Medicare, Insurance and Health Care

Course Description


  This course is designed to give the reader background information on Medicare and Medicaid, such as the history of its enactment and how it has progressed from that time. Although the original intent was to create “cradle to grave” coverage, the course shows why it ended up only for citizens who were older aged.


  The course briefly looks at how Medicare operates as far as coverage is concerned, why private insurance plays a role in Medicare, and the Spousal Impoverishment Act of 1988. It examines the one-payor system of Medicare and how that compares to other government programs for health care.


  The course looks at funding for Medicare, how Part D was created and why it was created, and what the financial future for the government program looks like. Because COVID-19 affected Medicaid, the course also examines how this virus and future viruses might affect Medicare and Medicaid. The course looks at an insurer’s ability to use risk mitigation to prevent excessive claims and protect people in the process. It looks at why effective business interruption policies can benefit Medicare’s participants along with people on major medical plans.


  The course looks at types of insurance that may be used alongside other insurance plans, including short-term insurance policies, and other health insurance options that could be available when group plans are affected by something like COVID-19.


  This course examines how insurance companies might offer policies following pandemics like COVID-19 and why it is necessary for the insurers to consider changes that affect insurance producers and policyholders. One element affected is the life insurance industry, including key-man insurance. This course looks at how and why those who buy life insurance products might be affected in coming years because of the virus (applications and underwriting primarily). Some policy provisions will be directly affected by COVID-19.


  The course looks at the insurance contract and the producer’s role in the future regarding policy applications. It looks at policy ownership (and why ownership matters), premiums and what affects them, and policy options. It also considers beneficiary designations, whether contingent or vested interest, and other elements of the insurance contract, including policy participation.


  The course looks at the role played by annuities in Medicaid participation. This includes the choices that buyers make when purchasing an annuity insurance contract. It examines the NAIC’s annuity best-interest requirements, including required disclosure forms.


  The course looks at situations where the insurance producer might have conflicts of interest and how that relates to the client’s best interests. Deceptive sales practices are discussed. Basically, all the NAIC best interest obligations are considered in detail. That means the course also considers when buying an annuity is not in the buyer’s best interests and what producers have an obligation to do when that is the case.


  Chapter 3 looks at the 21st Century Cures Act, but only as it relates to Medicare and Medicaid. The course goes through the applicable sections one by one. That would include Title XV, Medicare Part A, Title XVI relating to provisions relating to Medicare Part B, and Title XVII, other provisions relating to Medicare. This final chapter is complicated and best suited to experienced agents. Agents lacking sufficient experience may need to read this chapter more than once to grasp the full impact of the law.



United Insurance Educators, Inc.

8213 - 352nd St. E.

Eatonville, WA 98328

(253) 846-1155