Individual Health & Medicare Newsletter 

In This Issue
HORAN News
Individual Health News
Medicare News
 
Chris Mihin
 

Account Executive

 

Chris Mihin, Account Executive, provides direction concerning Individual Health insurance and Medicare for those individuals without access to group health coverage. As a Chartered Benefit Consultant (CBC), Chris simplifies the selection process by exploring all options for the client and helps determine which option will best suit their health insurance needs.
To educate clients of their Individual Health insurance and Medicare options, Chris offers client education sessions focusing on Medicare and Individual Health insurance.

 

CONNECT 

 
 
 
 
  


 

HORAN Medicare Seminars

Click here to register for the following seminars held at HORAN Corporate
Headquarters: 


- October 30, 2013
- 11:30 AM to 1:00 PM 

- November 12, 2013
- 6:30 PM to 8:00 PM

 

 

 
Health Tidbits
 

Individual Health & Medicare

Fall Newsletter 2013

 
Greetings! 
 

Now more than ever, consumers need help navigating the options available through the new Health Care Marketplace and Medicare. Open Enrollment Periods for both Individual Health and Medicare started on October 1, 2013. HORAN's Individual Health and Medicare team has the expertise and experience to guide individuals through their options. We are dedicated to providing clients with quality service and unbiased advice to navigate the health insurance landscape. We are committed to protecting your future today. I look forward to hearing from you soon.

 

 

Sincerely,

 

Chris Mihin, CBC

Account Executive

 

HORAN News

  

Please Welcome our Newest Individual Health & Medicare Team Member - John Kirk  

 


John recently joined the HORAN Individual Health & Medicare team. He assists and educates individuals concerning individual health insurance and Medicare options, and simplifies the selection process by exploring all options for the client and helps determine which option will best suit their health insurance needs. 

 
John has more than 20 years of experience in Medicare solutions. He earned a Bachelor of Business Administration degree from the University of Cincinnati, and John is also America's Health Insurance Plans (AHIP) certified and holds a Project Management Certification from Villanova University.
  

Individual Health

 

HORAN's Chris Mihin Interviewed on WMKV's Law Talk

 

Chris Mihin, Individual and Medicare representative at HORAN, discusses the impact of the Affordable Care Act on Individual Health insurance. Click here to listen to visit the Multimedia Center on the HORAN website to listen to the interview. 

 

 

Subsidies: Who is eligible and how do they work?

 

Starting January 1, 2014, some individuals may be able to get subsidies or tax credits when they buy health coverage. So who can get these subsidies or tax credits, and how do they work? We'll break it down for you.  

 

In 2014, people who qualify may be able to get a tax credit from the government to help them buy health coverage and pay their premiums. Or they may qualify for subsidies from the government to help them pay for their out-of-pocket health care costs. And they don't have to wait until tax time to get it. The tax credit can be used for any individual plan sold on the exchange or health care marketplace.   

 

Who qualifies

  • Tax credit:
    • People who are U.S. citizens or legally live in the U.S.
    • People earning between 100% and 400% of the federal poverty level if they are not eligible for other sources of minimum essential coverage, including government-sponsored programs such as Medicare and Medicaid or Medi-Cal in California.
    • Single people with household modified adjusted gross incomes from 100% to 400% of the federal poverty level would earn from $11,490 to $45,960 each year.
    • A family of four with household modified adjusted gross income from 100% to 400% of the federal poverty level would earn from $23,550 to $94,200 each year.
  • Subsidy:
    • People with incomes up to 250% of the federal poverty level may also get an extra subsidy when they buy a silver level plan. These subsidies are lower cost shares for services covered by the silver plan. The federal government subsidizes the higher benefits provided by the insurer. 

Who doesn't qualify

  • People who can get Medicare or Medicaid (Medi-Cal in California)
  • People who can get a plan of a minimum value at work with premiums that cost less than 9.5% of their earnings

 

When health insurance marketplace open enrollment starts Open enrollment for plans offered through the health insurance marketplace began on October 1, 2013, and plan coverage starts as early as January 1, 2014.

 

To learn about other health care reform topics, check out our consumer resource at anthem.com featuring Health Care Reform 4 You

 

 

Healthfinder.gov Provides Excellent Resources to Ensure Individuals Practice Healthy Habits

 

Click on the links below to learn how to keep yourself and your loved ones healthy and happy. 

Medicare News

  

Can Medicare Advantage Survive PPACA?

 

Across America, agents are waiting with considerable anxiety to see what the 2014 Medicare Advantage plans will look like. While there's a high level of interest every year in what the new plan designs will look like, this year is perhaps the most anticipated in recent history. 

 

Click here to read more. 
  

 

UnitedHealthcare Update to Physician Network Changes

 

UnitedHealthcare manages the physician networks for their plans to help meet the evolving needs of health care consumers. This includes adjusting the size and composition of their physician network as they strive to meet the specific needs of Medicare Advantage and/or Medicaid plan members.

 

As a result, in the coming months, select physicians for one or more of your Medicare Advantage and/or Medicaid members will no longer participate in the UnitedHealthcare Medicare and Medicaid plan networks. Please note: these changes do not affect members enrolled in Medicare Supplement (Secure Horizons or AARP-branded) or commercial plans.

 

Member transitions  UnitedHealthcare knows that members are impacted when they make changes to their network, and are taking steps to support members with smooth transitions to new care providers as appropriate to help ensure continuity of care.

 

They will be sending letters to affected members to notify individuals of care providers that will no longer participate in the UnitedHealthcare Medicare and Medicaid plan network as early as January 1, 2014 (network changes for New Jersey Medicaid plans have an October, 2013 effective date.) When appropriate, letters will suggest new care providers for members to consider for their ongoing care. Members are encouraged to call the number on their member ID card if they need help with identifying a new care provider.

 

In some plans, members may choose to continue seeing their current care providers on an out-of-network basis, in accordance with their out-of-network benefits. These changes have no impact on plan benefits, and members undergoing a treatment plan will be able to continue seeing out-of-network care providers consistent with federal requirements.

 

Provider directories   

These network changes are reflected in UnitedHealthcare's online provider directory as of October 1, 2013. It is highly encouraged to refer to the online provider directory in all cases to confirm care provider network and panel status for all potential enrollees, as changes may not be reflected in previously printed and/or downloaded directories. 

 

It is important to note that when searching for an in-network provider on the online directory, a provider's "Accepting New Patients" status must indicate "OPEN", even if the potential enrollee is an existing patient.  

 

Please refer to the Physician Network Changes - Frequently Asked Questions for Member Discussions that provide additional information and may be used in the event you receive any member inquiries.

 

For additional questions, please call the UnitedHealthcare Producer Help Desk (PHD) at 888-381-8581 or email phd@uhc.com. Please include your agent writing number in the subject line of the email. 

Anthem issues MLR refunds to qualifying Medicare Supplement members in California, Colorado, Maine, New Hampshire and Ohio

As you may be aware, Medicare Supplement premium changes are based on anticipated health care costs and claims trends. To support these changes, Anthem reviews Medicare Supplement premiums annually to ensure their cost estimates meet state regulated Medical Loss Ratio (MLR) requirements. MLR is the percentage of premiums that an insurer must spend on medical care.

 

When expenses are lower than expected, Anthem issues refunds to Medicare Supplement members in those qualifying plans.

 

Refunds for this year

Anthem began refund distributions on September 10, 2013, on certain plans in the following Anthem states:

  • California
  • Colorado
  • Maine
  • New Hampshire
  • Ohio

Please keep these points in mind relative to questions about the refund process:

  • These refunds range from approximately $3.51 to $487.08.
  • Qualifying members should have received a check in the mail in September.
  • Not all policies and members qualify for a MLR refund. This refund is specifically for those members who enrolled in the qualifying plans and who were covered on December 31, 2012, under those policies.
  • Anthem cannot predict whether there will be refunds in future years. This specific refund is based on total claims experience of all Medicare Supplement policyholders of a particular policy or group of policies.

Members who have questions about Medicare Supplement refunds should call Anthem customer service toll-free at:

  • California - 800.333.3883
  • Colorado - 866.438.9969
  • Maine - 877.890.4507
  • Ohio - 866.649.2037
  • New Hampshire - 800.877.5228

Sincerely,

 

Chris Mihin, John Kirk and Sherry Weaver 

The Individual Health and Medicare Team

 

 

HORAN HWL