Projected growth in Medicare Advantage market highlights untapped opportunities, study finds

Published 08/14/2017

Despite rapid-fire growth that has resulted in upwards of 33% of all Medicare beneficiaries now being enrolled in Medicare Advantage plans, few health plans are proactively marketing their offerings to consumers and all but a select few plans are falling short when it comes to successfully addressing provider integration and access to care for their members.

Those are the key findings of the J.D. Power 2017 Medicare Advantage Study, released Aug. 10.

“Medicare Advantage plans represent a significant growth opportunity, but many health plans are not maximizing that potential,” said Valerie Monet, Senior Director of the Insurance Practice at J.D. Power. “Our data shows that the ability to deliver consistently strong customer satisfaction in the Medicare Advantage market is becoming a key differentiator for the leaders in this space and that satisfaction is achieved through a series of highly choreographed best practices.”

Following are some of the key findings of the study:

• Health plans missing premarketing opportunity: Enrollment in Medicare Advantage plans has been consistently growing. The proportion of the population age 65+ in the U.S. is projected to increase from 14% to 21% in the coming two decades. Despite the significant opportunity to capture share of this market as they qualify for Medicare benefits, just 11% of members in the 60+ age cohort indicate that they had received any communications from their health plan regarding moving from current coverage to a Medicare Advantage plan. Among the 11% who have received premarketing contact from their health plan, overall satisfaction scores are 52 index points higher than among those who received no marketing contact (762 vs. 710, respectively, on a 1,000-point scale).

• Just half of members completely understand how their plan works: Industry-wide, just 54% of Medicare Advantage plan members say they “completely” understand how their plan works. When it comes to the cost for prescription drugs, fewer people understand how this works compared with last year.

• Provider integration remains a friction point for most members: Ensuring members generally see their doctor as a trusted partner in their medical care is the most important factor driving the highest levels of overall satisfaction with Medicare Advantage plans. Somewhat surprisingly, it is not the soft skills that engender this feeling of trust, but rather assistance navigating the myriad of healthcare providers and managing associated costs that matter most.

• Coordination of care emerges as key driver of customer satisfaction: A new KPI in 2017 is found to be one of the most important factors driving overall satisfaction with Medicare Advantage plans — coordination of care among doctors and other healthcare providers — but most members say their plan isn’t able to effectively help them with this. On average, just 34% of Medicare Advantage plan members indicate their plans met this criterion.

• Medicare Advantage member satisfaction stable year over year for most health plans: Overall satisfaction with Medicare Advantage plans is 799, on average, which is 9 points higher than the J.D. Power 2016 Medicare Advantage Study. Despite the significant opportunity to grow in this segment, only one plan improved the member experience significantly from the previous year, WellCare.

Medicare Advantage Plan Customer Satisfaction Rankings

Kaiser Permanente ranks highest in Medicare Advantage member satisfaction for a third consecutive year, with a score of 852, which is 49 points higher than the second-ranked plan. Highmark ranks second with a score of 803 and Humana ranks third with a score of 794 (see chart below).

Kaiser outperformed all other plans across five of the six factors that comprise the overall satisfaction index, and was also the only company to receive a “5 – among the best” rating in the J.D. Power Circle Ratings from consumers, while the second through fifth-place companies managed “3 – about average” ratings. The sixth- through 10th-ranked companies received “2 – the rest” ratings.

The study, now in its third year, measures member satisfaction with Medicare Advantage plans — also called Medicare Part C or Part D — based on six factors (in order of importance):

1. coverage and benefits (25%)

2. customer service (19%)

3. claims processing (15%)

4. cost (14%)

5. provider choice (14%)

6. information and communication (12%)

The 2017 Medicare Advantage Study is based on the responses of 3,442 members of Medicare Advantage plans across the United States.

For more information about the 2017 Medicare Advantage Study, visit

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We want to give you a jump-start on production to help you “Soar to the Summit” and join America’s Final Expense CompanySM at America’s Resort, The Greenbrier, next May!  Submit apps May 15th through June 2nd and a Soar to the Summit Bonus credit will be applied toward your annual production at the end of 2017!  See full details here.

Why You Should Add the Cancer Rider to GTL’s Advantage Plus

Which one of these makes more sense for your client’s budget?

$10,000 total out-of-network co-pay for cancer treatment
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$29.75 monthly for $10,000 cancer benefit*

It would take over 28 years of paying $29.75 per month to match the $10,000 benefit!  A 65-year-old would be 93 years old before matching the benefit!

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* Based on Lump Sum Cancer Rider of $10,000 at age 65.

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Another Hassle-free Innovation, Brought to You by UnitedHealthcare

We know agents don’t sit still – you are always on the go, on the road, meeting consumers in coffee shops, community centers and in their homes. You don’t have time for hassles. Remember Jarvis? You haven’t met yet, but in last month’s Focus News you learned how Jarvis’ hassle-free, intuitive platform will be replacing the UnitedHealthcare Distribution Portal at the end of April.

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Jarvis just might become your new best friend. With a modern look and feel, Jarvis is mobile enabled, which makes your busy day a bit less hectic.

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The Impact of Increasing Out-of-Pocket Costs

According to Crain’s March 24, 2017 article, now more than ever, hospitals are struggling to collect payments from insured patients who can’t afford or won’t pay the skyrocketing out-of-pocket costs — and some hospitals may become more aggressive in their collections to reduce bad debt. Click here to read the article.

This trend isn’t going anywhere…and neither is the need for Hospital Indemnity Insurance.

Guarantee Trust Life Insurance Company (GTL)’s Advantage Plus can help clients dramatically reduce their net out-of-pocket expenses, such as deductibles and co-pays related to a hospitalization event. 

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New Med Supps in OH & TN

Medicare Supplement Plan D now available in Ohio

Aetna now offers Plan D as part of the portfolio of Medicare Supplement options in Ohio. To view the rates, click here.

Why not Plan D?
Plan D is another option for your senior supplement portfolio with these great features:

  • Lower premium rates than Plan G
  • Pays the same commission rate as Plan G

And since Ohio prohibits Medicare providers from charging more than what Medicare allows, Part B excess charges (not covered by Plan D) are not applicable in this state.

NEW Medicare Supplement now in Tennessee

Aetna now offers new Medicare Supplement plans in Tennessee. Not only do the new plans offer competitive rates, but applicants residing in the same household can also apply for a 7% household discount.

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Visit the Agent Toolkit for Your Special Enrollment Period Marketing Needs

Looking to kick start your Special Enrollment Period (SEP) marketing efforts? Don’t forget to leverage the Agent Toolkit because, no matter what your marketing needs are, the Toolkit is here to help.

Based on usage from last SEP, click here for a list of the top 5 most used materials and the folder path where you can find them on the Agent Toolkit.

Medicare Advantage Disenrollment Period: Jan. 1 – Feb. 14

The Medicare Advantage Disenrollment Period
January 1-February 14, 2017

The Medicare Advantage Disenrollment Period (MADP) runs from January 1 to February 14 every year in accordance with the guidelines of the Centers for Medicare & Medicaid Services (CMS).

The purpose of the MADP is to give Medicare Advantage (MA) members an opportunity to disenroll from any MA plan and return to Original Medicare.

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Members who disenroll from their MA plans may choose a Medicare Supplement or other Medigap policy, provided they qualify.  Please note that using the MAPD to disenroll from a MA plan does not result in a Guaranteed Issue of Medicare Supplement Insurance.

Medicare Announces 2017 Parts A & B Premiums and Deductibles

This year’s Social Security cost-of-living adjustment will increase Medicare costs for beneficiaries.

Part B

About 70% of Medicare beneficiaries will pay $109 for their 2017 Part B monthly premiums, a 3.9% increase compared to the past four years.

The remaining 30% not “held harmless” will have a monthly premium of $134 in 2017, up 10% from 2016.

As in years past, the Department of Health and Human Services mitigated extreme increases for those not “held harmless,” those people who do not receive Social Security benefits, those who enroll in Part B for the first time in 2017, those who are directly billed for their Part B premium, those who are dually eligible for Medicaid and have their premium paid by state Medicaid agencies, and those who pay an income-related premium.

The Part B deductible also increased 13% to $183 in 2017.

Part A

The 2017 Part A deductible of $1,316 is a $28 increase from last year.

According to CMS, beneficiaries must pay a coinsurance amount of $329 per day for the 61st through 90th day of hospitalization ($322 in 2016) in a benefit period and $658 per day for lifetime reserve days ($644 in in 2016). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $164.50 in 2017 ($161 in 2016).

Those that haven’t acquired premium-free Part A from 40 quarters of Medicare-covered employment will pay $227 monthly for Part A coverage, a $1 increase from 2016.