Medicare sales without certifications
Medicare sales without certifications is a strategy for agencies that want to offer Medicare without the need for annual certs. Many agencies avoid Medicare due to the annual certification requirements on MAPD and PDP plans. A Medicare supplement only sales model will avoid the need for annual certs and also the annual AHIP cert requirement. In fact, this post will detail the best ways to offer supplements only to clients. As a result, agencies can add additional revenue they are currently leaving on the table.
Which plans require annual certifications?
Medicare Advantage plans of all types (PPO, HMO, PFFS, POS) and PDP plans require annual certifications. The requirement is for each company. As a result, some agents need to go through multiple certs every year to cover all the companies they offer. If the agents are using multiple companies, there is a high probability they will also need to take the AHIP cert every year as well. PDP plans also require certs which can be time consuming for those with multiple competitive PDP plans in their markets.
How do you offer Medicare without the certification requirements?
In any event, the only way to do this is by offering Medicare supplement plans only. It is true that some clients will only want a $0 premium MAPD plan but most will be open to looking at various Medicare supplement plans. A PDP plan is usually involved because 8 out of 10 Medicare supplement enrollees also take a PDP plan. There is an easy way to handle the need for a PDP plan with clients which will be reviewed in detail below.
What supplement plans need to be offered?
Sometimes both the state and the county you sell in will have a major influence on this answer. In general, to make Medicare sales without certifications work, you need to offer plans F, G and N as your high end bases offerings. You will also need some well priced lower cost options such as L, K and High Deductible F plans for those that need lower cost options. Agents will lose some sales to prospects that want a $0 premium MAPD plan but that will be a manageable number using a supplement only approach. Without the lower cost supplement option, there will be a large number of clients that simply will not want to pay the F,G or N premium.
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Benefits of the Medicare Supplement plans
To successfully offer Medicare sales without certifications it will be critical to understand the benefits and in addition, have a strong understanding of the clients out of pocket costs. Here is a quick rundown of each plan and the benefits they offer. Keep in mind, supplements only work with services approved by Medicare.
- Plan F- covers 100% of deductibles, co-insurance and copays not covered by Medicare. If Medicare covers a portion of the cost, the plan F will cover the remainder
- Plan G- Same benefits as plan F with the exception of the Medicare Part B deductible of $183. The Part B deductible is not covered by Plan G.
- Plan N- Plan N covers everything plan F covers with three exceptions
- Part B deductible of $183 is not covered
- Client can pay up to $20 for any physicians services (primary or specialist)
- $50 co pay for Emergency room visits
- Plan L- Plan L covers 75% of the costs not covered by Medicare A and B. Be sure to know your Medicare A and B benefits to understand what this means. There is an annual out of pocket max on Plan L of $2,560 for 2017.
- Plan K- Plan K will pay 50% of costs not paid by Medicare A and B. The annual out of pocket max on Plan K is $5,120
- High Deductible Plan F- This is one of the easier plans to sell if the agent and the client understand it. Click here to learn how the high F plan works. Take the time to learn the high F plan because the math supports enrolling every Medicare supplement client into this plan. I am not saying you should do that but the math supports it.
How much do clients pay toward Medicare out of pocket?
The reality, is clients pay a very low amount out of pocket on Medicare cost share (hospital A deductible and part B deductible and 20% coinsurance). Plans L, K and high F work so well because the client is only paying 20% of what medicare allows which is a huge reduction off of the normal charges. To understand this better, look at an article posted by a physician regarding Medicare cost share. Click for better understanding of Medicare A and B cost share
What about the Part D PDP plan?
If you want to sell the PDP plans to your clients, you will need to do the annual certs associated with them. To avoid the need for certs send you clients to the consumer facing CMS website which will do the work for them. They can go to the site, enter their medications and location and the site will find them the lowest cost plan. Click here for the CMS drug finder website.
The United Health Care Branded Supplement problem
The one flaw with the Medicare sales without certifications strategy is UHC branded Medicare supplements. UHC Medicare offers competitive supplements in many states. Some clients will want UHC based on name alone. You can receive compensation if you offer UHC branded Medicare supplements to your clients. The only issue is the cert. They are the only company that requires a cert for Medicare Supplement sales. You do not need to take AHIP but they do require an annual cert to sell the Medicare supplement plan. Luckily, the certification is not difficult and will not take much time. Some agents will avoid UHC Medicare branded supplements due to this issue. My suggestion would be to take the cert every year in order to offer them.