AHIP Discount Code

The Medicare AHIP for 2023 will be available on June 20th.  The cost will remain $175 for the 2023 certification course and exam.  The certification is $125 when taken through a number of the insurance company certification portals with the AHIP discount code built in.  Read below for additional updates on the 2023 certification.

Important: Current year AHIP certifications do not count toward the next AEP.  For example, if you take and pass AHIP in 2023 you cannot use it during AEP from October 15th to December 7th of 2023.  AEP business written during this time is effective for a 1-1-2024 start date.  As a result, you need the 2024 AHIP to write the business.   The 2024 AHIP will come out in June of 2023.  If you are looking to write MA or PDP business at that point, it is best to simply take the 2024 AHIP and skip the 2023 AHIP.  The 2024 AHIP will allow you to write business for the remainder of 2023.

AHIP discount code: $175 vs. $125

Accessing AHIP through the official Portal will cost $175.  2023 AHIP (Medicare + Fraud, Waste and Abuse (MFWA)) became available on June 20th 2023.  It is best to wait to take AHIP through a portal with the discount code.  That is how you get to take the course with the AHIP discount code built in.  The cost is reduced to $125 for those taking the course through a portal with the AHIP discount code built in.

CLICK HERE TO TAKE AHIP AT THE DISCOUNTED RATE OF $125

Course Content

The basic Medicare portion of the course will cover:

• Basics of Medicare fee-for service benefits (Original Medicare A and B)
• Different types of MA/MAPD and PDP plans
• Who is eligible and review of the benefits
• Training on nondiscrimination
• Requirements and rules for marketing and enrollment

Fraud, Waste, and Abuse (FWA) will cover:

• How to identifying FWA
• Overview of efforts being made to detect FWA
• Different methods to report FWA
• Review of 2023 MA/MAPD and Part D compliance requirements (Changes for 2024 already being proposed)

AHIP discount code: Recorded webinar on exam

Watch a recorded webinar on how to pass the 2023 AHIP exam 

Learn about the benefits we offer to agents

• We pay agents $500 per month toward all Medicare marketing and lead costs
• Seminar program averaging 50+ T-65 prospects per seminar (Agent does not need to invite attendees)
• Online enrollment and call recording through Connecture and Sunfire at no cost to agents
• 50% co-op on seminar costs
• Free agent websites

CLICK FOR MORE DETAILS

Watch a recorded webinar on all Crowe programs for Medicare agents

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Delayed Enrollment In Medicare Part B

When it comes to delayed enrollment in Medicare Part B, there are multiple factors to consider.  There are valid reasons why someone should and could delay enrollment in Medicare part B without a penalty.  However, the rules for who can delay are very specific. Failure to follow them can lead to delayed enrollment penalties in the future.  Read further to make sure you are following the rules.

Are you an insurance agent looking for more information on Medicare sales and contracting?  CLICK HERE FOR OUR RECORDED YOUTUBE WEBINARS

Who should considered delayed enrollment in Medicare Part B?

The majority of people turning 65 should enroll in both Medicare Part A and Medicare Part B.  Part B has a monthly premium that is either deducted out of the Social Security check or billed quarterly for those not receiving Social Security payments.  Those receiving SS payments when they turn 65 will be automatically enrolled in Medicare.  Those not receiving SS payments will need to manually enroll either at a local SS office or online CLICK FOR ONLINE ENROLLMENT

For some people it may make sense to delay enrolling in Medicare part B.  This often is the case for those that are working past the age of 65 or those getting coverage through a spouse working past age 65,  There are three specific conditions that need to be met in order to waive Medicare Part B and not be subject to a penalty down the road.

Delayed enrollment in Medicare Part B:  Conditions to waive B

• Actively working or getting coverage through an actively working spouse.  If your are working and getting coverage through work, you may be able to waive Medicare Part B.  Same goes for someone that is getting coverage through a working spouses employer coverage.
• Having coverage through the current employer.  The coverage needs to be through the working spouses employer.  If the spouse is working but getting coverage through Cobra, a past employer or an indvidual plan of some type, you cannot waive Medicare part B
• The employer group most have 20 or more employees.  If the employer has less than 20 employees you should enroll in Medicare Part B even if still working and getting coverage through work

Comparing the employer coverage to Medicare

Just because someone is meeting the criteria to waive part B does not mean the necessarily should.  The current employer plan monthly cost and benefits need to be compared to the cost of Orignal Medicare with a supplement and Part D drug plan or with a Medicare Advantage plan. It is simply a matter of seeing which way will provide more benefits for less premium.

Other things to look out for

• Delayed enrolllment in Medicare Part B can tricky.   For example: VA coverage is a valid waiver for Medicare Part D (drug coverage)  It is NOT, a valid waiver for Medicare Part B
• Cobra can be a valid waiver for Medicare Part D but it is not a valid waiver for Medicare Part B
• Working but having coverage through a plan from a former employer or COBRA is not a valid waiver for Part B
• PEO:  If you work for a small group less than 20 that is part of a PEO you may have an exception to the group of 20 or more rule.  Some PEO’s have a waiver for all their groups which allows the ones with less than 20 employees to be considered a group of 20 or more.

Delayed enrollment in Medicare Part B: Change in the Medicare GEP

Those who miss their initial enrollment in Medicare Part B have two possible election options.   The first is a Part B special election period and the second is the Medicare Part B general election period.

CLICK HERE TO LEARN MORE ABOUT THE MEDICARE GEP

Get contracted to offer Medicare Advantage, Part D and Medicare supplement plans

Real Life Medicare Sales Examples

As Medicare agents, we have access to a lot of training.  In person training with carriers and uplines, annual carrier certifications, AHIP and a number of other options.  The majority of trainings have great content but tend to be generic in nature.  They give us information on topics such as benefits, election periods, marketing rules and numerous other areas of Medicare.  They usually do not get specific to the real scenarios we run into, however.  The post below reviews the most common real life Medicare sales examples and how to handle them.

Note:  The most important part of all the following scenarios is to ask questions to understand the prospects specific situation.   Only when we understand the details about the person’s specific situation can we make solid recommendations. The reality is, many agents do not ask questions and just as many do not listen to the answers when they do ask.  Listening to the prospects concerns can make the sale for you.

Are you new to Medicare sales?  Watch this video for the basics on a Medicare sales appointment

Turning 65 prospect:   Example 1

The first of the real-life Medicare sales examples is the best one for agents.  When someone turns 65 and new to Medicare, we know the full CMS max allowable commission will be paid and the case will not be pro-rated.  A T-65 sale is really more of an education than a sale.  The person turning 65 usually does not know all the rules with Original Medicare.  They also may not be sure about the differences between a Supplement and Advantage plan.  Here is how to handle a T-65 meeting.

Information about Original Medicare

After you have asked some basic questions to understand the situation you should explain Original Medicare to the prospect.  The following points should be made:

• When Medicare A and B will start for them  (Remember those with a B-day on the first of the month will have a start date of the previous month)
• They are only auto enrolled if they are already receiving Social Security payments
  • If not receiving SS payments, give them the link to apply online
• The cost for Medicare Part B and how it will be billed.  It can either be taken out of the Social Security check or billed quarterly if not receiving SS payments.  Remember to tell them about “Medicare Easy Pay“
• Warn them about IRMAA for part B and D and how it works
• Explain the benefits of A and B and point out what they do not cover
• Tell them you will explain the two most commonly used ways people insure themselves to cover the cost shares not covered by Medicare

Information about Medicare Advantage and Medicare supplements

• Start with the supplement
• Explain that they will have a total of 3 plans and 3 premiums
• Showing this to them visually can help
• Give them the pro’s and cons of going with a supplement and drug plan
• Give them the pro’s and cons of a Medicare advantage plan
• Get their thoughts on which type of plan would be better for them
• Get a list of doctors (In case they go advantage) and Medications (Advantage or supplement and part D)

Information about enrollment periods and annual follow up

• Explain to them when they need to submit applications or enroll online
• Let them know you will call them every year during the AEP to review with them and see if there are better coverage options available for the next year

Real life Medicare sales examples:  Over 65 or turning 65 and working: Example 2

Know the Part B enrollment rules

When it comes to those still working past Medicare age, the agent needs to know the Part B rules for both valid waivers and enrollment.

Watch a YouTube video on Medicare for people working

• Who can delay enrolling in Medicare Part B at 65 or older?
  • There are 3 criteria that need to be met to waive Medicare Part B
    • The Medicare beneficiary must work for a company with 20 or more employees
    • They must be actively working or getting coverage through an actively working spouse
    • They must either have coverage through their employer or coverage through the actively working spouse’s employer
      • They cannot be working and getting coverage through a different means such as a former employer, cobra or an individual plan
      • Reminder:  VA coverage and COBRA are NOT valid reasons to waive Medicare Part B

Delayed Medicare Part B enrollment

• It is important to know how members enroll in Medicare Part B after age 65
  • If the member no longer meets the criteria to delay part B they will have an election when the criteria are no longer being met
    • An example would be someone who is working and getting coverage through work but decides to retire or loses employment
    • Loss of employment would trigger the need to enroll in Medicare part B
    • The member will need get an employment verification from the employer in order to enroll in Medicare Part B on a delayed basis
    • If the special enrollment for Part B is missed, the member must enroll in Medicare Part B during the general election period (GEP).  The GEP runs from January through March.

Stay on the employer plan or buy Medicare Part B and move to a stand-alone plan?

Although some people may be working and getting coverage through work, it may still make sense for them to enroll in Medicare.  The agent needs to look at the amount the employee is paying for coverage and the benefits they are getting.   They can then compare that to the additional cost of adding Medicare Part B and the benefits they would get from an Advantage or Medicare supplement plan.  The working member does not have to stay on the employer coverage if the math and benefits do not make sense.

Keep in mind someone working for an employer of less than 20 employees needs to sign up for Medicare Part B even if they are working and getting coverage through work.   They will need to pay for Medicare B regardless so it often makes sense to move this person to a Medicare Advantage or supplement plan.

Working with someone that is potentially dual eligible:  Example number 3

The 3rd real life Medicare sales example is working with dual prospects. Extra benefits have become a very important part of dual sales over the last few years.  Dual members are looking for plans that will provide the highest dental, vision, OTC, Flex and grocery benefits.  Other benefits such as utility cards have also become more important.  Other members look for transportation benefits.  The most important aspect for an agent is to ask questions and figure out which of those benefits are most valuable to potential members.  Once that is determined, the agent can quickly quote and compare the various dual benefits on Connecture, Sunfire or MyMedicareBot to find the plan that best meets the clients needs.

Figuring out which level of “dual” you are working with

Dual prospects often do not know the level of help they receive.  A number of dual plans only accept clients receiving a certain level of help.  Some plans accept full dual only while others will take full dual and/or QMB level.  While both full and partial duals (QMB) receive help with medications and Medical copays, the QMB only dual does not receive extra benefits such as dental and vision. As a result, the extra benefits of a dual plan can be more appealing to a QMB only.  Regardless, the agent needs to know the level of Medicaid the client currently has.  Enrollment systems such as Sunfire give the agent access to a limited version of Marx which allows them to look up the status.  Those without access to Sunfire can access the information through carrier platforms such as UHC Jarvis.

In the case when such systems cannot be accessed, agents can ask questions to help determine the level of coverage.  Asking the prospects if they pay copays when they see doctors can eliminate lower levels of help such as SLMB or ALMB (States that have ALMB) and SPAP programs that only help with medications.   If the prospects pays for medical copays but has limited medication copays and/or does not pay their Medicare part B premium, they likely are in a drug help only program.   If they do not pay medical copays but you are not able to determine full dual vs. QMB, it may be wise to suggest a dual plan that accepts both populations.

Final thoughts working with duals

In conclusion, the agent needs to identify the level of coverage, ask which extra benefits are most important to the prospects and then quickly find the plan that offers the richest of those specific benefits.  Lastly, keeping the dual on the books can always be a challenge.  As a result, it is important to stay in contact with dual populations and also encourage them to sign up for the federal do not call list.  Dual eligible populations are at a much higher risk of unknowingly switching plans over the phone due to the high volume of Medicare type calls they receive.  Being on the DNC can help reduce those calls.

Real life Medicare sales example number 4:  Trying out a Medicare Advantage plan

As agents, we often run into clients that have a Medicare supplement plan.   Often times they are familiar with Medicare Advantage plans and would like to try one but have never done it.  The main fear they have is not being able to get back into the Medicare supplement if they do not like the advantage plan.  Agents that understand the rules of an all time GI state, (NY, CT, MA, ME) and the Medicare Trial Right, can get more advantage sales.

All time GI states

It is much easier to have a Medicare supplement client try an advantage plan in one of the 4 all time GI states.  Given that underwriting is never allowed on Medicare supplements in these states, the member is able to try an advantage plan without the risk of being locked out of a supplement in the future.  As a result, the member can try the Medicare advantage plan and will always have the ability to change back to a supplement during the AEP or OEP if needed.

Medicare Trial Right

The Medicare Trial Right can be utilized in all time GI states and underwritten states when it comes to trying out an advantage plan.  The trial right allows the Medicare supplement member to try an Advantage plan with the GI right to move back to a supplement if they decide the advantage plan is not for them. It is very important for the agent to fully understand Trial Right rules when utilizing this strategy. When a Trial Right is in place, the member has 12 months to move back to a supplement.  During this time, they can make the move back on the first of any month during the 12-month period.

Trial Right number 1  

The member enrolled in an advantage plan when they became eligible at the age of 65.  If the member enrolled in Medicare at age 65 and their first plan was an advantage plan during their IEP, they have a 12-month Trial Right.  The Trial Right is only for those that enrolled at age 65.  There is no Trial Right for those that enrolled in Medicare after their turning 65 IEP.

Trial Right number 2

The second Trial Right is for those that have had nothing other than a Medicare supplement since they have been on Medicare A and B. (Regardless of their age when they enrolled in Medicare A and B)  If that member decides to try a Medicare Advantage plan for the first time, they will have a 12 month Trial Right.  This gives them the ability to try the Advantage plan for up to 12 months with the ability to move back to a Medicare supplement without underwriting during this time.

Real Life Medicare sales examples number 5: Prospects that are happy with their current plan

Agents will often talk to a prospect that is happy with their current plan.  Sometimes the agent can ask questions to determine if they are truly happy with it. Maybe there are plans that would fit them better they don’t know about or they may just be resistant to change.  If that is the situation, a good agent may be able to find a better option for them.  However, sometimes they actually are on the plan that has the best benefits for them.  When this happens, the agent will often move on to the next prospects without following up with the prospect again.  Many potential sales are lost when this happens.

Medicare supplement rate increases and Advantage plan benefit changes

The reality is that Medicare supplement rates increase, and Medicare Advantage plans can have poor renewals.  An Advantage plan that looked appealing one year may not look as good the next.  This may be due to an increase in copays, lowering of extra benefits or a new plan coming to the market with notably better benefits.

Had the agent kept the prospects contact information and scheduled a follow up during AEP, they may be able to write the prospect a new plan.  It is usually easier to follow up with such a prospect because a relationship has already been established.  On the other hand, if a follow up does not happen, the opportunity is lost.  It is important to schedule follow up AEP calls with past appointments or  with clients that you did not sell to.  This will help to build the sales pipeline and can be more time efficient than closing a prospect you have not established a relationship with.

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CMS Federal Register

The CMS Federal Register is where the Centers for Medicare and Medicaid services published all of the documents.  This includes rules, proposed rules and notices.  The proposed CMS rules are published in the document that allows comments for a certain period of time.  In fact,  there was a proposed rule added on 12/27/2022 that includes changes to the Medicare program contract for the year 2024.  This includes new rules and regulations for both the Medicare Advantage and the Prescription drug benefit program.  Changes to Medicare Cost plans and other rules that will become part of the Medicare Communications and Marketing Guidelines for 2024 are also included.  CMS MCMG for 2024

Want to watch a video about this information?  Click here for our recorded webinars

CMS Federal Register:  Potential changes to other areas in addition to Medicare marketing rules

The proposal on the register as of 12/27/2022 includes other changes.  This includes changes in the provisions of the Affordable Care Act as well as programs of care for the elderly.  There are changes to health information technology stndards and implementation. While the additional pending changes do not directly affect Medicare agents and how they can compliantly market, they will make changes to the experience of the Medicare beneficiary.  Below are highlights of some of the more impactful changes.

Potential changes of the proposal

The CMS Federal Register document would potentially have a major impact in the following areas:

• New rules for an organization or person in the definition of TPMO   TPMO would not be able to share beneficiary information.   This basically means that lead vendors would not be able to generate leads and send them to another TPMO.  This could have major implications for a sales organization or agent that relies on leads generated by a third party lead vendor.
• Lead would only be valid for 6 months.  There is not a limit currently.
• The Medicare Scope of appointment would need to be obtained 48 hours prior to the sales meeting.  They removed the “When practicable” language meaning there would be no exceptions
• The language regarding call recordings would be cleaned up to be more specific and provided clarification
• CMS will take a more proactive role when it comes to consumer complaints
• Agents/advertisers will no longer be permitted to use the Medicare card logo.  That may include no longer being able to have the word “Medicare” in any company title, websites or business cards.
• There could not longer be a sales meeting immediately after a Medicare educational meeting

Learn about our $500 a month lead, marketing and advertising program for agents

CMS Federal Register: Other areas

The new proposal would address other areas as well:

• Prior Authorizations by MA plans will follow similar rules to those currently in place with Original Medicare
• New election for Medicare Part D?  Currently, enrolling in Medicare Part B is not an election for Medicare Part D.  The language seems to imply it would become one in 2024
• The sales disclaimers may be changed to include additional language
• CLICK TO WATCH VIDEO ON CURRENT DISCLAIMERS AND CHANGES FOR 2024

The official website to review the posted document

CLICK FOR OFFICE GOVERNMENT REGISTER SITE

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Plan G High Deductible

A Medicare plan G high deductible plan (HDG) offers beneficiaries the comprehensive benefits of standard plan G at a much lower premium.   The premise is simple.   Like all supplemental (Medigap) plans, Medicare pays first.   The balance is submitted to the Medigap plan for payment.  The 2023 deductible amount is $2,700.  Therefore, enrollees  in a High deductible plan pay the first $2,700, after Medicare has made payment.  Once the $2,700 deductible has been met, the (HDG) covers the balance.   The Part B deductible applies toward the $2,700 deductible.

Both plans F and G have a high deductible option.  Plan F is only available to individuals eligible for Medicare prior to 1/1/2020.

The average cost of HDG is around $40-$90 per month. Medigap Plan G High Deductible cost varies based on several factors and will vary from company to company. Some of the most common factors private carriers assess include your age, location, tobacco usage, and gender.

Plan is ideal for those who:

• Are comfortable paying a higher deductible in exchange for lower monthly premiums
• Don’t often see the doctor or need to visit the hospital
• Live in a state that allows excess charges
• Enjoy traveling outside the U.S.

Click here for a summary of what Medicare HDG covers.

How to compare Medicare advantage plans:   Agent contracting

Agents can use our online link to request contracting with all the carriers they need. All contracts  pay agents directly at full allowable CMS max commission.  Because of this, the agent owns the cases they write (the book of business).

CLICK HERE FOR AGENT CONTRACTING

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Selling Medicare Advantage over the phone

Selling Medicare Advantage over the phone is becoming the most common approach with agents.  While there certainly are many agents selling face to face, phone sales has grown in popularity.  The business was trending this way but has been accelerated by COVID.

Read below to learn how to start making sales without face to face meetings.

Looking to get contracted with Medicare carriers?  Use our online contracting link to get started

General concepts and things to know when getting started

There are some basics people need to understand when selling Medicare Advantage over the phone.  For those that have already been selling Medicare on a face to face basis, phone sales can be a big adjustment.  In part, this is due to the difference in closing ratio between face to face and phone.  To a degree, it can be easier to get started with phone sales for those that have not sold face to face in the past.  The challenge for the new agent, not familiar with Medicare is learning the benefits and rules. (of which there are many)

Selling Medicare Advantage over the phone:  The positives and negatives

Selling by phone has some major advantages.  A phone sales agent is able to solicit and work more leads than a face to face agent.  They are not spending time on the road or engaging in long conversations in the office.  As a result, they can talk to many more people in a given day. The drawback is the closing ratio will be much lower by phone than it will be face to face.  An agent selling face to face may close 80% or higher.  The best case scenario for a phone sales agent is 20% but even that would be on the highest end of the scale. In other words, a phone agent must be able to accept failure much more often.  The benefit is they can speak to far more people in a day.

Types of leads for phone sales

Leads are essential with phone sales.  Without lead volume, the agent is going to be sitting around a lot and not making money. There are certain types of leads that work best when selling Medicare advantage over the phone.  The lead types most commonly used with phone sales are:

• Inbound call leads
• Warm transfer leads
• Call back recorded leads
• Online or data leads

We have leads available through LeadStar:  Click to learn more

Other lead types such as mailers can be used for phone sales but are not as efficient. Make note, there are subtle differences between the call leads but the process to work them is the same.  Online leads of any type are a different set up and approach given the nature of them.

Importance of tracking leads to determine a CPA

When working any of type of leads for phone sales, it is critical to track results.  Many agents focus on the cost per lead (CPL) vs. the cost per acquisition (CPA).  Some agents may shy away from certain leads due to the price.  At the end of the day, what really matters is how many of them you close for the cost.  If I am getting call back leads at $12 each but I only close 1 out of 20 vs. a $40 lead and you close 5 out of 20, the CPA comes out better on the $40 lead.    Tracking all results is the only way you can determine which lead type is giving you the best CPA.

Selling Medicare Advantage over the phone:  Set up to sell

The set up is different for phone vs. online lead sales.  We will focus on the phone set up and what agents need to do in order to start taking in leads and working them effectively.  The basic steps are listed below:

Access to Medicare plan quoting comparison and enrollment platform

Agents need to be able to quickly quote and compare plans when talking with prospects.  They need to be able to see all available plans in a given area side by side and be able to see the benefits of each.  It is important to see benefits amounts for things like dental, vision, OTC, grocery and Flex cards.  Sunfire, MyMedicarebot or Connecture are the 3 most common platforms agents work with.  CSG also offers the ability to quote and compare but the system does not have the ability to check medications, save profiles or enroll prospects.  Many agents still us the Medicare.gov plan finder.  The system works but profiles can only be saved if the client creates one.  More importantly, if the member self enrolls the agent does not get listed as the AOR on the case.

Enrollment platform

Being able to enroll the members is obviously important.  Medicare enrollments can be completed by voice signature or sending an enrollment link by text or email.   Luckily, the quoting and comparison platforms also have an enrollment function

The 3 most commonly used systems to address this are Sunfire, Connecture and MyMedicarebot.   Crowe and Associates gives agents access to all 3 platforms at no cost to the agent.

CLICK HERE TO LEARN MORE ABOUT ENROLLMENT PLATFORMS

Selling Medicare Advantage over the phone:  Call script

It is common for someone to focus on the idea of a set call script.  In reality, there is not one script for calling all lead types.  The script will vary slightly depending on the type of lead being called. (call back, warm transfer, live transfer, online)  The overall concept is the same for all of them however.  There are some basic skills that any good call agent will have.  Watch the video below and and access the blog for more details on the script.

CLICK FOR CALL SCRIPT MEDICARE

Do you need a CRM?

This question comes up very often.  A CRM is needed to track progress, call back prospects and also help automate other functions such as emails and social media posts.  The 3 enrollment systems in Connect4Medicare all have basic CRM functions that will save client data and allow to schedule call backs.    Many agents run successful practices using the basic functions of the built in CRM’s.  For those looking for a CRM with more functionality, there are a number of systems out there but they will come at a cost.   We have experience with a number of them.   Most notably they are Blitz, Radius Bob, Less annoying CRM and Go High Level. There certainly are many more however.

Read a review of most commonly used insurance CRM systems

Selling Medicare Advantage over the phone:  $500 a month toward lead costs

We give agents $500 a month toward lead and marketing costs.  Click the link to learn more

$500 a month lead and marketing plan for agents

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How to compare Medicare Advantage plans

Learn how to compare Medicare Advantage plans through online software at no cost.  There are multiple platforms that provide this service.   The 3 main agent sites are Connecture, Sunfire and MyMedicarebot.  Crowe and associates offers all 3 including recording capability to agents at no cost.   Medicare Plan Finder can also be used to quote and compare plans.  Please note;  agents do not receive credit for enrollments done through this site.   Agents are also unable to save each client profile on their own, that makes this not an ideal way to enroll clients.

How to compare Medicare Advantage plans:  Connect4Medicare

Crowe and Associates gives agents access to Connect4Medicare.  (C4M)   C4M provides access to the 3 main enrollment portals agents use in the Medicare space.  Connecture, Sunfire and MyMedicarebot all work in a similar manner.   All 3 have the ability to save client profiles including prescription and doctors lists.  Agents can save the profile for each client and access the specific Medication lists for future reference.   The systems will create compliant plan comparisons and the ability to enroll prospects over the phone.  Agents are able to fill out the entire application for prospects and send them the enrollment link via email, text or voice enroll.

Watch a video demonstration of the quote and enrollment systems

Looking at benefit details as an agent

It is important for Medicare agents to know how to compare Medicare Advantage plans quickly.  When speaking with clients, agents will need to be able to see specific benefits.  Knowing the difference in copays and other cost shares is important.  Given the current state of Medicare eligible people today, there is a increased focus on other benefits.  Benefits such as dental, vision, OTC, grocery cards and flex cards.  A detailed quote system will show the difference in these extra benefits.

Connecture vs. Sunfire vs. MyMedicarebot

Agents that know how to compare Medicare plans through these systems have the ability to quote all plans. They can quote plans they are certified to sell and also plans they are not contracted.  The question always comes up as to which system is the best at showing benefit details in the comparisons.  While all 3 systems are easy to use, Sunfire provides the most detailed comparisons the quickest.  This is especially the case with the extra benefits such as dental, vision, OTC, grocery and flex benefits.

How to compare Medicare advantage plans:   Agent contracting

Looking to get contracted?  Agents can use our online link to request contracting with all the carriers they need. All contracts are set up to pay agents directly at full allowable CMS max commission.  Because of this, the agent owns the cases they write (the book of business).

CLICK HERE FOR AGENT CONTRACTING

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Wellcare OTC 2023

If you are either a producer who offers MA plans or a member of a participating Wellcare MA plan, you should take a look at the Wellcare OTC 2023.

Click here to download the Wellcare 2023 OTC Catalog

Wellcare DSNP members learn about the Healthy foods card and $0 prescription co-pays.

There are 3 ways to order OTC items:

1.Purchase items from a participating OTCHS enabled store

Find a participating OTC store

1. Find approved items in your OTC catalog.  Keep in mind, your plan will only cover items listed in the catalog.
2. Go to either an OTCHS enabled  CVS pharmacy, CVS Pharmacy y mas or a Navarro store.  Important; not all CVS store participate in this benefit program.  To find a participating store either go to https://www.cvs.com/otchs/wellcare/storelocator or call  1-866-819-2516 (TTY 711).
3. Locate the OTC indicator on the top right of the shelf label and check the SKU number to be sure the item is eligible for the OTC benefit.  Some locations may have a OTCHS dedicated location.  Be sure to check your catalog to verify item eligibility.
4. Take your items to any sales register to complete your purchase.

Wellcare 2023 OTC QR code and store associate instructions

If the item you are looking for is not available, just contact OTCHS or visit the website to process your order.

Please note; the store’s regular retail price may vary.  To obtain the OTC item prices, please refer to your catalog.  CVS ExtraBucks cannot be combined with your OTC benefit or other promotional offers.

2. Order items Online

This is the quickest and easiest way to order your OTC items 24/7.   Please note; Online orders submitted by 11:59 pm ET will be processed the same day.
1.  Go to https://www.cvs.com/otchs/wellcare.  You need to create an account before your first order.  Just click the create account button and follow the instructions.
Important; each member must have a separate email address.  If a member shares an email address with spouse or caregiver who also has an OTC account, they will only be able to register one account.
2.  Once you sign in, you can see your benefit balance at the top of the page.  You can then view available products and add them to your basket.  The order total is automatically deducted from your balance at the top of the page.
3.  You will receive email notifications on your order status.
4. Orders for each benefit period must be placed by 11:59 PM ET of the last day of the benefit period.  Orders can be cancelled within 30 minutes of processing.

3. Order over the phone

1. Place your order over the phone; just call 1-866-819-2516.  Live agents are available Monday – Friday, 9:00 am until 8:00 pm local time.
2. Please have your ID and order ready before calling the agent.
3. You can use Wellcare’s automated IVR system 24/7 to either place an order, track an order, cancel an order, hear benefit information or order a catalog.

How to place an order by phone (IVR system):  Call OTC Health Solutions (OTCHS) using the phone number on file.  Your health care provider will provide the OTCHS your phone number.  If you want to change or add a number through the IVR system, you can provide the alternate number to the OTCHS agent.

FAQs Wellcare 2023 OTC orders

Due to the personal nature of the OTC products, no returns or exchanges are allowed. If you have either not received your order or received defective or damaged items, please call OTC Health Solutions 1-866-819-2516 within 30 days of placing your order.
If an item is out of stock, you will receive an item of either similar or greater value as a substitution.

Are you a member of a plan that offers SilverSneakers; click here to find participating locations.

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Anthem OTC 2023

Anyone who is a member of an Anthem Medicare Advantage plan with the OTC benefit, will need to access the Anthem OTC 2023 benefit information.

New members of Anthem will receive their ID card and welcome guide 2 weeks after their plan is approved.  The prepaid benefit card as well as the OTC catalog should arrive the following week.

Why do I need 2 cards:

1.  Members will present the Anthem ID card when they visit a providers office for either medical treatment or to use pharmacy benefits.
2.  You will use the The Nations Benefits Mastercard to access all the extra benefits such as;  OTC, Essential Extras, Healthy Groceries, Utility Benefit and Transportation.  The extra benefits are all loaded on the Nations Benefits Mastercard.

When you receive the Nations Benefits Mastercard,   it is inactive. There is a sticker on the card with activation instructions for the card.  You can either call 1-866-413-2582 or go online MyBenefits.NAtionsBenefits.com/Activate to activate your card.

To download the Anthem 2023 OTC Catalog- Click here

Some Anthem OTC 2023 information:

1.  The OTC benefit allowance is loaded onto your card the first day of every quarter

2.  Use the Benefits card to purchase eligible items from any of these categories: OTC, Assistive devices, healthy groceries as well as flex benefits.

3.  You may shop for OTC products once your plan is effective.

4.  Unused balances carry over to the next benefit period but all benefits must be used by midnight on 12/31/23 or they will be lost.

5.  Members can purchase store branded products from any of the categories in the store shopping guide section of the OTC catalog.

6.  You can also check product eligibility by using the MyBenefits Portal app to scan the product’s UC code.

7.  Once you are checking out of the store, you can choose either credit or debit and then swipe your card to purchase.  You do not need a PIN.

There are 3 different ways to use your Benefits Prepaid card for OTC items:

Purchase items in store at a participating, local retailer.  Some examples are:  Walmart, Giant Eagle, CVS, Rite Aid, Schnucks, Kroger & Albertsons.  To search for more participating stores; go to MyBenefits.NationsBenefits.com and search for retailers.  You will find the categories to choose store branded products from in the OTC catalog.   You can also use the MyBenefits portal app to scan the UPS codes on eligible products.

Members can either Shop for products online at MyBenefits.NationsBenefits.com or by downloading the MyBenefits Portal app from the App store or Google Play.   You will receive products in your home with no delivery fee.

Place an order over the phone and get free delivery.  Just call; 1-866-413-2582 (TTY 711).  This service is available 24 hours a day, 7 days a week.

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Best FMO for Medicare

Looking for the best FMO for Medicare agents?  Crowe and Associates offers agents and agencies access to a enrollment platforms, lead money, training and support.  Agents can access a number of Medicare carriers in all 50 states.  In addition, Crowe provides access to other lines of business such as life, final expense, annuities, LTC, health and indemnity products.  Read below for information on a number of the benefits we offer to insurance agents.

A different perspective for agents and agencies

Crowe and Associates started as a one agent without a single Medicare client.  As a result, we know personally what it takes to build a Medicare book of business and then to build an agency.  We share this experience with our agents.  Wether they want to build up a profitable book of business or start to recruit and grow and agency, we have the blueprint to help them do it.  Our agent programs were designed based on real experience of what agents need to be successful.  We are an independently run office in Connecticut which is backed by Pinnacle Financial Services to provide agents with support in a number of areas.

Best FMO for Medicare:  Turn-key turning 65 seminar program

Our Turning 65 educational Medicare seminar program averages over 50+ prospects per seminar.  Agents can focus their time on presenting and writing business instead of worrying about generating attendance.  We work with agents on the best practices for their educational seminar from start to finish.  Sample presentations are available along with hands on guidance and training.  Best practices such as where to hold the event, when to serve the meals, ideal presentation time, follow up and all other aspects are covered. Crowe offers 50% toward the cost of the first seminar and $500 toward all future seminars.  Agents and agencies utilizing our seminars write 20+ new policies per seminar when they follow our guidance.

Learn more about our T-65 Seminar program

Monthly Medicare lead and marketing reimbursement

Every agent with Crowe and Associates has access to $500 per month toward Medicare marketing and lead costs.  The program is simple.  The agent simply sends our their monthly lead or marketing receipt and we reimburse them up to $500 a month toward the cost.  There are no minimums to start and commissions are not reduced in any way.( All agents with Crowe are paid directly by the carrier and recieve CMS Max allowable commission) Agents can utilize the program as long as they want.  We have agents that have been using the program on a monthly basis for 6 years. Agencies can offer the program as a method to recruit agents into their hierarchy.

$500 monthly Medicare marketing and lead reimbursement program

Best FMO for Medicare:  Connect4Medicare online enrollment software

Connect4Medicare gives agents access to 3 online quote, comparison and enrollment platforms.  Agents can access Connecture, Sunfire and MyMedicarebot at no cost to them.  All 3 systems will quote and compare Medicare advantage, Supplement, PDP plans and other health benefits such as dental, vision and hospital indemnity. The system save client information, prescription and doctors lists.  All 3 offer online enrollment without the need for a face to face appointment.

More information on Connect4Medicare

Free agent websites, graphic design and SEO

Crowe strives to be the best FMO for Medicare agents by offering support for a number of online and search functions.  Agents can have a free website (Agent owns the URL) that is created specific to them with a CMS compliant quote and enrollment platform built in.  The site is provided at no cost to the agent.  We also offer guidance and support with SEO and online advertising through platforms such as Facebook, Google Ads, YouTube and linkedin.

Free agent websites

Best FMO for Medicare:  Support and training

Full agent support is provided by both our CT and PA locations.  Agents have access to a full time support team along with a contracting team and a dedicated contracting point person to help them coordinate all efforts. We provide training for day to day sales up to helping call centers get approved as offical call centers with each carrier.  If you prefer to watch training videos online, we hold multiple weekly training webnars from both CT and PA.  Our favorite training is helping agents build agencies and helping current agencies recruit and increase revenue.  We use online contracting so agents and sub agents only need to fill out contracting one time.  As a result, additional carriers can be requested at any time simply by email us.

Crowe YouTube recorded training webinars (Live webinars held on Wednesdays and Thursdays at 1:00 pm EST)

Pinnacle YouTube recorded training webinars (Live webinars held multiple times per week)

Crowe online contracting:  Fill out the online link to request contracting with the carriers you want