News to Use for Agents in the Senior Market
A Publication of Senior Marketing Specialists
Week of April 24, 2017
“We recently updated our AOR reassignment policy in the Aetna Medicare Producer Guide. It now outlines procedures that must be followed for members, agencies, agents and third parties to initiate AOR changes. Here are some key points:
- All AOR reassignment requests will be effective the first of the month following the date we receive all correctly completed documents.
- During a valid election period, if we receive multiple applications for one beneficiary for the same plan, the agent listed on the first application we receive and process will become the AOR.
- Agents are no longer permitted to submit an application during AEP with the intention of changing the AOR. The AOR may only be changed by application submission if the member enrolls into an entirely new plan.”
For details, please see pages 67-73 of the Aetna Medicare Producer Guide.
Why is this important? Becoming the agent of record for a client is a common request. Setting the proper expectations for your client will avoid confusion. It is important to note that there are Member-initiated Agent of Record Reassignments as noted on page 68.
Approximately 70% of senior center participants are women; half of them live alone. The majority are Caucasian, followed by African Americans, Hispanics, and Asians respectively.
- Compared with their peers, senior center participants have higher levels of health, social interaction, and life satisfaction and lower levels of income.
- The average age of participants is 75
- 75% of participants visit their center 1 to 3 times per week. They spend an average of 3.3 hours per visit.
Why is this important? Senior centers serve as a gateway to the nation’s aging network—connecting older adults to vital community services that can help them stay healthy and independent. As an agent, you can become involved in and network through these centers.
Use this handy Medicare tool to work through a series of questions to determine eligibility and costs.
Why is this important? Many situations like death and divorce arise that make determining the cost and eligibility of Medicare part A and B difficult. This tool will allow you, as an agent to answer these complex questions.
Medicare does not pay the largest part of long-term care services or personal care—such as help with bathing, or for supervision often called custodial care. https://longtermcare.acl.gov/medicare-medicaid-more/index.html
Video – “Long-term care: Does health insurance cover it?”: https://youtu.be/Livh4CoWvlM
Medicare.gov on Long Term Care: https://www.medicare.gov/coverage/long-term-care.html
Why is this important? Annually, 8,357,100 people receive support from the 5 main long-term care service; home health agencies (4,742,500), nursing homes (1,383,700), hospices (1,244,500), residential care communities (713,300) and adult day service centers (273,200). Source: https://www.cdc.gov/nchs/data/nsltcp/long_term_care_services_2013.pdf
For an on-the-go and printable version, try the talkingMEDICARE Dowloadable Edition!