It’s no surprise that Medicare Advantage (MA) and Medicare Advantage Prescription Drug (MAPD) enrollment is growing rapidly, especially for group retiree plans. The flexibility and benefits offered to retirees by group MA/MAPD plans is unparalleled, presenting stiff competition to the traditional types of benefits provided to retirees, such as COB or Medicare Supplement plans. Group MA/MAPD plans can be customized to meet the needs of a particular plan sponsor and offer the flexibility to utilize a passive PPO network. In a passive PPO network, a member can see any provider as long as that provider participates in Medicare and accepts Medicare payments.
MA/MAPD plans are only available from private health carriers who contract with the Centers for Medicare and Medicaid Services (CMS). Under these plans, carriers are responsible for 100% of the plan coverage, so they handle all the administration and pay the claim. CMS provides funding to the carrier based on a number of factors, including the expected use of medical resources as well as the plan’s performance. Carriers are focused on providing high quality, value-based care, which specifically aims to improve outcomes and reduce costs for everyone. RetireeFirst’s carrier partnerships focus on working together to ensure the health and well-being of retirees. Improved outcomes help carriers drive value back into the plan, which can help with better renewals and/or extra services.
Helping Close Gaps in Care is Important to All Stakeholders
One important aspect for consideration in maximizing the value for all stakeholders is closing gaps in care and managing preventative measures. A focus on health and wellness helps drive a healthier population, leading to reduced healthcare costs and prolonging healthcare for all. Carriers have innovative health and wellness programs for retirees, and personalized member relationships are often the best way to connect retirees to them. That’s what we do best at RetireeFirst. Our service model pairs well with Medicare and forges personal relationships and trust. Our team of Advocates can tailor outreach and education, which leads to increased engagement and results for all stakeholders.
Unique Approach Keeps Beneficiaries Healthy, Lowers Healthcare Costs
Group MA and MAPD plans typically include more comprehensive coverage than other group retiree plans, including original Medicare. This enhanced coverage can include lower copays, provide access to 90-day supplies of medication through mail-order or retail pharmacies, and ancillary benefits, such as discounted gym memberships and health and wellness programs. When plan members take advantage of these programs, it can have a positive impact on their overall health, potentially resulting in fewer doctors’ visits, hospital stays and emergencies.
Many plan sponsors see the value of utilizing an advocacy program for their retirees to help them better understand their benefits and navigate the healthcare system, as well as engage most effectively in the health and wellness programs offered by their insurance carrier. Through RetireeFirst’s advocacy service, MemberFirst, creating a positive experience for retirees is our top priority. Our team of Advocates truly care about helping members navigate Medicare and improve their health and wellbeing, resulting in happier and more engaged members. It’s all part of our highly revered caregiver, people-centric model.
By educating members on the benefits of health engagement, Advocates help close gaps in care, create a positive experience, and ensure better outcomes for everyone.
To learn more about RetireeFirst’s services – designed to improve retiree health while saving sponsors and members money – please visit retireefirst.com/services.