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    Home BlogPage 38

    Things you can’t say when selling Medicare

    By Ed Crowe | General Articles | 0 comment | 16 October, 2023 | 0

    Things you can’t say when selling Medicare

    There are very strict guidelines put in place by CMS that state the things you can’t say when selling Medicare plans.  We will cover some (not all) of them in this post.

    Click here to view the CMS Medicare Marketing guidelines.

    It may be difficult to understand but the CMS’ Final Rule 2024 states that agents must not use the word Medicare in any way that could be misleading or confusing either on your website or in the name of your business.  In some areas, you may need to remove the word Medicare from your business name.  Using the word Medicare in your business’ name may lead people to believe that you work for the government,

    It is important that prospects understand you are an independent advisor and represent a limited number of Medicare plans in any given area.  This language should be clearly stated on your website, business cards or any other marketing materials you hand out.

    Watch our YouTube video on Medicare Marketing rules

    We offer every Medicare plan available:

    Statements like this are not accurate considering that there are plans that do not even work with independent agents.  You may be appointed to sell several great plans, but misleading potential clients is not acceptable.  You must be very careful with the wording of anything you say or printed materials you use to represent your business.

    To read more about CMS’ 2024 Final Rule, click here.

    CMS also requires all TPMOs to put a disclaimer on all marketing materials or communications.  The disclaimer is also required when making phone calls to prospective clients.

    You cannot state that any Medicare plan is free:

    The marketing guidelines of CMS clearly state that neither Plan D plan sponsors nor agents can use the word free when describing a plan premium.  They are also not allowed to use the term free to describe a deductible or premium reduction a low-income subsidy or any cost sharing pertaining to dual eligible individuals.

    Although there are currently many Medicare Advantage plans that offer enrollees a $0 premium, using the word free to describe any plan can be confusing to some people.  Even if some plans do not charge a premium or co-pays for some services, that still does not mean the plans are free.  Enrollees will still need to pay co-pays, deductibles and co-insurance.   Clients must also use specific in-network providers for many services to be covered.

    Do not claim any plan will cover all of someone’s needs:

    There is no such thing as a plan that can cover every need of its members.  As an agent you should always look for the plan that best fits the needs of each individual client.  That is all anyone can do.  You must explain the pros and cons of each plan and provide a comparison of potential plans.  This way the client can choose which is the best fit.

    Never claim any one plan is the best plan available:

    As a sales agent, it may be easy to say one plan stands out as the best.  You should also know that the best plan for one person is not the best for another.  In this business there is no one fits all plan.  Each person has their own needs and wants when making a decision on which plan to choose.  Do not use misleading superlatives or unsubstantiated claims for advertising or when describing a plan to potential members.

    The only time it is ok to use superlatives in a plan description is when you have actual data to support your claim.  All claims either written or spoken must meet CMS requirements.

    A few more things not to say to clients:

    Do not tell a client that their current coverage might change.

    If you are looking at plan options for a potential client, you must explain the differences between a potential new plan and their current coverage.  This ensures they are satisfied with any plan changes they make.

    Never claim that Medicare approves of the benefits offered by a plan.

    Do not use this terminology when communicating with clients/potential clients either in person or on any marketing materials you use.

    Don’t mention products in a sales appointment that are not on your scope of appointment.

    If a client requests information about non-Medicare products during a Medicare sales appointment, you must tell them you can discuss these products at another time.  You should not try and bring up products that they did not agree to talk about when they signed the scope of appointment.  If they want to discuss life, annuities or other products, simply suggest an alternate time to discuss those products.

    Do not ask for contact information for your client’s friends or family.

    It is ok to let your clients know you appreciate a good review or referral. It is not ok to ask for anyone’s phone number or address if they did not consent for you contacted them.  You can provide clients with extra business cards to give to anyone who is interested in your services.  This way they can contact you if they choose.

    Never offer a gift or money to anyone for enrolling in a plan.

    It is important to know, it is illegal to offer gifts or financial incentives in exchange for enrollments.

    Click here for a generic scope of appointment.

    Take a look at our free training videos on YouTube

    See why you should work with Crowe and Associates

     

    Medicare Government Shutdown

    Medicare Government Shutdown

    By Ed Crowe | General Articles | 0 comment | 16 October, 2023 | 0

    Medicare Government Shutdown

    What Happens to Medicare During Government Shutdown?  As you’ve surely seen on the news, heard on the radio, or read in the paper, the United States government is facing a spending crisis. At the time of this article being written, lawmakers in Washington have until October 30th to pass a spending bill or the federal government will shut down, and many of the essential programs our citizens rely on will shut down with it.

     

    People are, reasonably, worried. Many of those people are older retirees who rely on Social Security and Medicare for their income and healthcare services. Since the federal government is in charge of these programs, people wonder, what happens to them during a government shutdown?

    The Good News

    Here’s the good news: “Checks will continue to go out,” according to Bill Sweeney, who is the senior vice president of government affairs at the AARP.  Mandatory spending include Social Security benefits.  These continue to go out to their beneficiaries. As far as Medicare goes, everything should continue mostly as normal. People with Medicare can continue to seek healthcare services.   Providers continue to get paid. Where this comes into question is based on how long a government shutdown, should there be one, continues. Medicare beneficiaries, Medicaid beneficiaries, and those enrolled in the Affordable Care Act could still use their coverage, and their doctors and providers could continue to submit bills and get paid.

     

    If a shutdown lasts a long time, it is more and more likely to affect those benefits. Medicare beneficiaries are most likely to feel an effect from a shutdown if the shutdown lasts a month or more. For the government shutdown looming at the time this article was written, Medicare has funding available for the next full three months, regardless of whether or not a spending agreement is reached before the October 1st deadline.

    Licensed Medicare Agents

    Medicare Government Shutdown- Click here to see what Crowe and Associates has to offer 

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    Aetna OTC catalog 2024

    Aetna OTC catalog 2024

    By Ed Crowe | General Articles | 0 comment | 14 October, 2023 | 0

    Aetna OTC catalog 2024

    If you are thinking about joining an Aetna Medicare advantage plan, you may want to take a look at the Aetna OTC catalog 2024.  Aetna provides 2 OTC catalogs for 2024.

    One is for members of participating MAPD plans.  This benefit is called OTCHS or over the counter health solutions.

    There are 3 ways to place an OTC order.

    If you are a member of an Aetna Medicare advantage plan; click the link below to download a copy of the OTC catalog.

    Download the MAPD OTC catalog 2024

    In store at a CVS pharmacy:

    there are a few exceptions; CVS pharmacies inside Target or Schnucks stores and some other select locations.  To see if your local CVS participates, just go to CVS.com/storelocator.

    You can refer to your OTC catalog to find the items that you want to purchase.  Please note: only items listed in the catalog are available with this plan.

    Once you are at the store, you can locate products marked with the blue shelf tag in the store.  Some store prices may differ from the price listed in the catalog.

    Redeem your benefit at any register by letting the cashier know you have the OTC benefit.  Just show them your member ID card of another valid ID and verify your eligibility for the quarterly benefit.

    The OTC Health Solutions offers members an easy way to access their benefit with the use of an app.  Just download the app from either the App Store for apple users or from Google Play for Android devices.  There are 3 steps to use the OTC app in CVS stores.  Some store have a dedicated OTCHS section.  If they do not, you an find eligible items with blue tags on store shelves.

    1.  Scan the item’s barcode to make sure it is an approved item.
    2. When you are ready to make your purchase, just show the cashier your digital barcode from you phone for a faster checkout.
    3. Once you are finished, you can check your remaining OTC benefit balance on your app as well as find answers to many FAQs.

    Purchase items online 24/7:

    First thing you will need to do is create an account.  Just go to CVS.com/otchs/myorder.

    Choose the create account button and follow the directions from there.  You will need your member ID, date of birth, zip code and email address.

    After you sign in, you will see your benefit amount displayed on the page.  You can then view available products and add them to your basket.  When you are finished shopping just click, checkout.  From there you will confirm the shipping address and review and place your order.  Items arrive within 14 days.

    You will receive an email with tracking information when your order is shipped.

    Order items over the phone:

    to place a phone order; call 1-833-331-1573 (TTY:711).  You will need to enter your birthdate so the system can verify your account.  They will also check your name and address.

    You should have the code for the items you wish to select.  If the item code is A10, you will enter the numerical code 10 only.  Once the system finds your item it will verify that it is correct.  When you are finished ordering, you can review the items in the cart and submit the order.

    Members of Aetna DSNP plans:

    Place OTC orders either online, by phone, through the mail or in select stores.

    Member of the Aetna DSNP plans can download a copy of their OTC catalog by clicking the link below.

    Download the Aetna DSNP OTC catalog 2024 Nations benefits

    To order by mail:

    please fill out the form provided in your OTC catalog and mail it to: NationsBenefits, 100 N. University Drive, Plantation, FL 33322.

    Ordering online

    Go to Aetna.NationsBenefits.com and create an account by following the instructions on the page.  Once you are logged in, you can:

    Search for items

    View product descriptions

    Check the available benefit allowance

    Order products

    Track your order

    Order by phone:

    To place a phone order; just call 1-877-204-1817 (TTY: 711).  Member experience advisors are there 8AM until 8PM, local time 7 days a week, except for holidays.

    Language support is available if needed.

    Please note:

    Due to the personal nature of the items, no returns or exchanges are permitted.  If you receive a damaged item, please call OTC health solutions within 30 days of receipt.

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    prepare for aep

    Prepare for AEP

    By Ed Crowe | General Articles | 0 comment | 13 October, 2023 | 0

    Prepare for AEP

    Prepare for AEP early.    As an independent insurance agent, Fall can be one of the most stressful times of the year due to the Annual Enrollment Period. But it doesn’t have to be! Although it will still be busy, there are four easy steps you can take now to ensure you’ll feel more prepared by October 15th. With these steps, you’ll be ready to capitalize on the biggest Medicare Advantage sales period of the year.

    Prepare for AEP – Take time to review and choose carrier plans

    This is the moment to take stock of your portfolio. Which carriers are you representing? Which of their plans have sold the best for you in the past? What do you have to offer new and returning clients? An agent should be familiar with the ins and outs of the plans they offer, including the benefits, costs, and applications so that you can meet the needs of your clients.

     

    Prepare for AEP -Get ready to sell

    Make sure that the basic requirements that you need to have met in order to legally and ethically sell Medicare Advantage have all been met. AEP is no time for surprises! Are your carrier certifications all completed? Is your AHIP exam completed and passed? Have you familiarized yourself with the new regulations from the Center for Medicare and Medicaid Services (CMS)? It is vital that you be in compliance with all certifications, exams, and regulations in order to sell Medicare products.

     

    Prepare for AEP -Gather resources and marketing tools

    AEP can go much more smoothly if you partner with an FMO, or a Field Marketing Organization. They often offer their agents and partners access to many free marketing tools and resources, like event planning, reimbursement for certain purchases that go towards marketing, compliance support, online portals for data analysis and platforms for call recording, and even teams of people whose job it is to support your sales.

     

    Look at the data

    This is a good time to look at the numbers from previous AEPs. Are there certain demographics you do particularly well with? Do you have some plans in your portfolio that haven’t sold well in a few years? Look for trends and patterns and use them to identify strengths and areas of improvement to focus your energy on during this AEP.

     

    With these steps, AEP may seem much less stressful than previous years, and maybe even much more exciting.

     Licensed Medicare Agents

    Prepare for AEP – Click here to see what Crowe and Associates has to offer 

    Keep up with all of our current events by clicking here. 

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    AEP Plan

    AEP Plan

    By Ed Crowe | General Articles | 0 comment | 12 October, 2023 | 0

    AEP Plan

    Develop a Marketing plan for AEP in 5 easy steps.  Even though Annual Enrollment Period 2024 is fast approaching, agents cannot actually begin marketing or selling Medicare Advantage products to clients until October 1st. However, there are plenty of things a savvy agent can do while they’re waiting to prepare themselves for what can be the most fast-paced time of the year. One way to get ahead is to develop a marketing plan. Here are five easy steps to creating your individual strategic AEP plan.

    Get specific about your target market

    The more specific you can be about who you want to reach, the better. Too often, the target is just “people over 65.” But who, really, are your key demographics? Are they married? Urban? Do they have any health conditions you can help them find specific coverage for? Are they from an area with fewer in-network providers? Essentially – who are the people you can most effectively help?

     

    AEP Plan – Know your audience

    It’s always valuable to get to know the people you’re selling to. This not only builds human connections and relationships between you and your clients, but it will help you integrate their unique needs and worldviews into your recommendations for their healthcare coverage. So, what kind of people are these? What do they watch, or read, or listen to? Who are their trusted news sources? Etc.

     

    AEP Plan – Get to know your competition

    This is an obvious one, but it’s important to find out what other agents and Field Marketing Organizations (FMOs) are doing in your area. If they have a specific niche covered successfully, you may want to develop a separate one. It is also worth asking if there is something you do well that they do not or cannot do. This will help you stand out from the crowd.

     

    AEP Plan – Make sure marketing is compliant

    Before October 15th, every marketing material, channel, video, website, and handout needs to be in compliance with all of the new regulations from CMS. That way, nothing will cause delays when AEP starts in earnest.

     

    AEP Plan – Check on returning clients

    Although you can’t talk about anything but their current year plans, it will be helpful to find out now what their experience of their Medicare Advantage plan has been like this year so that you can use that information to predict what kind of changes, if any, they’ll need to make in their coverage during AEP.

    Licensed Agents –

    AEP Plan – Click here to see what Crowe and Associates has to offer 

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    Inpatient vs. Outpatient

    Inpatient vs Outpatient

    By Ed Crowe | General Articles | 0 comment | 11 October, 2023 | 0

    Inpatient vs Outpatient

    It can be tricky to determine, at times, what is covered by Original Medicare and what is not. For instance, although Original Medicare has hospital insurance (Part A) and medical insurance (Part B), whether or not those insurances will cover hospital stays and procedures depends in large part on whether or not the patient is inpatient or outpatient. Beneficiary’s hospital status determines how much services cost in hospital, as well. To help clear things up, here are three real-life examples of what is covered and when:

    Susan goes to the ER with chest pain. She is then formally admitted to the hospital under a doctor’s orders.

    Inpatient vs Outpatient?

    In this case, Susan is an outpatient until she is formally admitted under the doctor’s orders, after which she is inpatient. Her Part A insurance would pay for her inpatient hospital stay and all related outpatient services provided in the three days before she was admitted. Part B of Medicare would pay for her doctor services.

    Jose goes to the ER with abdominal pain. The hospital keeps him overnight in observation, and then a doctor writes an order for admission on the second day.

    Jose would be inpatient after the doctor writes the order for admission on the second day, and his Part A hospital insurance would cover accordingly, including the outpatient services in the three days before admission (the overnight observation). Additionally, his medical insurance (Part B) would cover his doctor services.

    Laura is in the hospital for an outpatient surgery, but then is kept overnight due to high blood pressure. The doctor does not write an order to admit her, and she is released the next day.

    In this case, Laura is never an inpatient, and her hospital insurance would cover none of those services she used while on overnight observation. However, her Part B insurance would cover her doctor services and all relevant outpatient services she received at the hospital.

    These examples provide some real-life stories to help clarify what is covered by which part of Medicare and when, so you can best help your clients understand their benefits.

    Licensed Medicare Agents

    Click here to see what Crowe and Associates has to offer 

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    Life Insurance Myths

    Life Insurance Myths

    By Ed Crowe | General Articles | 0 comment | 9 October, 2023 | 0

     Life Insurance Myths

    Life insurance is not required by law like many other types of insurance, and many people choose to forgo these policies. However, it can be an extremely valuable investment in your financial health and that of your family. Let’s clear up some of the life insurance myths.

    Only the elderly need life insurance

    Life insurance policies are more affordable for younger applicants!  Don’t be fooled by this mythIt makes the most sense to purchase earlier rather than later. Many term life insurance policies are also made with the option to be rolled over into whole life policies once the beneficiaries are older.

    It’s too expensive

    Polls show us that this myth is so pervasive that over 50% of people overestimate the cost of life insurance. Just like with other types of insurance, policy cost is determined based on age, driving record, health, gender, etc. so there is a lot of variation in plan premiums. There are many affordable options for life insurance that can fit your budget.

    If you don’t work outside the home, you don’t need it

    Life insurance policies aren’t just about covering lost wages.   That is one of the life insurance myths.  They’re about being able to replace critical work, including domestic work. A stay-at-home parent can be a driver, tutor, cook, day-care, cleaner, and babysitter that goes uncompensated. If that person were to pass away unexpectedly, all of those roles would have to be replaced and compensated.

    I have group life insurance – that’s enough

    Some people get group life insurance through their work. But what happens if they’re laid off, or the company goes under? In addition to that risk, many employer-provided policies offer only several thousand worth of coverage, which wouldn’t put much of a dent in more than funeral costs.

    Personal savings is the same thing – life insurance myths

    Personal savings can be a great thing to have, but it is not the same as a life insurance policy. For one thing, personal savings can often be easily drained with one unexpected hospital stay. For another, there is no need to limit the amount of support a family receives after the death of a loved one. The more financial support there is, the fewer things there will be to worry about during that difficult time.

    I can’t buy life insurance with my pre-existing condition

    Do not fall prey to this life insurance myth.  If the pre-existing condition is minor or the beneficiary is managing the condition with medical treatment, there are many policies to choose from that will simply charge slightly more for coverage despite that condition. There are also guaranteed issue policies, which guarantee coverage without any disclosure of medical history or exam, meaning that they will be more expensive, but provide the coverage regardless of pre-existing condition.

    Life insurance can be a powerful tool in planning for the financial security of a family, and it’s helpful to understand exactly what it is and what it can do before making any decisions about it.   Don’t let any life insurance myths confuse you.

    Licensed Agents

    Are you a licensed certified Medicare or agent already dispelling life insurance myths?   Work with a better FMO.   Click here to see what Crowe and Associates has to offer. 

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    Subscribe to our YouTube channel.   We provide weekly training.  We cover up to date topics on webinars.   And, we host weekly zoom calls.  Additionally, use this opportunity to network with other agents.

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    Medicare Sales Tips

    Medicare Sales Tips

    By Ed Crowe | General Articles | 0 comment | 5 October, 2023 | 0

    Medicare Sales Tips

     Let’s be honest: generational differences are real, and people do change as they age. And they should! Priorities change as your life changes, and with advanced age usually comes advanced experiences and perspective. As Medicare insurance agents, the majority of your client basis is likely going to be 65 or older. Here are four Medicare sales tips to keep in mind when communicating with this population:

     

    Use the proper terms

    Ever had to hesitate before using a term for older people in a conversation? Do they prefer seniors? The elderly? Aged? No one wants to be offensive, and everyone has different preferences for how to be referred to. The good news is that there have been studies done on which terms for older people are the most well-received. In general, the term “older” is the most widely accepted by this age group. There’s nothing wrong with being an older person, and it’s true to their experience. Most people also like “seniors,” although not “senior citizens,” as they feel that it’s patronizing. The least liked term according to these studies was “elderly,” as people thought it made them sound frail. “Elder,” however, has a positive connotation associated with advanced wisdom and experience. Now, there are always exceptions to every rule, but with this knowledge you’ll be less likely to unintentionally offend your clientele.

     

    Don’t use Senior Speak

    This is one of the important Medicare sales tips when dealing with individuals over 65.  Speaking of seniors, there’s a verbal phenomenon that we’ve noticed that they really don’t like. Ever heard of Senior Speak? It’s when people use simplified language and even a higher pitched voice while talking to older people. Sometimes they use names like “sweetie” or “dear” instead of the person’s actual name. They might even be unaware they’re doing it. It can come off as extremely patronizing and condescending, since they wouldn’t be doing that with younger clients. It’s based on the assumption that the older clients cannot understand what you’re saying as well as younger ones, which is not only a rude assumption but, most of the time, completely incorrect. Making a conscious effort to communicate normally with older clients will prevent you from unconsciously slipping into Senior Speak and risking your sale.

     

    Medicare Sales Tips – Practice patience

    Let’s just be frank: You’re going to have to repeat yourself with clients over 65. Not because they are slower or don’t understand what you’re saying, but because for most of them this is the first time hearing all of the information you’re telling them. And it is a lot of information, with jargon and acronyms and things that take time to understand. They will have questions that seem obvious to you because you work in the industry and deal with the information every day. For people outside the industry, it can be very complicated. Using analogies and real-life examples can be very helpful for clarification.

     

    Guide, don’t decide

    Everyone wants to be in charge of making their own decisions. While you may think you know what’s best for your client, you still need to allow them to make the final decision on the best plan for their healthcare needs. A good mantra here will be, “Guide, don’t decide.” You cannot make the decision for them, but you can gather enough information about their healthcare needs and desires to guide them in the right direction towards choosing a plan that compliments their lifestyle.

     

    Putting these four tips into your toolbox can help ensure that you’re practicing effective and respectful communication with a large portion of your client base.

    Licensed Agents

    Medicare sales tips  – Click here to see what Crowe and Associates has to offer 

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    CMS Rules 2025

    CMS Rules 2025

    By Ed Crowe | General Articles | 0 comment | 4 October, 2023 | 0

    CMS Rules 2025

    CMS announced changes to drug  cost rules. The Center for Medicare and Medicaid Services (CMS) adjusts rules and regulations yearly.  This is to optimize the effectiveness of the federal Medicare program. Recently, they announced a new development that was a direct effect of President Joe Biden’s Inflation Reduction Act. The Inflation Reduction Act (IRA) included a larger redesign of the Medicare Part D prescription drug benefit. It is part of an attempt by the Biden administration.  And, is intended to address the high cost of prescription drugs in the United States.  Let’s discuss the CMS rules 2025.

    Guidance

    The Center for Medicare and Medicaid Services released the first of several guidance documents regarding this change, called the Medicare Prescription Payment Plan program. It is a voluntary program meant to allow Medicare beneficiaries to spread the out-of-pocket cost of their prescription drugs over twelve months. The Medicare Prescription Payment Plan, a monthly payment plan, is designed to help “those who struggle the most with high upfront prescription drug costs,” according to the director of Medicare, Meena Seshamani. The Inflation Reduction Act also included a $2,000 cap on out-of-pocket prescription drug costs under Part D, which will take effect in 2025.

    Essentially, starting in 2025, seniors will be able to pay their prescription drug costs in capped, regular monthly payments instead of in lump sums at the pharmacy during pick up. According to a statement released concerning the new regulations by CMS, “This will be helpful for people with Medicare Part D who have high cost-sharing earlier in the plan year by spreading out those expenses over the course of the year.”

     

    This is all good information and good news for beneficiaries, but insurance carriers have questions. There is not yet guidance on how this new regulation will affect the insurance carrier’s plans for 2025. CMS rules 2025  information will be available in the next draft of guidance that is released.   And,  carriers will have to wait until early next year.

     

    Licensed Agents

    CMS Rules 2025 – Click here to see what Crowe and Associates has to offer 

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    Improve Website Conversion Rate

    Improve Website Conversion Rate

    By Ed Crowe | General Articles | 0 comment | 2 October, 2023 | 0

    Improve Website Conversion Rate

    There’s endless ways that the ubiquitousness of the internet has changed the insurance industry. Agents who sell Medicare can now enroll people over the phone from their computer, all while being in compliance with all of the rules and regulations from the Center for Medicare and Medicaid Services. This is also why it’s so vital for your business to have a user-friendly website. Your website is free advertising, and it will be how many of your clients will find your services. But, if your website isn’t driving possible clients to contact you, or take other related actions, it needs some work. Here are some tips to improve your website’s conversion rate and provide more actionable steps for your future clients.  Improve your website’s conversion rate with these tips.

    Understand the importance of conversion rate

    Conversion rate is the percentage of online visitors that take a desired action when they visit your website. For many agents, that would be clicking a “contact us” button, or even a “request a meeting” button. Conversion rate is such an important metric because it is a way to measure how successful the website is at advertising and representing your services. It’s a marketing metric.

    • Optimize your website

    If the call-to-action buttons aren’t prominently displayed, your conversion rate will likely be lower than it could be. If your interface is clunky, or the graphics are cheesy, or the website isn’t streamlined for ease of use, all of these things can lead to lower conversion metrics. Review your website as if you are a customer. Is it doing the most it could be doing to convince visitors to act?

    • Write engaging copy

    The copy on your website should be clear and concise, yes, but this is also an opportunity to engage with your prospective clients. Let your voice come through as well, because your likability can be helpful in motivating people to act.

    • Use social proof

    Social proofs are customer testimonials, reviews, or real-life examples that show that your previous clients are happy with their experience. These count for a lot with encouraging prospective and new clients to act when they visit your website.

    If you think of your website as an extension of your agency, then visitors are really experiencing a first-impression of working with you when they are on your website. Make it a good first impression with these tips and watch your conversion rate increase.

    Licensed Agents

    Not only can we  help Improve Website Conversion Rate- Click here to see what Crowe and Associates has to offer 

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    Medicare Advantage Year in Review

    Medicare Advantage Year in Review

    By Ed Crowe | General Articles | 0 comment | 28 September, 2023 | 0

     Medicare Advantage Year in Review

    In nearly every line of work, circumstances can evolve and change at a rapid rate. In the Medicare field, there are so many moving parts because of the involvement with the federal government, assorted agencies, state governments, and private insurance carriers, it is vital to review the data from previous years to see what the rundown is. This can help inform savvy agents as to what to expect from the coming year as well as offer valuable perspective. These are some of the key trends and takeaways from Medicare Advantage in 2023.  Here is the Medicare Advantage year in review.

    MAPD

    • More than half of the people eligible enrolled in Medicare Advantage (MAPD) for 2023. That’s approximately 51% of beneficiaries, or 30.8 million people. As a piece of the eligible Medicare population, that means that that figure has jumped up by 19% in 2007 to 51% in 2023. Since 2022, the population enrolled in Medicare Advantage has increased by 8%. In the next decade, the percentage is expected to rise to over 62% enrolled in Medicare Advantage.

     

    • One in five beneficiaries of MAPD are enrolled in a plan offered by a union or an employer. That is about 5.4 million people, or about 20% of the population. In the following five states, the group enrollees counted for a third or more of all enrollments: Alaska, Michigan, New Jersey, Maryland, and West Virginia.

     

    • In the past five years, enrollment in Special Needs Plans (SNPs) has doubled. This means than 5.7 million Medicare beneficiaries are enrolled in special needs plans.

     

    • Two private insurance carriers, Humana and UnitedHealthcare, account for nearly half of all Medicare Advantage (MAPD) enrollment nationwide. Together, the two companies account for about 47% of Medicare Advantage enrollment

    This brief overview of some of the more variable statistics from this year may help agents to plan ahead for the future. For instance, the market for Medicare Advantage plans is expected to continue to grow. What can you do now to optimize your business?

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    Tips for AEP 2023

    Tips for AEP 2024

    By Ed Crowe | General Articles | 0 comment | 27 September, 2023 | 0

    Tips for AEP 2024

    Fall is on its way, and that means that the Annual Enrollment Period, or the AEP, is fast approaching. It’s often the busiest time of the year for agents and brokers. The vast majority of Medicare sales happen in that short 54 day period, and it can be stressful. Here are four questions to ask yourself and your agency before the AEP begins so you can optimize your success:

     

    Am I following the new compliance rules?

    As you surely know by now, the new rules from the Center for Medicare and Medicaid Services (CMS) are out and they have made some changes to their categorization of agents. All insurance agents and brokers are now considered Third Party Marketing Organizations (TPMOs). This comes with some new rules, including these disclaimers, which are required by law to be on all communications (website, emails, print, etc.).

     

    If you are marketing fewer than all of the plans available in your area, use this one: “We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”

     

    If you are marketing all of the plans in the service area, use this one: “Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.”

     

    Am I recording phone conversations with clients eligible for Medicare?

    This is another new regulation from CMS for this coming AEP season.  All calls with people who are Medicare eligible must be recorded (not just sales calls). This is to protect both the agents and the clients. There are many programs available to help make this process as streamlined as possible, like CallVault.

     

    Who have I had the most success helping lately?

    It is a good time to reflect on the last few successful client interactions you’ve had. Is there something they have in common? Did you use a certain approach with all of them, or did they share a common thread? Are they all from a certain background, of a certain age, or did the lead come from a particular source? And, are the clients you’re having the most success with also the clients that you’re spending the most time and money to access?

     

    What does my Medicare portfolio look like?

    Do the Medicare Advantage plans, prescription drug plans, and Medicare Supplement Insurance plans (or Medigap) fulfill the needs of your clients? Are they finding these plans appealing, or are they looking for something you currently don’t carry? If the products you have are what the clients are looking for in your area, that makes sales all the more simple.

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