Walmart And UnitedHealth Group Launch Medicare Advantage Partnership

Walmart and UnitedHealth Group are beginning a major 10-year collaboration to provide healthcare ... [+] Walmart

Walmart and UnitedHealth Group are rolling out a major partnership to provide healthcare services and “improve the patient experience” for Medicare Advantage enrollees in certain markets across the country.

The 10-year collaboration announced Wednesday between the retail giant’s fast-growing Walmart Health business and UnitedHealth’s Optum health services will begin in 2023 in Florida and Georgia where Walmart Health has a combined 15 locations. Eventually, the collaboration will be expanded across the U.S., serving Medicare Advantage health plan enrollees no matter which health plan seniors choose.

“This is Walmart being able to be provide care to all seniors 65 plus and for everyone who is eligible in Medicare Advantage plans,” Dr. Cheryl Pegus, executive vice president of Walmart Health & Wellness said in an interview. “No matter who your insurer is, this 10-year collaboration is going to enable us to deliver the care needed, first in Georgia and Florida.”

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. And in recent years, the Centers for Medicare & Medicaid Services has allowed Medicare Advantage plans to cover more supplemental benefits, adding to their popularity among seniors.

Across the country, health insurers have escalated expansions into new areas, pushing Medicare Advantage enrollment to record highs. Medicare Advantage plans added more than 2 million beneficiaries for this 2022 coverage year, boosting the program to 45% of all Medicare enrollment, according to a study earlier this year by The Chartis Group.

Over time, the collaboration could mean hundreds of thousands of new customers for both Walmart and UnitedHealth Group, which is already the biggest provider of Medicare Advantage coverage via its UnitedHealthcare health insurance business. UnitedHealthcare is the nation’s largest health insurer and includes 7 million Medicare Advantage enrollees.

“We’re on a journey to transform health care, connecting more people to the right care at the right time — at a cost that makes sense,” Walmart chief executive officer Doug McMillon said in a statement. “This collaboration puts the patient at the center of health care by leveraging the strength and complementary skill sets of our two companies to accelerate access to quality care.”

UnitedHealth chief strategy and growth officer Dan Schumacher said Optum’s role in the collaboration will be to help Walmart clinicians through Optum’s vast data and related analytics designed to improve patient outcomes. The Optum unit of UnitedHealth Group owns and operates hundreds of doctor practices, outpatient clinics, surgery centers and group practices as well as an analytics operation that uses data from its health plans and providers to improve care and outcomes.

Walmart Health facilities feature an array of primary medical services, urgent care including X-ray services, dental and eye care, and behavioral health services as part of a new model being replicated in several markets across the U.S.

The collaboration is expected to grow over time and spread to other markets across the country, which could mean a huge influx of seniors into Walmart Health locations and potentially more subscribers to UnitedHealth Group’s Medicare Advantage plans. The collaboration will also be working on new health plans created by UnitedHealth and Walmart.

Beginning in January, the collaboration will include a co-branded Medicare Advantage plan in Georgia called “UnitedHealthcare Medicare Advantage Walmart Flex.” Also in January, Walmart Health Virtual Care will be “in network for commercial members in UnitedHealthcare’s Choice Plus PPO plan, giving consumers another option to access care when and where they want it,” the companies said Wednesday.

“UnitedHealth Group and Walmart share a deep commitment to high-quality and affordable primary care led services that address all of a patient’s health needs in ways that are convenient for them and improve health outcomes,” said Andrew Witty, chief executive officer, UnitedHealth Group.

I’ve written about health care for three decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary

Source: Walmart And UnitedHealth Group Launch Medicare Advantage Partnership

Critics by

Walmart’s clinics could get a boost of new customers from UnitedHealth’s Medicare Advantage members, while UnitedHealth gains access to the largest U.S. retailer’s footprint and a venue to enroll more people, Evercore ISI analysts Mike Newshel and Elizabeth Anderson said in a research note. Walgreens last October invested $5.2 billion in primary-care provider VillageMD, which has more than 200 locations across 15 markets.

Walmart’s effort with UnitedHealth will target common ailments among aging Americans such as heart disease and diabetes. When it gets under way in January, the collaboration is expected to initially offer seniors healthcare at 15 Walmart Health locations in Georgia and Florida. The focus will be on value-based healthcare, a model in which hospitals and doctors’ offices are reimbursed for the care they provide through multiple Medicare Advantage plans.

Walmart already provides physicians, community-health workers, behavioral-health therapists and nurse practitioners to help serve seniors who are “already going to buy other products” at Walmart’s health facilities, she said. Walmart’s healthcare personnel will be able to use Optum, a health services company owned by UnitedHealth Group, which gives providers data analytics on patients. The collaboration also includes the expected launch of a Walmart and UnitedHealth Group co-branded Medicare Advantage plan in Georgia.

Walmart and UnitedHealth Group had partnered in January to provide free, at-home COVID-19 tests.

Medicare Advantage is leading the innovative use of value-based care — delivering better health outcomes, through better quality care at a better cost for Medicare beneficiaries.

  • Medicare Advantage is the public-private partnership in Medicare where 27 million seniors and Americans with disabilities receive coverage today.
  • 98 percent of Medicare Advantage beneficiaries report that they are satisfied with their health coverage, and 97 percent report satisfaction with their network of physicians, hospitals, and specialists.
  • Medicare Advantage enrollees report nearly $1,600 in savings compared to beneficiaries in Traditional Medicare.
  • Medicare Advantage’s population is increasingly diverse. 31.5% percent of beneficiaries are minorities, compared to 20.8% percent in Traditional Medicare.
  • Medicare Advantage beneficiaries experience more preventive care and screenings and lower rates of avoidable hospitalizations compared to those enrolled in Traditional Medicare.
  • Unlike Traditional Medicare, for which an individual pays a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs, Medicare Advantage typically covers all in one monthly premium, often with extra benefits at a lower cost to the enrollee.

Related contents:

What does CVS’s new deal signify about Medicare Advantage? The Health Care Blog

Letters: Enough with the Medicare calls. Require retention pond fences Columbus Dispatch, Ohio

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If You’re Still Working at 65, How To Avoid Costly Medicare Mistakes

Key Points
  • You could face lifelong late-enrollment penalties if you don’t sign up for Medicare when you’re supposed to.
  • The rules for enrollment when you already have insurance through your job depend partly on whether your employer is large or small.
  • It’s important to know that once you sign up for Medicare, even if only for Part A (hospital coverage), you can no longer contribute to a health savings account.

Workers who are nearing age 65 and have health insurance through their job may want to consider how Medicare could factor into their medical coverage.

While not everyone must sign up for Medicare at that age of eligibility, many are required to enroll — or otherwise face lifelong late-enrollment penalties.

“The biggest mistake … is to assume that you don’t need Medicare and to miss enrolling in it when you should have,” said Danielle Roberts, co-founder of insurance firm Boomer Benefits.

Roughly 10 million workers are in the 65-and-older crowd, or 17.9% of that age group, according to the Bureau of Labor Statistics.

The general rule for Medicare signup is that unless you meet an exception, you get a seven-month enrollment window that starts three months before your 65th birthday month and ends three months after it. Having qualifying insurance through your employer is one of those exceptions. Here’s what to know.

The basics

Original, or basic, Medicare consists of Part A (hospital coverage) and Part B (outpatient care coverage).

Part A has no premium as long as you have at least a 10-year work history of contributing to the program through payroll (or self-employment) taxes. Part B comes with a standard monthly premium of $148.50 for 2021, although higher-income beneficiaries pay more through monthly adjustments (see chart below).

Some 43% of individuals choose to get their Parts A and B benefits delivered through an Advantage Plan (Part C), which typically includes prescription drugs (Part D) and may or may not have a premium.

The remaining beneficiaries stick with basic Medicare and may pair it with a so-called Medigap policy and a stand-alone Part D plan. Be aware that higher-income beneficiaries pay more for drug coverage, as well (see chart below).

Remember that late-enrollment penalties last a lifetime. For Part B, that surcharge is 10% for each 12-month period you could have had it but didn’t sign up. For Part D, the penalty is 1% of the base premium ($33.06 in 2021) multiplied by the number of full, uncovered months you didn’t have Part D or creditable coverage.Working at a large company

The general rule for workers at companies with at least 20 employees is that you can delay signing up for Medicare until you lose your group insurance (i.e., you retire).

Many people with large group health insurance delay Part B but sign up for Part A because it’s free. “It doesn’t hurt you to have it,” Roberts said. However, she said, if you happen to have a health savings account paired with a high-deductible health plan through your employer, be aware that you cannot make contributions once you enroll in Medicare, even if only Part A.

Also, if you stay with your current coverage and delay all or parts of Medicare, make sure the plan is considered qualifying coverage for both Parts B and D. If you’re uncertain whether you need to sign up, it’s worth checking with your human resources department or your insurance carrier.

“I find it is always good to just confirm,” said Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans. Some 65-year-olds with younger spouses also might want to keep their group plan. Unlike your company’s option, spouses must qualify on their own for Medicare — either by reaching age 65 or having a disability if younger than that — regardless of your own eligibility.If your employer is small

If you have health insurance through a company with fewer than 20 employees, you should sign up for Medicare at 65 regardless of whether you stay on the employer plan. If you do choose to remain on it, Medicare is your primary insurance. However, it may be more cost-effective in this situation to drop the employer coverage and pick up Medigap and a Part D plan — or, alternatively, an Advantage Plan — instead of keeping the work plan as secondary insurance.

Often, workers at small companies pay more in premiums than employees at larger firms. The average premium for single coverage through employer-sponsored health insurance is $7,470, according to the Kaiser Family Foundation. However, employees contribute an average of $1,243 — or about 17% — with their company covering the remainder.

At small firms, the employee’s share might be far higher. For example, 28% are in a plan that requires them to contribute more than half of the premium for family coverage, compared with 4% of covered workers at large firms. Original Medicare consists of Part A (hospital coverage) and Part B (outpatient care coverage). Excluding limited exceptions, there is no coverage related to dental, vision or hearing, which can lead to beneficiaries forgoing care.

“It would be a significant improvement [to provide coverage] for people who often go without needed care because they can’t afford it and for people who pay a lot for the care they need,” said Tricia Neuman, executive director for the Kaiser Family Foundation’s program on Medicare policy. Some beneficiaries get limited coverage for dental, vision and hearing if they choose to get their Parts A and B benefits delivered through an Advantage Plan (Part C), which often include those extras. About 40% of beneficiaries are enrolled in Advantage Plans.

However, Lipschutz said, the extra coverage generally is not comprehensive. On the other hand, if expanded benefits — no matter how generous — were required under original Medicare, they’d become standard in an Advantage Plan.

Source: If you’re still working at 65, how to avoid costly Medicare mistakes

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IRS Delivers Covid-19 Surprise To Workers:  A Chance To Redo Their 2021 Health Plan And FSA Choices

If your employer lets you make changes to your workplace healthcare elections for 2021 under new Treasury guidance, it could cut your tax bill.

 

Wish you could change your health plan for 2021? In newly released guidance on new flexible rules for healthcare and dependent care FSAs, the Internal Revenue Service has included a new Covid-19-relief surprise: Employers can allow employees to make changes prospectively to health care coverage for 2021.

“The guidance is very employer and employee friendly; it really gives a lot of flexibility,” says Jake Mattinson, an employee benefits lawyer with McDermott Will & Emery in Chicago.

Notice 2021-15 allows for mid-year changes to employer-sponsored health care coverage, healthcare flexible spending accounts and dependent care accounts. It will help employees whose medical and caregiving situations have changed because of the coronavirus pandemic. That is, if your employer is on board.

Usually healthcare elections are set in stone on a calendar year basis. Last May, the Treasury Department came up with a partial mid-year fix for 2020, allowing prospective changes and extending grace periods and carryovers through year-end (IRS Notice 2020-29). But employees still cried foul: they had socked away more money than they could spend in these workplace tax-favored accounts, and would be subject to forfeiture rules.

In December, in the tax provisions tied onto the year-end spending package, Congress passed new special rules allowing rollovers and more for leftover 2020 and 2021 FSA money for employees and ex-employees. Notice 2021-15 answers a lot of the open questions about how to implement the new rules.

For 2021, you can revoke an existing healthcare plan election and make a new election, or revoke an existing election and attest that you’re getting coverage elsewhere. Say you picked an HMO plan, but really want to be in a PPO plan. Or say you decide you’d be better off under a spouse’s plan. This gives you the chance to make a mid-year change. That allowance is not in the December law, so it was a surprise, Mattinson says.

For healthcare and dependent care FSAs, the guidance says employers can allow employees to carryover unused amounts they’ve stashed in these accounts from the 2020 and 2021 plan years. It wasn’t clear before, but the IRS says that any plan can implement a 100% carryover or extended grace period, no matter what feature the plan had before, Mattinson says. That means employees might be able to carry over their whole balance (instead of just $550 under current law) from one year to the next.

The extended grace period could go out 12 months, instead of just 2.5 months. as of January 1, 2022, everything would shift back to the regular rules. Under the regular rules, you can stash up to $5,000 pretax per year in a dependent care FSA, but if you don’t use the money for the specified year, you lose it. You can put up to $2,750 in a healthcare FSA, and if you don’t use it, you may be able to either use it up during a grace period or carry over $550.

Don’t get your hopes up just yet: Employers have to adopt these changes, and while some have already been working on amendments to their plans based on the December law even before today’s guidance, others have decided to do nothing. “The reaction among employers is mixed; everyone has their own ideas of what to implement. It’s all optional,” says Mattinson. One client said they would implement it all, while another client said they wouldn’t make any of the changes, for example.

Some of the nitty-gritty guidance surrounds COBRA and health savings accounts. For COBRA, the guidance makes clear that if an employer lets terminated workers seek reimbursement from an FSA, that won’t hurt their qualification for COBRA. For health savings accounts, the guidance clarifies that for employees who want to make a midyear change into a high deductible health plan with an HSA, they could convert a general purpose FSA to a limited purpose FSA so as not to be disqualified from contributing to the HSA.

Notice 2021-15 is 34 pages long and includes detailed examples, suggesting this is an area of the tax code that could be simplified! Here’s a bullet point summary of the law changes addressed in the IRS guidance; employers can:

 

  • allow employees to carry over unused money up to the full annual amount from the plan year 2020 to 2021, and also from the plan year 2021 to 2022 for healthcare and dependent care FSAs
  • allow up to a 12-month grace period for employees to incur new expenses and submit claims against unused accumulated funds for plan years ending in 2020 or 2021 for healthcare and dependent care FSAs
  • allow midyear election changes on a prospective basis without a change in status event for plan years ending in 2021 for healthcare and dependent care FSAs
  • allow dependent care reimbursement up to age 14 in cases where an employee’s dependent turned 13 in 2020 and the employee had leftover funds from 2020 (this special carry forward rule helps employees whose dependents “aged out” during the pandemic) for dependent care FSAs
  • allow health FSA participants who stop participating in the plan (ex-employees) during calendar year 2020 or 2021 to continue to receive reimbursements through the end of the year, including grace periods (this post-termination benefit applies to healthcare FSAs, not dependent care FSAs)

 

Further reading: Healthcare And Childcare FSA Fix For 2021, Finally: Special Carry Over Rules And More

Follow me on Twitter or LinkedIn.

I cover personal finance, with a focus on retirement planning, trusts and estates strategies, and taxwise charitable giving. I’ve written for Forbes since 1997. Follow me on Twitter: @ashleaebeling and contact me by email: ashleaebeling — at — gmail — dot — com

Source: IRS Delivers Covid-19 Surprise To Workers:  A Chance To Redo Their 2021 Health Plan And FSA Choices

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