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There are Just 24 months Between S.S.D.I. and Medicare Automatic Qualification

There are 24 months Between S.S.D.I. & Medicare Automatic Qualification

What You Need to Know to Grow Your Book of Business.

The Social Security Administration estimated in December 2018 that 8.5 million Americans received Disability Income or S.S.D.I.. To get a sense of who is covered by S.S.D.I., check the Administration’s Definition of Disability and view its complete list of impairments for adults and children.

What does this mean for you the agent? S.S.D.I. and Medicare work together to support individuals with disabilities. Independent Medicare agents have a rewarding opportunity to serve these disadvantaged beneficiaries. Whether someone is physically disabled and needs assistance with mobility or those with intellectual disabilities or those suffering with mental illnesses, they all need assistance with finding the right health coverage for them. Many times, S.S.D.I. beneficiaries qualify for Medicaid due to lower earnings over their lifetime. This provides you with a unique opportunity to partner with others to assist these beneficiaries. Once they have Medicare, you have a client for life!


“Realizing the the implications that Medicare is not just for seniors 65 and older opens up your book of business to new streams of income.”


It’s fairly simple, once a person has been on S.S.D.I. for 24 months, he or she automatically qualifies for Medicare. You can read more about eligibility for S.S.D.I. here. Individuals with S.S.D.I. can receive Medicare benefits before 24 months if they are fully disabled & have no expectation to work because of their disability. This is not granted automatically; the beneficiary must apply for it. I have had some clients receive Medicare benefits within three months of applying once they began receiving S.S.D.I..


Independent Medicare Agents have a Rewarding Opportunity to serve these Disadvantaged Beneficiaries

Most states do not have Medicare Supplements available to individuals under age 65. If Medicare Supplement plans are available, they can be cost prohibitive because most companies are group or age rated. An individual on Medicare due to Disability is bound to have higher health costs, so they often go with a Medicare Advantage plan simply because that is their only choice. Many Medicare Advantage plans have different networks than your new S.S.D.I. clients may have used in the past, so make sure they are comfortable changing their doctors and specialists.


“It’s fairly simple: Once a person has been on S.S.D.I. for 24 months, he or she automatically qualifies for Medicare”


It’s often the case that many individuals with a disability & families with a disabled family member don’t know where to turn for help. Some have Medicaid, some have no insurance and some live off of their savings.  Tragically, we have bared witness to cases where disabled clients have been Bankrupt by medical bills and are now on Medicaid after burning through their entire life savings because they had no insurance. Most are in their Forties or Fifties and believed they had at least 10 to 20 years or more to work.

Knowledgeable and caring Medicare agents can really make a positive difference in the lives of Disabled prospects by helping these individuals understand S.S.D.I. & Medicare. Realizing the the implications that Medicare is not just for seniors 65 and older opens up your book of business to new streams of income.

Call RB Insurance at 800-997-3107 or email to learn more about Social Security Disability Income, Medicare for Disabled individuals and how to Market yourself to new prospects. RB Insurance Group, llc. A Field Marketing Organization (FMO) for Insurance Agents and Agencies, specializing in the Senior Insurance market. The Agent Advantage Blog is designed with your business agents in mind. Explore the information below & subscribe to our blog to get CMS and regulatory updates with the agent’s perspective. Then give us a Call:800-997-3107 or Email: Producer@rbi-group.com  to find out how RBI can help you expand your business!

Disability Evaluation Under Social Security*

Listing of Impairments –  Adult Listings (Part A)

The following sections contain medical criteria that apply to the evaluation of impairments in adults age 18 and over and that may apply to the evaluation of impairments in children under age 18 if the disease processes have a similar effect on adults and younger children.

1.00
Musculoskeletal System

2.00
Special Senses and Speech

3.00
Respiratory Disorders

4.00
Cardiovascular System

5.00
Digestive System

6.00
Genitourinary Disorders

7.00
Hematological Disorders

8.00
Skin Disorders


9.00
Endocrine Disorders


10.00
Congenital Disorders that Affect Multiple Body Systems

11.00
Neurological Disorders

12.00
Mental Disorders

13.00
Cancer (Malignant Neoplastic Diseases)

14.00
Immune System Disorders

Listing of Impairments – Childhood Listings (Part B)

The following sections contain medical criteria that apply only to the evaluation of impairments in children under age 18.

100.00
Low Birth Weight and Failure to Thrive

101.00
Musculoskeletal System

102.00
Special Senses and Speech

103.00
Respiratory Disorders

104.00
Cardiovascular System

105.00
Digestive System

106.00
Genitourinary Disorders

107.00
Hematological Disorders

 108.00
Skin Disorders


109.00
Endocrine Disorders


110.00
Congenital Disorders that Affect Multiple Body Systems

  111.00
Neurological Disorders

 112.00
Mental Disorders

113.00
Cancer (Malignant Neoplastic Diseases)

114.00
Immune System Disorders

*Information from Social Security Administration Website:
https://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm
https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

2019 Medicare Cost-Sharing

Medicare cost-sharing

RBI National Sales Manager: Charlie Ferrell

Charlie started his senior insurance career after a brief 30-year stint in the restaurant industry. In the 13 years since then, he has been blazing trails and setting standards for excellence all over! A native son of Utah, he has been a state manager for RBI as well as a managing general agent for UHC, Coventry, Molina and other carriers! Charlie came to RBI as the National Sales Manager in 2015, and is an invaluable resource for our agents and staff for marketing, compliance, and sales topics! Charlie’s field experience with senior insurance sales has made him an expert in our insurance CRM: Medicare Sales Engine. If all of that wasn’t enough, Charlie specializes in the Dual-Eligible market and is leading the charge behind RBI’s new “Dual Eligibles for Newbies” seminars!

2019 Medicare Cost-Sharing

Medicare has released the 2019 Medicare cost-sharing amounts and MOOP for standardized Medicare Supplement Plans. Without further ado, here it is!

Medicare cost-sharing

Part A: Hospital Insurance

Hospital

  • $1,364 (+$24) deductible per benefit period.
  • $341 (+$6) for days 61-90.
  • $682 (+$12) for 60 lifetime reserve days (days 91-150.)

Skilled Nursing

  • $170.50/day (+$3) for days 21-100.

Part A premium

  • $437 if you’ve worked less than 30 quarters.
  • $240 if you’ve worked over 30 quarters but less than 40.

Part B: Medical Insurance

  • $135.50 premium. Deductible remains at $185.
  • Cost-sharing remains the same for Part B services, Medicare pays 80% and the beneficiary pays 20%.

Part D: Prescriptions

Deductible: $415

  • The standard part D deductible for 201 is $415.  Many plans however have eliminated the deductible entirely.

Initial coverage limit: $0 – $3,820

  • After the deductible has been met, beneficiaries enter into stage 2, the Initial Coverage Limit.  At which point beneficiaries will either pay 25% or more typically they will have co-pays for tiers 1 – 5.
  • Once the retail amount (what you pay + what the carrier pays) of your prescriptions reaches $3,820 for the year, beneficiaries will enter into gap also known as the “doughnut hole.”

Coverage Gap/Doughnut hole: $3,820 – $5,100

  • Once in stage 3, more commonly referred to as the “Gap” or the “Doughnut-Hole” beneficiaries will be paying 25% for brand name drugs and 37% for generics.
  • After out-of-pocket (what you and the manufacturer pay) costs reach $5,100 beneficiaries will enter into stage 4 or “Catastrophic Coverage.”

Catastrophic Coverage

Medicare cost-sharing

  • Once in stage 4, beneficiaries will pay the greater of:
    • 5% OR
    • $3.40 copay for generics and $8.50 copay for all other drugs.

Prescription drug coverage premiums range from $12.70 and up.

Part C – Medicare Advantage plans

Premiums for Medicare Advantage plans range from $0 and up.

Max-out-of-Pocket: $6,700

Cost sharing for Medicare Supplement plans

  • Deductible for the High Deductible plan F is $2,300
  • MOOP
    • Plan K: $5,560
    • Plan L: $2,780

We hope everyone is having a successful AEP and thank you all for your hard work!  While AEP ends in a little over a week, it’s important to remember that there is an incredible year-round opportunity in the Medicare market that most agents aren’t taking advantage of.  To jump start your business in the new year, the time to start is RIGHT NOW!  Plan out community events and any marketing necessities to keep the momentum going.  If you want help with marketing, contact us to do a MAPS plan.

Not yet contracted with RB Insurance Group?  Give us a call today to learn how RBI will take your Medicare business to new heights! 1-800-997-3107!



2020 ahip discount certification
Medicare cost-sharing
Aetna certification

Medicare Marketing Madness!

Join Justin Bever, our Chief Strategy Officer and Marketing Guru, for Medicare Marketing Madness! This webinar will cover in broad strokes how successful Medicare Marketing is used by our top brokers. Learn the costs, methods, and secrets about how to turn your budget into leads you can sell!

This Webinar starts at 11:00 AM MST. Here are a few of the topics that will be covered!

    • Learn about New Rules and Regulations and how to leverage them
    • Find out Proven Methods for consistently generating Medicare leads in your market!
    • Discover and demystify how to use Direct Mail to fill your pipeline
    • Build a budget for your continued marketing success
    • Target the exact market you want to work!

To ask questions and participate, you’ll need the following:

  1. Access to an internet connection and computer (or mobile)
  2. A phone or microphone to call in with
  3. Questions you need answering!

New and Improved: Medicare Sales Engine

Join us on Thursday, April 11th, and learn all about the “New and Improved: Medicare Sales Engine!”

This Webinar starts at 11:00 AM MST. Here are a few of the topics that will be covered!

    • What is the Medicare Sales Engine?
    • New features, capabilities, and changes
    • How to use this powerful tool to maximize your selling efficiency

To ask questions and participate, you’ll need the following:

  1. Access to an internet connection and computer (or mobile)
  2. A phone or microphone to call in with
  3. Questions you need answering!

Medicare Educational Events for Newbies

Join us on Thursday, March 21st, and take part in RBI’s “Medicare Educational Events for Newbies” webinar.

This Webinar starts at 9:00 AM MST. Here are a few of the topics that will be covered!

    • New Medicare Educational Event rules for 2019!
    • How to grow your business with Medicare Educational Events
    • Best Practices for compliantly generating business from these events

To ask questions and participate, you’ll need the following:

  1. Access to an internet connection and computer (or mobile)
  2. A phone or microphone to call in with
  3. Questions you need answering!

What’s the big deal about MA-OEP?

Join us on Thursday, March 7th, to take part in RBI’s “What’s the big deal about MA-OEP?” webinar.

Back due to popular demand, we are hosting another LIVE webinar session of “What’s the big deal about MA-OEP?” We will start off this webinar with a presentation about the new Medicare Advantage Open Enrollment Period and will cover topics like:

    • Who can use this new enrollment period?
    • What are the marketing restrictions regarding MA-OEP?
    • Why this enrollment period is good for beneficiaries
  • How to take advantage of other agents poor follow-up work and how to grow your business during MA-OEP!

To ask questions and participate, you’ll need the following:

  1. Access to an internet connection and computer (or mobile)
  2. A phone or microphone to call in with
  3. Questions you need answering!

Finding Dual Eligibles

Our most popular webinar, “Finding Dual Eligibles,” is back for 2019!

On February 21st at 9:00 am (Arizona Time) you’ll have the chance to learn from someone who got their start in the Dual Eligible market and has since built their career off of it. RBI’s very own Charlie Ferrell will be covering the following:

  • Who is a Dual Eligible?
  • What are the different levels of extra help?
  • What are Medicare Sales Programs and what do they cover?
  • How to compliantly find and reach potential clients
  • How to market yourself to these potential members

Rob Douglas Presents: United National Life

Join Rob Douglas and RBI on Tuesday, February 12th for “Rob Douglas Presents: UNL” webinar.

RB Insurance Group is proud to have special guest, Rob Douglas from United National Life show you how to boost your sales now that the AEP is over with United National Life. See below for a brief preview of what we will be covering:

  • Who is United National Life?
  • UNL’s Hospital Indemnity
  • UNL’s Short Term Home Health Care

What’s the big deal about MA-OEP?

Join us on Thursday, February 7th, to take part in RBI’s “What’s the big deal about MA-OEP?” webinar.

We will start off this webinar with a presentation about the new Medicare Advantage Open Enrollment Period and will cover topics like:

    • Who can use this new enrollment period?
    • What are the marketing restrictions regarding MA-OEP?
    • Why this enrollment period is good for beneficiaries
  • How to take advantage of other agents poor follow-up work and how to grow your business during MA-OEP!

To ask questions and participate, you’ll need the following:

  1. Access to an internet connection and computer (or mobile)
  2. A phone or microphone to call in with
  3. Questions you need answering!

There are Just 24 months Between S.S.D.I. and Medicare Automatic Qualification

There are 24 months Between S.S.D.I. & Medicare Automatic Qualification

What You Need to Know to Grow Your Book of Business.

The Social Security Administration estimated in December 2018 that 8.5 million Americans received Disability Income or S.S.D.I.. To get a sense of who is covered by S.S.D.I., check the Administration’s Definition of Disability and view its complete list of impairments for adults and children.

What does this mean for you the agent? S.S.D.I. and Medicare work together to support individuals with disabilities. Independent Medicare agents have a rewarding opportunity to serve these disadvantaged beneficiaries. Whether someone is physically disabled and needs assistance with mobility or those with intellectual disabilities or those suffering with mental illnesses, they all need assistance with finding the right health coverage for them. Many times, S.S.D.I. beneficiaries qualify for Medicaid due to lower earnings over their lifetime. This provides you with a unique opportunity to partner with others to assist these beneficiaries. Once they have Medicare, you have a client for life!


“Realizing the the implications that Medicare is not just for seniors 65 and older opens up your book of business to new streams of income.”


It’s fairly simple, once a person has been on S.S.D.I. for 24 months, he or she automatically qualifies for Medicare. You can read more about eligibility for S.S.D.I. here. Individuals with S.S.D.I. can receive Medicare benefits before 24 months if they are fully disabled & have no expectation to work because of their disability. This is not granted automatically; the beneficiary must apply for it. I have had some clients receive Medicare benefits within three months of applying once they began receiving S.S.D.I..


Independent Medicare Agents have a Rewarding Opportunity to serve these Disadvantaged Beneficiaries

Most states do not have Medicare Supplements available to individuals under age 65. If Medicare Supplement plans are available, they can be cost prohibitive because most companies are group or age rated. An individual on Medicare due to Disability is bound to have higher health costs, so they often go with a Medicare Advantage plan simply because that is their only choice. Many Medicare Advantage plans have different networks than your new S.S.D.I. clients may have used in the past, so make sure they are comfortable changing their doctors and specialists.


“It’s fairly simple: Once a person has been on S.S.D.I. for 24 months, he or she automatically qualifies for Medicare”


It’s often the case that many individuals with a disability & families with a disabled family member don’t know where to turn for help. Some have Medicaid, some have no insurance and some live off of their savings.  Tragically, we have bared witness to cases where disabled clients have been Bankrupt by medical bills and are now on Medicaid after burning through their entire life savings because they had no insurance. Most are in their Forties or Fifties and believed they had at least 10 to 20 years or more to work.

Knowledgeable and caring Medicare agents can really make a positive difference in the lives of Disabled prospects by helping these individuals understand S.S.D.I. & Medicare. Realizing the the implications that Medicare is not just for seniors 65 and older opens up your book of business to new streams of income.

Call RB Insurance at 800-997-3107 or email to learn more about Social Security Disability Income, Medicare for Disabled individuals and how to Market yourself to new prospects. RB Insurance Group, llc. A Field Marketing Organization (FMO) for Insurance Agents and Agencies, specializing in the Senior Insurance market. The Agent Advantage Blog is designed with your business agents in mind. Explore the information below & subscribe to our blog to get CMS and regulatory updates with the agent’s perspective. Then give us a Call:800-997-3107 or Email: Producer@rbi-group.com  to find out how RBI can help you expand your business!

Disability Evaluation Under Social Security*

Listing of Impairments –  Adult Listings (Part A)

The following sections contain medical criteria that apply to the evaluation of impairments in adults age 18 and over and that may apply to the evaluation of impairments in children under age 18 if the disease processes have a similar effect on adults and younger children.

1.00
Musculoskeletal System

2.00
Special Senses and Speech

3.00
Respiratory Disorders

4.00
Cardiovascular System

5.00
Digestive System

6.00
Genitourinary Disorders

7.00
Hematological Disorders

8.00
Skin Disorders


9.00
Endocrine Disorders


10.00
Congenital Disorders that Affect Multiple Body Systems

11.00
Neurological Disorders

12.00
Mental Disorders

13.00
Cancer (Malignant Neoplastic Diseases)

14.00
Immune System Disorders

Listing of Impairments – Childhood Listings (Part B)

The following sections contain medical criteria that apply only to the evaluation of impairments in children under age 18.

100.00
Low Birth Weight and Failure to Thrive

101.00
Musculoskeletal System

102.00
Special Senses and Speech

103.00
Respiratory Disorders

104.00
Cardiovascular System

105.00
Digestive System

106.00
Genitourinary Disorders

107.00
Hematological Disorders

 108.00
Skin Disorders


109.00
Endocrine Disorders


110.00
Congenital Disorders that Affect Multiple Body Systems

  111.00
Neurological Disorders

 112.00
Mental Disorders

113.00
Cancer (Malignant Neoplastic Diseases)

114.00
Immune System Disorders

*Information from Social Security Administration Website:
https://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm
https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

2019 Medicare Cost-Sharing

Medicare cost-sharing

RBI National Sales Manager: Charlie Ferrell

Charlie started his senior insurance career after a brief 30-year stint in the restaurant industry. In the 13 years since then, he has been blazing trails and setting standards for excellence all over! A native son of Utah, he has been a state manager for RBI as well as a managing general agent for UHC, Coventry, Molina and other carriers! Charlie came to RBI as the National Sales Manager in 2015, and is an invaluable resource for our agents and staff for marketing, compliance, and sales topics! Charlie’s field experience with senior insurance sales has made him an expert in our insurance CRM: Medicare Sales Engine. If all of that wasn’t enough, Charlie specializes in the Dual-Eligible market and is leading the charge behind RBI’s new “Dual Eligibles for Newbies” seminars!

2019 Medicare Cost-Sharing

Medicare has released the 2019 Medicare cost-sharing amounts and MOOP for standardized Medicare Supplement Plans. Without further ado, here it is!

Medicare cost-sharing

Part A: Hospital Insurance

Hospital

  • $1,364 (+$24) deductible per benefit period.
  • $341 (+$6) for days 61-90.
  • $682 (+$12) for 60 lifetime reserve days (days 91-150.)

Skilled Nursing

  • $170.50/day (+$3) for days 21-100.

Part A premium

  • $437 if you’ve worked less than 30 quarters.
  • $240 if you’ve worked over 30 quarters but less than 40.

Part B: Medical Insurance

  • $135.50 premium. Deductible remains at $185.
  • Cost-sharing remains the same for Part B services, Medicare pays 80% and the beneficiary pays 20%.

Part D: Prescriptions

Deductible: $415

  • The standard part D deductible for 201 is $415.  Many plans however have eliminated the deductible entirely.

Initial coverage limit: $0 – $3,820

  • After the deductible has been met, beneficiaries enter into stage 2, the Initial Coverage Limit.  At which point beneficiaries will either pay 25% or more typically they will have co-pays for tiers 1 – 5.
  • Once the retail amount (what you pay + what the carrier pays) of your prescriptions reaches $3,820 for the year, beneficiaries will enter into gap also known as the “doughnut hole.”

Coverage Gap/Doughnut hole: $3,820 – $5,100

  • Once in stage 3, more commonly referred to as the “Gap” or the “Doughnut-Hole” beneficiaries will be paying 25% for brand name drugs and 37% for generics.
  • After out-of-pocket (what you and the manufacturer pay) costs reach $5,100 beneficiaries will enter into stage 4 or “Catastrophic Coverage.”

Catastrophic Coverage

Medicare cost-sharing

  • Once in stage 4, beneficiaries will pay the greater of:
    • 5% OR
    • $3.40 copay for generics and $8.50 copay for all other drugs.

Prescription drug coverage premiums range from $12.70 and up.

Part C – Medicare Advantage plans

Premiums for Medicare Advantage plans range from $0 and up.

Max-out-of-Pocket: $6,700

Cost sharing for Medicare Supplement plans

  • Deductible for the High Deductible plan F is $2,300
  • MOOP
    • Plan K: $5,560
    • Plan L: $2,780

We hope everyone is having a successful AEP and thank you all for your hard work!  While AEP ends in a little over a week, it’s important to remember that there is an incredible year-round opportunity in the Medicare market that most agents aren’t taking advantage of.  To jump start your business in the new year, the time to start is RIGHT NOW!  Plan out community events and any marketing necessities to keep the momentum going.  If you want help with marketing, contact us to do a MAPS plan.

Not yet contracted with RB Insurance Group?  Give us a call today to learn how RBI will take your Medicare business to new heights! 1-800-997-3107!



2020 ahip discount certification
Medicare cost-sharing
Aetna certification

AEP: What to do Now?

AEP: What to do Now! Q&A Webinar

Join us on Thursday, October 4th, to take part in our “AEP: What to do Now?” Q&A session!

This session is for any and all agents and that want some useful tips and tricks about generating new business, cross-selling, and more! During this Q&A, you’ll have the opportunity to ask our panel of experts the questions you REALLY need answered.

To ask questions and participate, you’ll need the following:

  1. Access to an internet connection and computer (or mobile)
  2. A phone or microphone to call in with
  3. Questions you need answering!

 

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