Medicare special enrollment period
If you have a client that needs a Medicare plan outside their IEP, you need a Medicare special enrollment period to get them the coverage they need. In this post, we go over the different special enrollment periods and how clients qualify.
Understanding Medicare Special Enrollment Periods
Medicare Special Enrollment Periods are designated times outside of the IEP (Initial Enrollment Period) or the AEP (Annual Enrollment Period) when individuals can make changes to their Medicare coverage. These periods are only allowed under specific circumstances. The SEP provides an opportunity for individuals to enroll in a Medicare plan or change their existing coverage.
Watch a YouTube video on SEPs
Qualifying Events for SEPs
There are several life events that provide Medicare beneficiaries an opportunity for a Special Enrollment Period. We have listed some of the more common events that qualifying for an SEP below.
Moving
If a beneficiary moves to a new location that isn’t served by their current Medicare plan, they are eligible for an SEP.
Losing employer coverage
When an employee or their spouse loses their existing employer-sponsored health coverage, they qualify for a SEP to enroll in Medicare.
Qualifying for Extra Help
If a beneficiary qualifies for either their state’s Extra Help program or Medicaid, they qualify for an SEP and have the ability to change their plan as much as 1 time per quarter for the first 3 quarters of each year.
Click here to view more SEP details
Maximizing Special Enrollment Periods
If your client qualifies for a Special Enrollment Period, it’s essential to act promptly to make sure they get the coverage they need within the time limits for the SEP. Here’s what you need to know to use the SEPs:
Know the deadlines
Each Special Enrollment Period has a specific deadline, so be sure to understand when the enrollment window opens and closes.
Review all plan options
Agents should take the time to review their client’s Medicare coverage options carefully. Consider factors such as premiums, deductibles, copays, network of providers as well as prescription drug coverage (when applicable) to find the plan that best fits their personal needs.
We provide many benefits to all our agents, including free quoting & enrollment tools. These quote engines make it easy to look at the top plans side by side for your clients review.
Learn about Connecture & Sunfire
Explore Additional Benefits
Medicare Advantage plans offer additional benefits beyond Original Medicare, such as dental, vision, otc benefits, and much more. Show the client a side by side comparison of the top plans and see e which one fits their needs.
Stay Informed
Keep yourself informed about changes to Medicare rules and regulations, as well as any updates to coverage options. Staying informed helps agents remain compliant and provide the best advice to their clients.
Find out about SEPs for Emergencies or Disasters
Medicare Special Enrollment Periods are valuable opportunities for individuals to changes their coverage outside of typical enrollment periods. By understanding who qualifies for a Special Enrollment Period and how to use it, you ensure that clients have the coverage they need.
It is important to review all the options available to your clients and be sure they make an informed decision. Click here to learn why you should contract with multiple Medicare carriers.
Hospital Indemnity plans
If you are a Medicare agent, it is a good idea to consider adding hospital indemnity plans to your product offerings. In the event someone becomes ill and is hospitalized, these plans provide clients an additional layer of coverage. Hospital Indemnity insurance provides policyholders a chance to protect their savings and lower their out-of-pocket costs.
It is important to note; when it comes to hospitalization, there are limits to what Medicare Advantage or Medicare supplement plans cover. When that happens, a hospital indemnity plan can provide an extra peace of mind for beneficiaries.
What is hospital indemnity insurance
Hospital indemnity insurance is additional health coverage that individuals can purchase and add an extra layer of protection. These plans have a monthly premium like other insurance coverage. If the beneficiary has to stay in the hospital, they receive a fixed payment amount they can use to cover any out-of-pocket costs members incur. Beneficiaries can use the payment to cover whatever they need such as, deductibles, co-pays, medication or for things like rehabilitation or home care expenses.
Unlike other insurance plans, hospital indemnity policies send payments directly to the policyholder. This gives beneficiaries more freedom to choose where their money goes. A good hospital indemnity plan should be easy to get, has no deductible or pre-certification and is not difficult to get payments from when you need them.
What hospital indemnity insurance covers
The coverage provided by a hospital indemnity plan depends on the plan chosen and the riders added. We have listed a few basic things these plans cover below.
- When a beneficiary has a hospital stays weather or not surgery takes place.
- If they are confined in an ICU (intensive care unit).
- In the event they are confined in a CCU (critical care unit).
Additionally, there are plans that offer coverage of all or some of the items listed below.
- If a beneficiary has medically necessary outpatient surgery , as opposed to an elective outpatient surgery.
- If they require outpatient diagnostic imaging procedures, x-rays or lab procedures.
- Some plans include payments for ambulance services.
- There are plans that event pay for emergency room visits or specific doctors office visits (not routine annual checkups).
Waiting periods for benefits
In most cases, there is a 30 day waiting period for illnesses that result in a hospital stay. The waiting period varies by carrier and the plan chosen. However, some plans will not have a waiting period for hospitalization for an accidental injury. It is important that enrollees understand all benefits of their plan choice, including waiting periods, before they decide on a policy.
Hospital Indemnity plan cost
Hospital indemnity plans charge a monthly premium like any other health insurance. The cost depends on several factors including the plan & company choice, as well as age, gender and location.
It is important to consider if hospital indemnity insurance is worth getting or not. The beneficiary needs to consider what their current health plan covers, their out-of-pocket cost including deductibles and co-pays and co-insurance and the cost for an average hospital stay. They also have to take into account their personal financial situation and if they can better afford the coverage or payment for the out-of-pocket expenses.
Opportunity for cross sales
Hospital indemnity plans provide a great opportunity for Medicare agents to make a cross sale. Many of your current clients could benefit by purchasing one of these plans. Clients who enroll in a Medicare advantage plan without a premium ($0) may want to add an affordable hospital indemnity plan that adds that extra layer of protection. Their Medicare advantage plan may leave them paying high co-pays or deductible for a hospitalization. Be sure to go over their budget and possible value of adding the coverage.
Agents should go over the average cost of a hospital stay and the possible out-of-pocket cost as compared to the cost of adding a hospital indemnity plan. Do the Math for them. Make sure it is a viable option before they sign up.
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Rules for hospital indemnity insurance sales
It is important to remember, there are rules to follow when you offer a hospital indemnity plan to a client. Agents cannot mention this or any other product at a Medicare appointment if it is not included on the scope of appointment.
Watch a YouTube video on the scope of appointment rules.
Medicare enrollment dates
If you are either getting close to your 65th birthday or are in Medicare sales, you should understand the Medicare enrollment dates.
Enrolling in Medicare can be confusing for beneficiaries and understanding the enrollment process is crucial to access the benefits your clients need. From IEPs to SEPs, the Medicare system is designed to accommodate various life circumstances. In this post, we go over several of the Medicare enrollment periods and how beneficiaries can use them to get the healthcare coverage they need.
Initial Enrollment Period (IEP)
The Initial Enrollment Period (IEP) is the first opportunity for most individuals to enroll in Medicare. IEP is a 7 month time frame that starts 3 months before the month of your 65th birthday, includes your birthday month, and ends three months after the month you turn 65. During this period, individuals can sign up for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) if they choose to.
Learn more about enrollment periods
Special Enrollment Periods (SEPs)
Special Enrollment Periods (SEPs) are designated times outside the initial enrollment period when individuals can sign up for Medicare due to specific qualifying events. Some of the most common qualifying events include:
Loss of Employer Coverage
If a beneficiary is covered under a group health plan through their own or their spouse’s current employment, they are eligible for an SEP when they lose the employer coverage.
Moving out of the plans service area
When a client moves out of their plan’s service area, they qualify for an SEP to enroll in a new Medicare plan.
Becoming Eligible for Extra Help
Individuals who become eligible for Extra Help with Medicare prescription drug costs qualify for an SEP to enroll in a Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan (Part C) that includes prescription drug coverage.
General Enrollment Period (GEP)
For individuals who miss their initial enrollment period, the General Enrollment Period (GEP) provides another chance to enroll in Medicare. The GEP runs each year from January 1st to March 31st. Coverage obtained during this period begins the first of the month after you enroll. it’s important to note, beneficiaries who wait until the GEP may have to pay a late enrollment penalty.
Click here to learn about late enrollment penalties LEPs
Annual Enrollment Period (AEP)
The Annual Enrollment Period (AEP), also known as the Medicare Open Enrollment Period, runs each year from October 15th until December 7th. During this time, Medicare beneficiaries can make changes to their Medicare coverage. This includes; switching from Original Medicare and Medicare Advantage plans, as well as joining, dropping, or switching prescription drug plans.
How to best use the Medicare enrollment dates
- Stay Informed: Keep track of your eligibility and enrollment periods to ensure you don’t miss important deadlines.
- Review Your Coverage Needs: Regularly assess your healthcare needs to determine if current coverage is still suitable or if changes are necessary. Agents make sure you contact your clients regularly, especially during AEP to go over coverage options for the following year and ensure they are happy.
- Seek Assistance if Needed: If you have questions or need guidance regarding Medicare enrollment, it is best to reach out to a licensed insurance agent.
Medicare agents be sure to maintain your book of business, click here for some ideas.
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Understanding Medicare enrollment dates is essential for to ensure beneficiaries have access to the healthcare coverage they need. By familiarizing yourself with the various enrollment periods and their significance, you can navigate the Medicare system with confidence and peace of mind. Remember, staying informed and proactive is key to making the most of your Medicare enrollments.
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Medicare Supplement Free Look Period
If you are an agent who offers Medicare plans, it is important to understand opportunities to provide clients with the coverage they deserve. For those enrolled in Medicare, supplement plans offer an additional coverage option. Because choosing the right supplement plan is an important decision, sometimes a client may change their mind. To safeguard against errors, Medicare offers the free look period. In this post, we discuss the Medicare supplement free look period, why it’s important, and how beneficiaries can use it.
Learn the difference between Medicare Supplement and Medicare Advantage plans
What is the Medicare Supplement Free Look Period
The Medicare supplement free look period is a time beneficiaries can review their new Medicare supplement plan and, if unsatisfied, make changes without penalty. This period typically lasts for 30 days after the plan’s effective date.
If the client buys a Medicare Supplement policy during their 6-month Medicare Supplement OEP and are unhappy with it, they can change to another Medicare Supplement policy. When the client gets a new (second) Medicare Supplement policy, they have 30 days to decide if they are going to keep it. This time period is called the 30-day free look period. The client shouldn’t cancel the first Medicare Supplement policy until they are sure they want to keep the second Medicare Supplement policy. Unfortunately, they have to pay both premiums for the month they have both.
Reasons to change a supplement plan
- Paying for benefits you don’t need.
- Client needs more benefits.
- Do not like the insurance company
- They need a lower cost plan
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Why Does the Free Look Period Matter
Peace of Mind
Because choosing a Medicare supplement plan is overwhelming, sometimes beneficiaries make decisions in haste or without full understanding. This can lead to dissatisfaction. The free look period offers reassurance to beneficiaries, allowing them to thoroughly evaluate their plan and its benefits at their own pace.
Risk Mitigation
Mistakes in selecting a Medicare supplement plan can be costly, both financially and in terms of coverage gaps. The free look period serves as a safety net, enabling beneficiaries to rectify any errors or misunderstandings without facing financial penalties or being locked into a plan that doesn’t meet their needs.
Consumer Protection
The free look period is designed to protect Medicare beneficiaries from being pressured into purchasing plans that may not be suitable for them. It empowers individuals to make informed decisions about their healthcare coverage without feeling rushed or coerced.
Medicare supplement plan comparison – click here
Making the Most of the Free Look Period
Thoroughly Review the Plan
It is important to go over all aspects of the Medicare supplement plans your client is considering. Please remember, this not only includes coverage but all costs involved.
Compare Plans
To ensure the client has made the best plan choice, agents should comparing it with other available plans. This can help you identify any discrepancies or better alternatives.
Seek Guidance
Beneficiaries should reach out to a licensed insurance agent for assistance. They provide valuable insights and help navigate the confusing landscape of Medicare coverage.
Document Everything
Important: clients should keep detailed records of their conversations with insurance provider representatives. They need to include any changes made to their plan or communications regarding the free look period. This documentation serves as evidence in the event there are any disputes or discrepancies.
The free look period is an opportunity for beneficiaries to ensure they have the right coverage for their healthcare needs. Individuals who take advantage of the free look can make informed decisions. They can also, rectify mistakes, and achieve peace of mind regarding their healthcare coverage. Remember, health is invaluable, and the right Medicare supplement plan can make all the difference in accessing quality healthcare.
What is a Medicare Trial Right
Because there are so many Medicare enrollment periods, there are some that may get overlooked. One of the lesser-known yet significant enrollment opportunities is the Medicare Trial Right. We will go over what a Medicare Trial Right entails, and who qualifies.
When an agent has a client enrolled in a Medicare Advantage (MA/MAPD) plan and they wan to change back to Original Medicare, they may be eligible for a trial right. If this is the case, they have an opportunity to change their plan without having to wait for the AEP (Annual Enrollment Period). This enrollment period allows beneficiaries a chance to go back to Original Medicare or original Medicare and a Supplement and /or PDP plan. This gives beneficiaries a way to get the coverage they need if the plan they chose is not a good fit for their current healthcare needs.
How does a Trial Right work
Trail Rights apply to beneficiaries who enroll in a Medicare Advantage plan for the first time. The enrollee has a 12 month time frame to try a MA/MAPD plan. This enrollment period is very similar to the Medicare supplement free look although they each have their own qualifying rules and the time you have to use each one is different. New MA/MAPD beneficiaries have a Trail Right period of 12-months. On the other hand, enrollees of Medicare Supplement plans are entitled to a free look period of 30 days.
Watch a YouTube video on the differences between Medicare Advantage vs. Medicare Supplement plans
Who qualifies for a Trial Right
Beneficiaries Who Enrolled in an MA/MAPD plan when they first signed up for Medicare
It is important to understand the timelines associated with the Medicare Trail Right. If a beneficiary enrolls in a Medicare Advantage plan during their Medicare Initial Enrollment Period (IEP), they can change to Original Medicare anytime during the first 12 months of enrollment in the Medicare Advantage plan. Here’s an example: if a client turns 65 and chooses a MAPD plan for November 1st, the trail Right period runs until December 30 of the next year. This means they can opt to disenroll form the MA/MAPD plan and go back to Original Medicare anytime during those 12 months.
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Medicare Supplement beneficiaries who chose to enroll in a MA/MAPD plan for the first time
When Medicare Supplement plan enrollee decides to try a MA/MAPD plan for the first time. If they decided they do not like the MA/MAPD plan, they have 12 months to go back Original Medicare.
Important: beneficiaries who use the Trial Right can choose to enroll in a PDP plan as well as a Medicare Supplement plan. They do not have to go through underwriting for the Medicare Supplement plan.
Benefits of Medicare Trial Right
- Flexibility: It provides enrollees the ability to explore Medicare Advantage Plans or switch back to Original Medicare without penalty.
- Tailored Healthcare: Enables individuals to find the best plan for their healthcare needs, preferences and budget.
- Peace of Mind: Offers peace of mind in the event the chosen plan doesn’t meet expectations, the beneficiary can change their plan.
What to consider before using the Trial Right
- Beneficiaries need to understand their current plan, including coverage, costs, and provider network.
- Research alternatives: Compare coverage, costs, provider networks, and additional benefits.
- Make an informed decision: Assess healthcare needs, preferences, and budget to determine the best course of action.
- Enroll in the new plan: Once enrollment in the new plan is confirmed, inform your current Medicare Advantage plan that you are disenrolling.
Other enrollment periods
Please remember, beneficiaries can only use the Trial Right one time. However, there are several other options that provide an opportunity for a client to change plans.
Learn about other Medicare election periods
Disenroll from a Medicare plan
Enrollees can disenroll from a Medicare Advantage plan by contacting the provider directly or contacting your local Medicare office 1-800-MEDICARE (1-800-633-4227).
Many beneficiaries do not know about the Medicare Trial Right period. It is up to the agent to make sure clients are aware that they have options if they are unhappy. It is always important to be sure the client gets the healthcare they need.
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CT MSP income limits 2024
It’s important for agents and Connecticut residents on Medicare to stay up to date on changes in healthcare programs that impact their lives. One such program is the Medicare Savings Program (MSP). This program provides assistance to beneficiaries with limited incomes cover their Medicare costs. Understanding the CT MSP income limits 2024 is vital for beneficiaries. Especially when they depend on financial assistance to get the healthcare they need.
What is the Medicare Savings Program
The Medicare Savings Program (MSP) is a state-administered program. It helps individuals with limited income and resources pay for Medicare premiums, deductibles, coinsurance, and copayments. The program is available to those eligible for Medicare Part A (hospital insurance) and meets specific income and asset criteria. In Connecticut, the MSP is administered by the Department of Social Services (DSS) and provides critical financial assistance to eligible beneficiaries.
Income Limits for the CT Medicare Savings Program 2024
Because the Medicare Savings Program in Connecticut consists of 4 levels of help, the income limits vary based on each separate program within MSP. The state also adjusts the income limits based on the size of each household. The income limits for each MSP programs, as of 2024, are listed below.
QMB (Qualified Medicare Beneficiary) Program
The QMB program provides the highest level of help. Those who qualify for this program, have an income level of up to 100% of the Federal Poverty Level (FPL). This program helps pay for Medicare premiums, deductibles, coinsurance, and copays.
SLMB (Specified Low-Income Medicare Beneficiary) Program
The SLMB program provides assistance with Medicare Part B premiums. To qualify for this program, individuals should have an income level of between 100% and 120% of the FPL.
ALMB (Additional Low-Income Medicare Beneficiary) Program
The ALMB program provides payment assistance with the Medicare Part B premium for those who have income between 120% and 135% of the FPL.
QDWI (Qualified Disabled and Working Individuals) Program
To qualify for the QDWI program, individuals must be under age 65, disabled, working, and not eligible for Medicaid. These individuals must have income of up to 200% of the FPL. This program provides assistance for individuals paying their Medicare Part A premiums.
Please note: the income limits are subject to change annually. There are other factors that affect MSP eligibility including: household size and financial resources.
How to Apply for Connecticut’s Medicare Savings Program
Beneficiaries who want to apply for CT’s MSP program, can do so through the DSS (Department of Social Services). The beneficiary must provide information such as: income, assets, Medicare enrollment, and other relevant information. DSS provides help completing the application for anyone who needs it.
Individuals apply for benefits by completing a CT state application form. There are several ways to complete and return the form, including; online, through the mail, or dropped off at a local DSS Regional Office. An authorized person can do the application for the beneficiary if they need them to.
For a list of local DSS offices, click this link.
To apply online, visit www.connect.ct.gov, you will see a tab to ‘Apply for Benefits.’
Beneficiaries who wish to apply for MSP program only, please download and complete application below:
Medicare Savings Program Application (W-1QMB)
Formulario de Renovación de programas de ahorro de Medicare (W-1QMBS)
To apply for the MSP program as well as additional programs such as: SNAP (food stamps), Medicaid for Employees with Disabilities (MED-Connect), Medicaid for the Aged/Blind/Disabled (HUSKY C), and/or cash assistance, download the application below.
Click here to apply for Husky C and or Cash assistance program benefits
Haga clic aqui para Husky o asistencia en efective CW-1ES Solicitud de Beneficios
MSP in Connecticut provides an essential service to many individuals. It provides financial assistance to cover Medicare costs. It is necessary to be aware of the income limits. eligible individuals can take advantage of this valuable program and access the healthcare they need without undue financial strain. As we navigate the complexities of healthcare, let’s ensure that everyone has the opportunity to receive quality care and support.
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You have the right to a copy of the completed application. You can request a copy from DSS at any time in either in electronic or paper format.
For additional information on how to apply, please visit www.ct.gov/dss/apply.
Federal Communications Commission regulations
The new Federal Communications Commission regulations on lead generation will lead to changes in the insurance lead market. As of January 27th 2025, organizations must get “one-to-one” consent before contacting consumers. In other words, people buying leads must get explicit, individual consent before contacting the lead. The goal of this rule is to eliminate the sale of mass market leads to multiple agents.
Previous to the new rule clarification, the TCPA did not address the use of lead generation. The new rule focuses on the lead buyer and puts the emphasis on their need to obtain one to one consent when buying leads. It also states that leads must be related to the services the consumer showed an interest in. In other words, when a consumer goes online to get an auto quote, a agent cannot contact them about Medicare plans, credit cards, mortgages, etc. This also means, lead companies cannot sell consumer information to multiple buyers. This is a common practice with shared online leads.
Click here for proposed rule FCC document
What type of leads will the new rules apply to?
The new Federal Communications Commission regulations “one-to-one” consent and “related services” rule will make many of the leads insurance agents purchase today non compliant next January. The main types of leads this will be applicable to are:
- Shared online leads: lead companies sell shared leads to multiple agents and do not meet the “one-to-one” consent rule
- Aged leads of any type: because lead companies resell aged leads to other agents, they are not compliant
- Live transfer phone leads: It will be difficult to maintain one to one consent with live transfer leads. The marketer on the phone talks to the prospect and then transfers them over to the agent which will no longer be allowed
- Any lead that originated from a different advertisement: Many insurance leads did not originate that way. The consumer may be interested in another product, but their information was sold as an insurance lead.
Which type of leads will be allowed after the new Federal Communications Commission regulations?
Most of the lead types insurance agents use today will still be allowed. If the lead creation source sends the consumer directly to the purchasing agent, they will be allowed. This would include direct mail, exclusive online leads, consumer direct inbound call leads and social media advertising such as Facebook or Google ads.
Consumer Direct Inbound Medicare, Final Expense and ACA Call Leads for $38
What does this mean for insurance agents and agencies buying leads?
Does this mean lead vendors will stop selling shared leads to insurance agents? Unfortunately not. The enforcement of the new rule focuses on the those who purchase them. Those selling the leads will likely continue to offer them after January 27th of 2025. This may lead to a scenario with agents continuing to purchase leads that do not have “one-to-one” consumer consent. Agents that continue to purchase leads without one-to-one consumer consent will be exposing themselves to demand letters and litigation from consumers and law firms.
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Medicare SEPs
If you are in Medicare sales, you know there are several opportunities to enroll a client in a Medicare plan, that is why Medicare SEPs are so important to understand. There are times when a beneficiary qualifies for an SEP such as; if they move or lose their current coverage through no fault of their own. If they lose coverage for non-payment, they do not qualify for an SEP.
Starting an insurance agency
If you enjoy helping people get the medical coverage they need, have the ability to make a sale and want to build your own business, starting an insurance agency might be the perfect venture for you. In this post, we’ll walk you through some of the steps you need to take to start your own insurance agency and set yourself up for success.
Before you start an insurance agency, it’s crucial to research the type of insurance products you plan to offer and develop a solid business plan. There are many types of insurance products you can market; this includes; auto, home, life, health or Medicare. Once you are licensed to sell the products you decided to offer, you need to identify your target market, understand their needs, and assesses the competitive landscape.
Licensing and Education
To become an insurance agent, you’ll need to obtain the necessary licenses and certifications. These requirements vary depending on the types of insurance you plan to sell and your location. Most states require pre-licensing education courses and passing a licensing exam. Additionally, ongoing education may be required to maintain your license.
Click here to learn how to get an insurance license in CT.
Choose the products you want to focus on
While it’s essential to offer a variety of insurance products, choosing to sell a particular product line helps you focus your efforts and lets you gain extensive knowledge in a specific area rather than learning a little about several things. Focusing on a specific demographic, industry, or type of coverage can bring you to the forefront of an industry and differentiate your agency from competitors.
Learn how to build a successful Medicare agency
Legal Structure and Insurance
Before you start, you should decide on the legal structure for your agency. Do you want it to be a sole proprietorship, partnership, LLC, or corporation. Consulting with a lawyer can help you make the best choice and ensure compliance with local regulations. This will protect your agency from liabilities.
You also need to purchase insurance for your agency, such as errors and omissions (E&O) insurance, to protect your assets from potential lawsuits.
Build Your Team
As your agency grows, you may need to hire additional staff to handle sales, customer service, and administrative tasks. Depending on the job you are filling, you should look for individuals who are knowledgeable about insurance products, customer-oriented, and who enjoy helping others. If you are hiring back office staff, you need individuals who represent your business in a professional manner and have office skills. These individuals need to earn about the insurance business over time. Once they do, this will be a huge value add. It can take some of the pressure off you to answer every question that comes up and it frees up your time to concentrate on other things such as recruiting.
Watch a YouTube video on how to recruit insurance agents
Joining a good, supportive FMO can also be a great way to get guidance on how to grow your business into a successful agency. A good FMO provides you with advice , training an many other tools that will help you grow your business into a well-oiled machine!
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Create a Marketing Plan
Develop a comprehensive marketing strategy to attract clients and generate leads for your agency. Utilize a mix of online and offline marketing tactics, such as social media, email marketing, networking events, and advertising. Consider partnering with other businesses or organizations to expand your reach.
Take a look at the CMS marketing guidelines
Set Up Your Office
Whether you choose to operate your agency from a physical location or work remotely, it’s essential to create a professional and inviting workspace for you and your team. Invest in essential office equipment, such as computers, phones, and furniture, and establish efficient workflows to streamline operations.
Focus on Customer Service
Providing exceptional customer service is key to building long-lasting relationships with your clients and earning their trust. Be responsive to their needs, communicate clearly and effectively, and go above and beyond to exceed their expectations. If you follow this advice, you will maintain your book of business as well as get free leads from the recommendations of other happy clients.
Learn how to maintain your book of business
Stay Compliant
Stay up to date with industry regulations and compliance to ensure that your agency operates legally and ethically. This includes adhering to privacy laws, maintaining accurate records, and following industry best practices.
Watch a YouTube video on Medicare marketing rules for 2024
Continuous Learning and Growth
The insurance industry is constantly evolving, so it’s essential to stay informed about new trends, technologies, and regulations. Invest in ongoing training and professional development opportunities to enhance your skills and keep your agency competitive.
Starting an insurance agency requires hard work, dedication, and perseverance, but with the right approach and mindset, it can be a rewarding and lucrative endeavor. By following these steps and staying committed to providing value to your clients, you can build a successful insurance agency that makes a positive impact in your community.
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Medicare Advantage Marketing Ideas
Participate In Local Events
It is always a great idea to get out there in the community. This helps people see you and know you are a resource. If you come across as someone who is knowledgeable and caring, your interactions will result in leads. Senior centers or local soup kitchens or any event where you can offer educational guidance or answer questions is an opportunity to build a relationship and your reputation in the community.
Host An Educational Event
This is the same idea as volunteering at local events. You have an opportunity to provide Medicare beneficiaries useful information and present yourself as a valuable community resource. Educational events like in-person seminars or online webinars offer more than one way to provide information to those who need it. It is important to note, there are specific rules put in place by CMS that you must follow when you host an event.
Please remember, hosting an event is not usually free of charge. The venue may charge you for use of their facility as well as the price of providing snacks or generic print materials you provide to attendees. It is important to know; you may not spend more than $15 per person on snacks. There may be a cost for hosting a webinar as well. You may need to pay for zoom meetings or some other online webinar tools. This might depend on the number of attendees.
To see how to host a compliant educational event; click here
Learn the rules for hosting a sales event
Client Referrals
Agents who build good relationships with their clients and provide good service, will undoubtedly receive referrals. It is not a bad idea to actually ask for referrals from your clients. Just be sure you make the request in a tactful way. Medicare clients have friends, co-workers and relatives and everyone is looking for a trusted person to help navigate the complicated world of Medicare.
This is a great source for leads and costs the agent nothing.
Social Media Platforms
Because there are so many people using social media these days, social media is a great way to get information out to large numbers of people quickly. Many seniors use Facebook on a daily basis and are the number of seniors who use it is growing. This means, Facebook is a good tool to communicate with potential clients. If you post useful tips and information for Medicare beneficiaries to use, you will establish yourself as an authority on Medicare and this will lead to more business and a growing Medicare book. You can also join online groups to become part of their community and a valued resource.
There are other social media platforms you can use such as YouTube, Instagram Twitter/X, LinkedIn, TikTok or Snapchat ; just to name a few that come to mind. Some of these are better than others for reaching out to seniors. Many agents find YouTube a good way to present valuable information to a wide audience. Whatever social media outlet you choose, they are a great no-cost way to gain name recognition.
Click here to watch some free Medicare training videos on our YouTube channel
Build A Business Website
If you are serious about having your own business, it is important to to have a website. This tool helps give you professional credibility as well as provides an overview of the services you offer and any other information you want to provide to those seeking assistance with their Medicare coverage.
There are many low cost ways to get your website set up including GoDaddy or Google. Crowe agents receive free help with their website and logo design through the talented design team at Pinnacle.
Crowe or Pinnacle agents can use this link to request design services
Find out the other benefits of working with Crowe
Email Marketing
Email is another low cost way to reach potential clients. There are several companies that provide this service such as; Campaigner, GetResponse, Salesforce, HubSpot, Constant Contact, MailChimp, Brevo or Omnisend. Each of these services offers different features such as; lead capture forms, marketing analytics and design help to name a few. The important thing to remember is to remain compliant with all CMS regulations before sending out a mass email. This includes providing all email recipients with an easy way to opt out of future emails.
Take a look at the CMS marketing guidelines
Compliance
Please note: advertisements intended to draw a beneficiary’s attention to an MA plan or plans and includes content about; plan premiums, cost sharing, or benefit information(this includes those that do not mention a specific plan by name even when advertisements include multiple MA organizations), it MUST be submitted to CMS for approval before it is sent out.
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Maintaining your Medicare book
After you make the sale, maintaining your Medicare book is extremely important. The happiness of your existing clients is as important as brining in new business. Both new and existing clients add to your bottom line and keep your business going. In fact, if you maintain good relationships with all our clients, they will refer their friends and family to you, and this provides a continuous stream of business. Staying in contact with your clients on a regular basis, reminds them that you are there for them and keeps them from looking for help from another agent.
Stay in contact with your clients
There many opportunities to stay in contact with your clients. It is important to be consistent with this so they remember you are there for them if they have any questions or concerns. This prevents them from seeking guidance from another available agent.
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Examples of when to reach out:
- After their application is submitted, you should let them know when it is approved and approximately when to expect their new card.
- Once they enroll in a new plan, it is a good idea to check in and see if they are happy with their choice.
- At the beginning of AEP or a little before, you can contact them to get any health , medication or provider updates needed to check plan options for the following year. Remember, you cannot discuss new plan details until October 1.
- If a potential client is coming up on their IEP.
- When a client has an SEP opportunity.
- It is a good idea to send each client a birthday or condolence card when appropriate.
- If you have any pertinent information that the client may want to know about. If you are hosting an event, or there is something else you think they need to know.
Keeping up to date of client information will make it easier to stay in contact. If you have an automated system to remind you of important dates, that is helpful especially once your book grows.
Ways to initiate contact
These days, there are several ways to contact your clients. If you are sending an important message with a deadline, it may be best to pickup the phone and give them a call or test message. Here are some ways to communicate with your clients or prospects:
- Make a phone call or send a text.
- Schedule a video call or zoom meeting.
- Mail them cards or other general information that is not urgent.
- If they are ok with it, you can send them an email. For bulk emails, be sure to include an opt out.
- For general information, you can post announcements on your social media platforms such as Facebook, or LinkedIn.
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Compliant communications
No matter how you choose to communicate with your clients, it must be compliant with CMS regulations.
- Get a permission to contact from your potential client
- If you plan to make phone calls or send texts, be sure to abide by the (TCPA)Telephone Consumer Protection Act guidelines.
- Be sure to record any marketing, sales or enrollment calls you make to remain compliant with CMS’s regulations. If it is a phone call to an existing client say hello or check in , you do not need to record it.
- Always comply with the CAN-SPAM Act for emailing
Click here to view a YouTube video of the key elements to a compliant phone recording
It is important to follow compliance guidelines when you send out a bulk email. Be sure you do not use misleading information in your email. If you are sending an advertisement, make that clear when possible. Always include an opt-out for future communications. It is important to include your contact information and address in your signature. Agents must include a TPMO disclaimer on all email communications.
In the event you are sending an email to a specific client, you may not need to follow all the rules exactly as stated. Always use your best judgement and if you are in doubt best to err on the side of caution.
Sending out mail
If you are sending out a card, application or something else to just an individual, it is a good idea to include instructions, contact information and postage paid return envelopes when necessary. When you are sending out bulk advertisements or informational mailings, don’t forget to follow all CMS guidelines.
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More about using social media
Social media communications are a fantastic way to reach thousands of beneficiaries. You can use these platforms to build your credibility as a source for Medicare information. Be sure to invite your clients to like your page and let them know you will put interesting or helpful information on there so they should make it a point to check it. You can post important deadlines and update for clients and anyone who may view your information. If you are going to be at a local event or hosting an sales or educational event, this gets the word out to everyone quickly. These types of platforms are a good way to get important information out as well as a tool for marketing.
Medicare annual wellness visits
For Medicare beneficiaries, it is very important to stay vigilant with their health care. Medicare annual wellness visits (AWV) are an essential tool to maintain good health. Unfortunately, many beneficiaries are unaware of how significant this is and what it entails. In this post, we discuss the importance of wellness visits and their benefits.
Understanding Medicare Annual Wellness Visits
Medicare Annual Wellness Visits (AWVs) are preventive care appointments. These appointments help assess and maintain the overall health of Medicare beneficiaries. Unlike traditional annual physical exams, AWVs focus on preventive care planning, risk assessment, and health promotion. The purpose of these appointments in not to diagnose or treat existing conditions. Please note; anyone who has has Medicare Part B for over 12 months, is eligible for an annual wellness visit. It is important to understand; these visits are not a physical exam.
There is not cost for the visit as long as the provider accepts Medicare assignment and the Medicare Part B deductible does not apply. Although, if your provider preforms additional test, you may have to pay the Part B deductible as well as co-insurance. In the event these services are not cover under the preventative visit.
Why are annual wellness visits so important
- Prevention Over Cure: When providers use this approach, they prioritize preventive care, to detect potential health risks early on. This helps prevent them from escalating into serious conditions. By identifying risk factors and developing personalized prevention plans, beneficiaries can take proactive steps towards better health outcomes.
- Comprehensive Health Assessment: AWVs provide beneficiaries with a comprehensive overview of their current health status. By taking a holistic approach that includes screenings for cognitive impairment, depression, and functional ability, all aspects of health are addressed and monitored.
- Establishing a Baseline: Regular AWVs enable healthcare providers to establish a baseline of a beneficiary‘s health status. This facilitates better care management and early detection of changes in health in subsequent visits.
- Patient-Centered Care: ensures patient-provider communication is a priority. This fosters open dialogue about health concerns, lifestyle factors, and goals. This collaborative approach allows beneficiaries to actively participate in their healthcare decisions and take steps toward good health.
- Cost-Effective Care: Preventive care, as emphasized in AWVs, is proven to be more cost-effective in the long run compared to treating advanced diseases. Medicare can reduce healthcare costs by investing in preventive measures to avoid chronic conditions.
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Components of an annual wellness visit
- Health Risk Assessment: Beneficiaries undergo a thorough assessment of their medical history, current health status, and risk factors for chronic diseases.
- Personalized Prevention Plan: Based on the health risk assessment, healthcare providers develop a personalized prevention plan that fits the individual’s needs and goals. This may include recommendations for screenings, vaccinations, lifestyle modifications, and community resources.
- Health Education: AWVs offer an opportunity for beneficiaries to receive education on various health topics. This helps them make informed decisions about their well-being.
- Review of Medications: Healthcare providers review the beneficiary’s current medications to verify they are safe, effective, and appropriate for their needs.
- Referrals and follow-up visits: If necessary, healthcare providers refer beneficiaries to specialists or other healthcare services for further evaluation or treatment. Follow-up appointments are scheduled, when needed, to check progress and adjust the plan accordingly.
To sum it up
Medicare annual wellness visits are an important tool for the promotion of good health and well-being of Medicare beneficiaries. When we prioritize preventive care, health assessments, and patient-centered approaches, beneficiaries have the information they need to be proactive in their healthcare and wellbeing.