Trends in Health Insurance

A new report from the Employee Benefit Research Institute examines trends in health insurance coverage and the factors that affect coverage, including the strength of the economy. "While the percentage of the non-elderly population with employment-based health benefits was unchanged between 2006 and 2007, and the percentage with public coverage increased, resulting in a decrease in the uninsured, this should not be viewed as an indicator of things to come in 2008," the authors note. "As compared with 2007, unemployment was higher in 2008, meaning fewer individuals will have access to health insurance through a job, and gas and food prices were higher, meaning more individuals will have to choose between health insurance coverage and basic necessities."