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Medicare Supplement (Medigap) plans can experience rate increases typically once or twice a year. The timing and frequency of these increases depend on the insurance company and can vary. Here are some key points:

1. Annual or Semi-Annual Increases: Most insurance companies raise rates annually, often around your birthday or the policy anniversary month. Some companies may increase rates twice a year
2. Factors Influencing Rate Increases: Rate increases are influenced by several factors, including rising healthcare costs, inflation, and the overall claims experience of the insurance company
3. Notification: Insurance companies are required to notify you in advance of any rate increases, so you will have time to review and consider your options 
4. Variation by Plan and Company: The amount of the rate increase can vary significantly depending on the specific plan and the insurance company. For example, Plan F, Plan G, and Plan N may have different average rate increases

You can use our CSG quoting tool to see a company’s rate history using the “Market Analytics” button. We recommend that five years after issuing someone on their first Medicare Supplement plan that you attempt to requote them for a less expensive rate while they are still young and healthy. This is especially true since carrier products are entering and exiting the market all the time.

Get a quote: https://www.urlinsgroup.com/medicare-quoting-tools.html 

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The late enrollment penalty for Medicare is charged by the Centers for Medicare & Medicaid Services (CMS). This penalty is added to your clients monthly premium if they didn't sign up for Medicare Part A, Part B, or Part D when they were first eligible and didn't have other creditable coverage.

If they believe they shouldn't have a late enrollment penalty, they can take the following steps to address it:

Starting January 1, 2025, there are two new Special Enrollment Periods (SEPs) for dually eligible individuals and those eligible for Extra Help (low-income subsidy):

1. Review the Notice: Carefully read the notice they received about the penalty. It should explain why the penalty was assessed. 
2. Gather Documentation: Collect any documents that support their case. This might include proof of other creditable coverage (like employer-sponsored insurance) during the period in question.
3. Request Reconsideration: Fill out the "Part D LEP Reconsideration Request Form" provided with their notice. This form allows them to formally request a review of the penalty decision. 
4. Submit the Form: Send the completed form and any supporting documents to the Independent Review Entity (IRE) as instructed on the form.
5. Follow Up: The IRE will review their request and notify them of their decision, usually within 90 days. 

Part D penalties will be invoiced with their carrier plan. This is not a carrier issue and not their determination, but they can help get it resolved.

Learn more: https://www.cms.gov/medicare/appeals-grievances/prescription-drug/late-enrollment-penalty-appeals 

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The Centers for Medicare & Medicaid Services (CMS) has introduced new rules to better integrate Medicaid and Medicare services for dually eligible individuals. These changes, part of the 2025 Medicare Final Rule, aim to improve care coordination, accessibility, and affordability for enrollees.

One significant change is the push for "exclusively aligned enrollment," where beneficiaries obtain both Medicare and Medicaid benefits from either the same plan/organization or two plans under the same parent organization.

This approach is designed to streamline services, reduce costs, and improve outcomes for enrollees.

Starting in 2027, CMS will limit enrollment into certain Dual Eligible Special Needs Plans (D-SNPs) to individuals who are also enrolled in or in the process of enrolling in an affiliated Medicaid managed care organization (MMCO).

Starting January 1, 2025, there are two new Special Enrollment Periods (SEPs) for dually eligible individuals and those eligible for Extra Help (low-income subsidy):

1. Dual/LIS SEP: This SEP allows full-benefit dually eligible individuals, partial-benefit dually eligible individuals, and Extra Help-only eligible individuals to make a once-per-month election into Original Medicare and a standalone prescription drug plan (PDP). It also allows a once-per-month election to switch between standalone PDPs.
2. Integrated Care SEP: This SEP allows full-benefit dually eligible individuals to make a once-per-month election into a fully integrated dual eligible special needs plan (FIDE SNP), highly integrated dual eligible special needs plan (HIDE SNP), or an applicable integrated plan (AIP). This SEP is designed to align enrollment with an integrated D-SNP and Medicaid managed care organization (MCO).

The main differences between Dual Eligible Special Needs Plans (D-SNPs) and Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) lie in their level of integration and the scope of services they cover:

1. D-SNPs (Dual Eligible Special Needs Plans):
2. General Integration: D-SNPs are Medicare Advantage plans designed for individuals who are eligible for both Medicare and Medicaid. They coordinate Medicare and Medicaid benefits but may not fully integrate all services.
3. Coordination of Benefits: D-SNPs must coordinate Medicare and Medicaid benefits, but the level of integration can vary. They are required to have a Model of Care approved by the National Committee for Quality Assurance (NCQA) and engage in care coordination.
4. FIDE SNPs (Fully Integrated Dual Eligible Special Needs Plans):
5. High Level of Integration: FIDE SNPs provide a higher level of integration by offering comprehensive coverage of Medicare and Medicaid benefits under a single legal entity. This includes primary care, acute care, long-term services and supports (LTSS), behavioral health services, and prescription drug coverage.
6. Aligned Enrollment: FIDE SNPs require exclusively aligned enrollment, meaning beneficiaries must be enrolled in both the FIDE SNP for Medicare benefits and the organization's Medicaid managed care plan.
7. Integrated Services: FIDE SNPs integrate member materials, enrollment processes, communications, grievances and appeals, and quality improvement processes across Medicare and Medicaid.
   In summary, while both D-SNPs and FIDE SNPs aim to coordinate care for dually eligible individuals, FIDE SNPs offer a more comprehensive and integrated approach to managing both Medicare and Medicaid benefits.

Learn more: https://www.pa.gov/agencies/dhs/resources/medicaid/chc/chc-mcos.html66

To make changes your Community Health Choice (CHC), you can follow these steps:

1. Log into your My Member Account portal: You can access it here99.
2. Request the change: Community Health Choice will process the change within 24-72 hours, and the effective date will be the next month.
   Alternative methods: You can also request to change your provider via live chat, text messages, or by calling their toll-free number at 1-888-760-2600.

Alternative methods: You can also request to change your provider via live chat, text messages, or by calling their toll-free number at 1-888-760-2600.