Sell Medicare Supplemental Plans
For agents who are on the fence about whether or not selling Medicare Advantage and Supplemental plans is right for them, here are five reasons that selling Medicare can be a lucrative and helpful career move.
-
The Large Market
According to PEW polls, over 10,000 people celebrate their 65th birthday every day in the United States. That is a large and accessible market. Medicare Supplements is also a needed service for the elderly, who will very likely need this medical and hospital coverage as they continue to age. The size of the client pool will continue to increase and the market will not get saturated.
-
High Profit Potential
Medicare Supplement sales tend to offer high sales commissions even in the first few years of experience as well as annual residuals. In this way, selling Medicare Supplements can provide ongoing compensation for the agents who sell it. The plans also require very little servicing on the client’s behalf and that limits the ongoing work that the agent will have to put into maintaining those clients.
-
Competitive Rates
Coverage is standardized across each plan, because of the guidelines set up by the federal government that the contracted private insurance plans have to follow. This means that beneficiaries will receive the same benefits regardless of the company that is servicing their supplemental plan. The differences are in premium costs and locations, which means that insurance agents need to have access to the best carriers in order to provide for their clients.
-
Help Clients You Already Have
As an insurance agent, it is very likely that some of the clients you already have qualify or are soon to qualify for these insurance plans. Be proactive by reaching out to your business clients when they approach their 65th birthdays and let them know that you can help them access Medicare Supplemental Plans.
-
The Ease of Getting Started
There is no specific certification to get in order to sell Medicare Supplemental Insurance Plans. Additionally, there is no enrollment period during which you have to sign up to sell them. It is a year-round opportunity to help your clients and make significant income.
Get Contracted
Our agents receive $500 Free Marketing Leads. Download the details.
Use our online link for a hassle free start! – Click here.
Learn more. Subscribe to our YouTube Channel.
Medicare Part D History Timeline
Let’s take a brief look at the Medicare Part D history timeline. Medicare Part D, or Medicare Prescription Drug Coverage, is not a part of the Original Medicare as provided by the federal government. The federal government contracts with private companies to sell this particular kind of supplemental Medicare insurance. There are two main sources of Part D coverage.
Stand Alone Plans
The first is Prescription Drug Plans, or PDPs. These are standalone companies that sell only prescription drug coverage and do not provide hospital or medical insurance coverage. United HealthCare is an example of the companies who provide these plans through their contracts with the federal government.
MAPD Options
The second source of coverage for Medicare Part D plans are Medicare Advantage Prescription Drug Plans, or MA-PDs. These are Medicare Advantage Plans, which cover hospital, medical, and prescription drug coverage in a single plan. In other words, these Medicare Advantage Plans cover Original Medicare and prescription drug coverage. Medicare Part C is another name for MAPD. There are four main categories of MA-PD plan types.
Health Maintenance Organizations (HMOs):
These follow what is called a gatekeeper model, meaning that every aspect of the beneficiary’s coverage is controlled by the plan and the plan’s membership. The primary care physician must belong to the HMO, the beneficiary must choose specialists that are within the plan, and the prescription drug coverage must be taken from the HMO as well instead of a separate prescription drug plan (PDP).
Preferred Provider Organizations (PPOs):
This is similar to the previous HMO plan in that the beneficiary must choose a primary care physician, but they do not need to have a referral to see a specialist. While they can choose care out-of-network, they will pay more to do so. In PPOs as well as HMOs, the beneficiary must take the prescription drug coverage offered with the plan rather than choose a separate PDP.
Private Fee for Service Plan (PFFSs):
These are by far the most flexible plans, in which beneficiaries can choose any licensed provider in the United States who is authorized to provide services and agrees to treat them. Like the PPOs, however, members may pay more in fees if they choose to go to a provider who is not a member of the licensed group of practitioners that are contracted with the insurance company. Some PFFSs provide a prescription drug plan and some do not. If the PFFS provides a prescription drug plan, the beneficiary has to take the coverage offered. If the PFFS does not provide drug coverage, then they can choose to get their prescription drug coverage through a separate PDP.
Special Need Plan (SNP): There are three segments of the population who are eligible for these Special Needs Plans. 1. People who are considered dual eligible, meaning they have qualified for both Medicare and Medicaid. 2. People who are institutionalized. And 3. People who have chronic conditions. People who belong to an SNP must take the prescription drug coverage provided and may not go through a separate PDP to access alternative coverage.
Put your knowledge of the Medicare Part D history timeline to use.
Already a certified Medicare agent?
Work with a better FMO! Our agents have access to state of the art quote, enrollment and CRM software at no charge. Additionally, we offer every agent $500 every month to cover lead generation costs.
Click here to learn more about our benefits and programs.
Medicare Supplement guaranteed issue rights
If you are enrolled in Original Medicare, you might consider enrolling in a Medicare Supplement (also referred to as Medigap or Med Supp) plan. Medicare Supplement plans cover some of the out-of-pocket costs that Original Medicare does not cover. These costs include things like; deductibles, co-pays, and coinsurance. When you enroll in a Medicare Supplement plan, you need to understand your guaranteed issue rights.
What does Guaranteed Issue mean?
It means that you have the ability to enroll in a Medicare Supplement plan without having to undergo medical underwriting. In other words; the insurance company cannot ask you any health-related questions or deny you coverage based on your health status. These rights apply only in certain situations which are specified by law.
You have guaranteed issue rights in the following situations:
- You are in your Medigap Open Enrollment Period: The Medigap-Open-Enrollment-Period is a six-month period that starts the first day of the month in which you are both 65 or older and enrolled in Medicare Part B. During this time, you have guaranteed issue rights and can enroll in any Medicare Supplement policy sold in your state, regardless of your health status.
- You lose your Medicare Advantage Plan or Medicare Supplement policy: If you are enrolled in either a Medicare Advantage plan or a Medicare Supplement policy and the plan stops offering coverage in your area, you have guaranteed issue rights to enroll in a Medicare Supplement plan within 63 days of losing your coverage.
- You move to a new state: If you move to a new state and your current Medicare Supplement policy is not available in your new location, you have guaranteed issue rights to purchase a Medicare Supplement plan within 63 days of moving.
- You have a trial right to a Medicare Advantage Plan: If you enroll in a Medicare Advantage Plan for the first time and within the first 12 months of enrollment you decide to disenroll. You have guaranteed issue rights to enroll in a Medicare Supplement plan within 63 days of disenrollment.
- Your Medicare Supplement insurance company goes bankrupt: If your Medicare Supplement insurance company goes bankrupt and you lose your coverage as a result, you have guaranteed issue rights. You have 63 days to enroll in a Medicare Supplement policy.
What if You Don’t qualify for a Guaranteed Issue Policy?
You may still be able to enroll in a Medicare Supplement plan. The only catch is, the insurance company can ask you health-related questions. If they do not like the answers, they can deny you coverage based on your health. Additionally, if the plan accepts you with a pre-existing condition, you may have to pay a higher premium amount for your coverage
Just to summarize; it is important to understand your rights when it comes to enrolling in a Medicare Supplement plan.
If you have guaranteed issue rights, you can enroll in a plan without going through medical underwriting. This can save you time and money. If you do not have guaranteed issue rights, you may still be able to purchase a policy, although you should prepare to answer health questions and potentially pay a higher premium.
For more details on your guaranteed Issue rights; click here
If you need help choosing the best Medicare option, give us a call at 203-796-5403 and speak to a licensed Medicare sales agent.
click here to learn more about us
To view more images by this artist; click here
A Brief History of Medicare and Medicaid
Groom yourself for trivia night with this brief history of Medicare and Medicaid. Original Medicare, or what is known as Parts A and B (hospital and medical coverage), is a relatively new feature in the United States. It was signed into law on July 30, 1965, by then-President Lyndon B. Johnson. Of course, changes have been made since then. In 1972, Medicare was expanded to cover people with disabilities, people with end-stage disease requiring dialysis or kidney transplants, and people who select Medicare at age 65 and older. Additionally, more benefits, such as prescription drug benefits have been added.
At first, Medicaid only offered benefits to a certain group of people: those receiving cash assistance from the federal government. Medicaid has changed since then as well, as a much larger group is covered now, including: low-income families, pregnant women, people with disabilities regardless of age, and those who need long-term care. Under these newer laws, states have the responsibility and ability to change their Medicaid programs to best cover their vulnerable populations, thus ensuring the best use of the federal and tax dollars that cover Medicaid.
Y2K Changes
In 2003, the largest change was made to the Medicare and Medicaid program in over 38 years: The Medicare Prescription Drug Improvement and Modernization Act. Medicare Advantage Plans or Medicare Part C became available under the MMA. This act also expanded Medicare to include an optional prescription drug benefit, known as Part D. Medicare Part D went into effect in 2006.
Since 2006, the largest change to Medicare and Medicaid has come with the Affordable Care Act (ACA). ACA created the health insurance marketplace and subsidized health insurance for millions of Americans. As a result, Medicare and Medicaid have been able to better coordinate how they cover their beneficiaries and provide quality health care services.
Medicare Marketing
Already licensed and certified to sell Medicare? We offer agents a slew of cutting edge tools free of charge. Learn the details here.
Get $500 every month for leads!
Click here to appoint with a better FMO.
Subscribe to our YouTube Channel for weekly updates and training.
Click here to view more images by this artist
History of Medicare Advantage
The origins of Medicare Advantage, also known as Medicare Part C, are in the 1970s. Medicare is ever evolving. Let’s discuss the high level history of Medicare Advantage. The details are consistently redefined even today.
In a nutshell, the greater part of the 3 decades following the 1970s bring beneficiaries major changes.
Balanced Budget Act of 1997
The Balanced Budget Act of 1997 established the new Part C of Medicare – Medicare + Choice. Medicare Choice is an early version of what we know today as Medicare Advantage. Additionally, the Balanced Budget Act aimed to earn federal savings within the Medicaid system in three areas. The gross federal Medicaid savings comes from three sources: Repeal of minimum payment standards from hospitals, nursing homes, and community health centers.
History of Medicare Advantage – Medicare Modernization Act
In 2003, the Medicare Modernization Act passed. Medicare Part D, prescription drug coverage and benefits, are established. At this time, Medicare Choice Plans are officially renamed Medicare Advantage Plans. Before 2003, Medicare offered no prescription benefits or coverage. Because of this new coverage, beneficiaries can recently get all of their medical needs covered in one place, with one cohesive plan, and with one convenient ID card.
Privatized insurance companies begin to offer Medicare Advantage plans. These companies contract with the United States government to provide plans that fit strict guidelines. MAPDs typically cover the same benefits as Original Medicare, in addition to extra coverage including out-of-pocket maximums, some minimal dental coverage, some hearing coverage, and, in most cases, prescription drug coverage. Private insurance companies offer Medicare Advantage (MA) plans. Insurance carriers contract with the program. Medicare Advantage plans provide hospital, outpatient, and, usually, prescription drug coverage. These plans supplant benefits under Medicare parts A, B, and D. However, plans are risk-based plans. Advantage plans are not universal plans covered by the federal government. And, there is variation in the quality and quantity of benefits that purchasers receive. They are ubiquitous, though, with over 98% of beneficiaries having had access to privatized plans in 2017.
Already a certified Medicare agent?
Work with a better FMO! Our agents have access to state of the art quote, enrollment and CRM software at no charge. Additionally, we offer every agent $500 every month to cover lead generation costs.
Click here to learn more about our benefits and programs.
Subscribe to our YouTube Channel here.
Click here to view more images by this artist
Medicare Annual Enrollment 2023
As we get closer to the end of the year, many people start thinking about the Medicare Annual Enrollment 2023. During this time of the year, you can make changes to your Medicare coverage for the upcoming year. It is important to note; each year Medicare plans change. Some plans add benefits to a plan or change the way they cover a medication. Whether you’re a first-time Medicare beneficiary or have been on Medicare for years, you should check your plan each year to stay informed about the changes that may effect your coverage for the following year.
When is Annual Enrollment 2023:
Medicare Annual Enrollment begins October 15, 2022 and ends on December 7, 2022. During this time, you’ll be able to make changes to your Medicare coverage for the upcoming year.
What changes can I make during the Medicare AEP
- Beneficiaries of Original Medicare may change to a Medicare Advantage plan.
- If you are on a Medicare Advantage plan you can change to Original Medicare.
- You may decide to enroll in a PDP (Part D, prescription drug plan).
- You can also change from one Medicare Advantage plan to another.
- Some people switch from one PDP plan to another.
- Other individuals may choose to drop their Part D coverage altogether.
Things to consider before changing your Medicare coverage:
- Each year you should review your healthcare coverage. Many people find it invaluable to enlist the expertise of a licensed insurance agent for this. Because there are so many plan options it can get confusing. Make sure you understand your current coverage so it will be easier to compare it with the best plan choices for next year.
- Think about your health care needs especially if they have changed. If possible, try to consider what you may need in the upcoming year.
- If you are on a Medicare advantage plan, be sure to check that your health care providers will still be in-network. Providers and facilities (hospitals, labs, out patient clinics) do make changes during the year and if you skip this step, it could be very costly.
- Members of PDP plans need to carefully check their plan’s formulary. Private insurance companies do change these each year and something that is covered this year may not be next year. It is possible there is a prescription drug plan that is a better fit for you for next year.
- If possible, it is a good idea to look at the total cost of this year’s plan (plan premium, deductibles, co-pays and co-insurance) to see if you can save money next year. It is important to think about your budget as well as your healthcare needs.
There are many resources to help you learn more about the Medicare Annual Enrollment 2023:
- Visit the Medicare.gov website: The official Medicare website provides information about all aspects of Medicare.
- State Health Insurance Assistance Programs (SHIPs): SHIPs offer free, personalized Medicare counseling and assistance. These programs can also provide valuable information on programs for those with a limited income.
- Medicare and You Handbook: The Medicare and You Handbook is a comprehensive guide to Medicare that is updated each year and mailed to all Medicare beneficiaries.
- Call a local insurance agent. Make sure the agent is licensed and appointed to sell the most competitive plans in your area. If you find a reliable and knowledgeable agent, this will help narrow down the choices for you to make an informed decision.
The Medicare Annual Enrollment 2023 is an important time of year for Medicare beneficiaries to review and make changes to their coverage. By staying informed and considering your health care needs, you can make the best decisions for your health and budget.
Please note; any changes you make during the Medicare Annual Enrollment period will not take effect until January 1, 2024.
There are other enrollment periods that yo may be able to take advantage of during the year.
to view more images by this artist; click here
NABIP
NAHU (National Association of Health Underwriters) changed their name to NABIP (National Association of Benefits and Insurance Professionals. The brand name change started in January of 2023. NABIP represents more than 100,000 Licensed health producers including agents, consultants, brokes and upline entities. As an organization, they host a number of state and national events. Use the link at the bottom of this post to see upcoming events near you. Agents can register for each event through the link.
About Members
NABIP Members work with and help millions of consumers get the best policy at the most affordable price. Members also help clients with service, compliance and claims issues. NABIP advances the interests of health insurance profesionals through advocacy at state and federal levels of the government. Their members help millions of health insurance consumers with both individual and group benefit decisions on an annual basis.
Want to become an insurance agent or broker? CLICK HERE TO LEARN MORE or ONLINE CONTRACTING FOR INSURANCE AGENTS
Members clients
The clients of NABIP members range from individuals and small businesses under 5 employees to Fortune 500 companies. Members help their clients find the best healthcare at the most affordable price. In addition, members advise clients on a full line of other products such as dental, Medicare Advantage, Medicare Supplements, disability and a full range of indemnity products. NABIP holds members to a Code of Ethics which requires them to make recommendations with their clients best interest in mind.
NABIP member benefits
Members have access to a number of educational opportunities such as advanced professional designations, CE classes and online learning courses. NABIP promotes its members with professional conferences, networking functions, business tools and mulitple publications. They also advocate for members at the state and federal level of government in the interest of their members.
NABIP Medicare Portal
The Medicare Portal gives members access to a variety of helpful information and tools from certification information to legislative updates. NABIP is the only organization currently representing agents and brokers working with Medicare products.
Looking for online Medicare sales and marketing training? CLICK HERE FOR RECORDED TRAINING VIDEOS
Calendar of events
The NABIP event calendar lists upcoming events such as the Annual Convention, NABIP Capitol Conference, Regional Conferences, State Conferences, Medicare Summits and Industry Meetings.
FIND AND AGENT
Find an agent with the link below. A zip code range will yield the best results. A single zip code will yeild the best.
To view more images by this artist; click here
How to avoid Medicare mistakes
If you are getting close to your 65th birthday, you need to know how to avoid Medicare mistakes. Some mistakes can be difficult to repair and may end up costing you money.
Let’s start by explaining what original Medicare is; Original Medicare is a health insurance program offered by the federal government. There are 2 parts to original Medicare. The first part is Part A. In general, Part A covers hospital costs. The second part is Part B. Part B covers things such as doctor’s visits as well as other outpatient services. Most providers participate in original Medicare.
Here are some mistakes people make with Medicare:
1. Waiting to long to sign up for Medicare
There are specific time that you can sign up for Medicare coverage. The most common is your initial enrollment period. This enrollment period begins 3 months before he month you turn 65 and ends 3 months after the month you turn 65.
If you choose not to sign up during your initial enrollment period (IEP), you will need to wait until the Medicare general enrollment period (GEP). The GEP starts January 1st and ends March 31st each year. Your Medicare coverage begins the first day of the month after you apply.
Signing up for Medicare late may leave you with a late enrollment penalty. This penalty can add 10% to your monthly Part B premium for every year (12 months) you delay. This penalty applies only if you do not have other credible insurance coverage (credible coverage is most likely an employer sponsored plan). If you have insurance either through yours or your spouse’s employer, you may be able to delay your Medicare enrollment until you retire or lose your group coverage.
2. Not enrolling when your employer coverage is considered secondary insurance
Although your employer provides health insurance, you may still need to enroll in Medicare. One thing that helps determine if you need to sign up is the size of the company. If there are 20 or more employees, your group health insurance is considered your primary coverage and Medicare is secondary coverage. When this is the case, you may want to delay signing up for Medicare while you or your spouse are still working.
If the employer has less than 20 employees, Medicare normally becomes the primary insurance once you turn 65 and the employer coverage becomes secondary. This can happen even if you have not signed up for Medicare yet.
Additionally, both retiree coverage and COBRA are considered secondary coverage. This means these plans will pay for claims only after Medicare has paid their portion. If this is the case, signing up for Medicare on time is very important.
Because there are exceptions to every rule, it is important to speak with your human resources or benefits manager to determine if your employment based health insurance is primary or secondary to Medicare.
3. A lack of understanding of your coverage options
Because original Medicare does not cover 100% of your medical expenses, you will need some type of additional coverage. In general, you have two options for coverage. You can choose either original Medicare with a supplement and drug plan or a Medicare Advantage plan. Many factors will help you decided which type of coverage is best for you. You will have to consider things such as; your health, the doctors you see, the area you live in (plan availability), your finances and weather or not you travel.
Some people prefer a Medicare Supplement plan:
These plans are a good choice for individuals who do not want to check a doctor’s network and do not like the idea of referrals for services needed. If you are considering this choice, keep in mind, you will need to purchase a separate prescription drug plan. Both the Medicare supplement and the drug plan will have a monthly premium.
When choosing a prescription drug plan (Part D), always check your list of medications and see which plan covers them the best
Find out more about Medicare Supplement plans
Medicare Advantage plans are another choice:
Medicare Advantage plans are offered by private insurance companies. They cover Medicare Parts A & B and most times Part D benefits as well. These plans are very competitive and offer many additional benefits that you cannot get with a Medicare Supplement plan. Some of the benefits include dental, eye and hearing as well as free transportation to medical appointments and much more.
Some things to consider when choosing a Medicare Advantage plan are; are you current doctors in the plans network? Although many of the plans are PPOs (this means they provide out-of-network coverage), Some of the plans are HMOs and they do not provide out-of-network coverage. This means it is very important to check your list of providers (doctors & hospitals) and make sure they are in-network with any plan you are considering. Click here to learn more about MA plans.
4. Forgetting to sign up for Part D
Because original Medicare does not cover prescriptions, you will need to enroll in a plan that covers your medications. Make sure you have Part D coverage as soon as you are eligible for Medicare. If you do not have credible drug coverage when you are first eligible, Medicare will penalize you. The penalty may not be a large amount but, it will last the entire time you are on Medicare.
Credible coverage is Drug coverage that is considered equal to or better than what a Part D plan provides. If you are either staying on employer coverage, receive retiree benefits or Tricare military benefits you probably have credible drug coverage. If you choose to enroll in a Medicare Advantage plan, most of them include Part D coverage as well.
When you choose to purchase a Medicare Supplement plan, you need to purchase a stand alone prescription drug plan (part D). Independent insurance companies offer Part D plans and the coverage varies from plan to plan. If you choose to purchase either a stand alone drug plan or a Medicare Advantage plan, you need to check the cost of your prescriptions on that possible new plan.
Each part D plan has a list of covered drugs (a formulary) this will tell you if your prescription is covered and what your co-pay will be. If your drug is not on the formulary, you may need to request an exception from the plan, pay for the drug out of pocket or file an appeal wit the insurance company to cover the cost.
If you lose your drug coverage for some reason
You are eligible for a special enrollment period for up to two-months after. During this special enrollment period, you can sign up for a Part D plan without a penalty. If for some reason you lose your drug coverage and do not replace it for over 63 days, you may have to pay a penalty.
5. Being unaware of your Out-of-pocket costs
Once you meet your Medicare deductibles, Medicare pays about 80% of approved charges. You will be billed for the remaining cost as well as the deductible. That is why it is a good idea to purchase either a Medicare Supplement and Prescription drug plan or a Medicare Advantage plan to help pay these costs.
Here is a list of some of the costs associated with Medicare:
- Plan premium – Medicare consists of many parts. Most people qualify for free Medicare Part A (hospital coverage) if they have worked the required amount of 40 quarters. If you have not worked long enough, there is premium for Medicare Part A. Medicare Part B (doctor’s visits) has a premium of $164.90in 2023. You will need to pay this amount via deduction from your Social Security check or by quarterly invoice. If you enroll in a Medicare Supplement plan and a Part D plan, they will both have a premium to pay. Medicare advantage plans may also come with a monthly premium although there are many $0 options for these plans.
- Deductible – In 2023, the deductible for Medicare Part A is $1,600 for each benefit period. It is not an annual deductible. The Part B deductible is $226 annually in 2023. Most Part D plans also have deductibles, but this varies by plan.
- Co-pays – this is an amount that is decided by the plan you are on and is applied to specific services/providers you use for care. To view the co-pays associated with your plan, please refer to the summary of benefits for your plan.
- Coinsurance – this is a percentage of the cost of services or prescriptions you receive. Original Medicare usually pays 80% of the cost leaving the beneficiary with a 20% cost share. With Part D plans, you may need to pay a percentage of the cost for more expensive name brand drugs.
6. Not signing up because you assume you can’t afford to get Medicare coverage
Fortunately, there are many programs in place to help individuals with limited income pay premiums and cost shares.
The federal government offers a program called Extra Help. This program helps qualified individuals pay for both Part D premiums and the cost of their medications. To see if you qualify for Extra Help; click here.
In addition to the federal Extra Help program, several states offer pharmaceutical assistance. These program can also help individuals pay for prescriptions. Check to see if the programs are available in your state.
Most states offer the MSP (Medicare Savings Program). This program offers help to pay for both Part A & Part B premiums as well as deductibles, co-insurance and co-pays. There are 4 levels of help available on this program based on the individuals income. Learn more about the MSP
Click here to view more images by this artist
Common Definitions in Medicare and Supplemental Insurance
The jargon around Medicare and insurance in general can feel very inaccessible to potential clients. One of the ways that agents can earn the trust of those clients as well as inform them and help them find coverage that works for them is to know the common definitions in Medicare and Supplemental insurance.
The following are some of the common Medicare-related terms that clients will need to know:
This is the period of time during which people can enroll in, disenroll from, or change their Medicare Advantage, Supplemental plans or prescription drug plans. This is also the period of time in which beneficiaries can return to original Medicare. Choices made during this time period are effective January 1st of the following year. The time period is October 15th to December 7th.
Not every beneficiary will reach this gap. However, the coverage gap for 2023 begins after the beneficiary and their drug plan have spent $4660 dollars on covered and approved medications. While in this coverage gap, members with higher prescription drug costs will pay a higher percentage of the cost of their medicine.
Deductible:
This is the amount that beneficiaries will pay for benefits before the plan begins to pay for their benefits. These include medical coverage, including services, prescriptions, and products.
Initial Coverage Election Period:
This is often referred to by its acronym, the ICEP. This is the period of time when a person who is eligible for Medicare can sign up to receive those benefits for the first time. It begins three months before the person’s birthday month, includes the birthday month, and ends three months after the birthday month. It is a seven month period.
Medicaid: It is easy to get confused between Medicare and Medicaid. Medicaid is a program that provides health-coverage for certain low-income people. Most often included are pregnant women, the elderly, and those with disabilities. It is funded jointly by federal and state money.
Agent Resources
Every agent gets $500 to cover monthly lead costs. – No gimmicks! No production requirements to start.
Learn why to work with a better FMO. If you are currently appointed with another upline and looking to change, instructions are here.
Click here to begin contracting.
Subscribe to your YouTube Channel.
Click here to view more images by this artist
Five Strategies for Getting and Keeping Clients
Agents need to learn how to effectively approach their potential clients in order to provide them with appropriate supplemental health insurance that will cover what is needed. Here are five strategies for getting and keeping clients.
-
Establish Rapport
This can truly be as simple as treating clients like the people and individuals that they are rather than as revenue. Empathy and confidence can go a long way here, as well as asking open-ended questions to get clients to open up to you in ways that may help you determine how to best help them.
-
Understand Motivations
There are nearly unlimited options for Medicare Supplemental Plans. With this in mind, it is crucial that an agent find out what is important to the client. Once the agent understands what procedures, services, and goods are likely to be needed, it will be much easier to recommend a supplemental plan that fits with the client’s lifestyle.
-
Educate Clients
It is vital that clients are informed about all of their options. Before they will buy a supplemental plan, they need to believe that they need what the agent is offering them, which requires the knowledge to evaluate their options. Part of educating clients is illustrating how the right levels of coverage will affect their lives moving forward. Many clients who come to purchase supplemental insurance will have little idea of how the system works, so it is very important that agents are knowledgeable enough to give them the information they need to make educated decisions.
-
Tell Relatable Stories – (key to getting and keeping clients)
Often, agents can be tempted to quote facts and figures as a way to convince clients to purchase supplemental coverage. However, it is often much more effective to tell personal stories. Anecdotes about how the right level of coverage has positively affected former customers or acquaintances can do much more for convincing than abstract numbers can.
-
Discuss Costs in a Positive Light
Although clients will have to pay to purchase the supplemental plans, agents can make this far more palatable. One of the ways to do this is to give examples of how the level of coverage they are paying for will positively affect their lives.
Five Strategies for Getting and Keeping Clients – Training Videos.
Click here to watch our training video – Best Practices to Build an Agency.
Or, click here to subscribe to our YouTube Channel.
Watch a webinar on building a Medicare agency
Get $500 monthly to cover Medicare Lead costs. Click here to find out how.
Click here to view more images by this artist
What Do Healthcare Customers Want?
Healthcare is an unusual industry because the patient, or beneficiary, is also the customer. What Do Healthcare Customers Want? Customers, by and large, have an ever-evolving list of things they look for in choosing which products they want to purchase. In order to help best determine which supplemental insurance plans are best for your clients, you need to know what is important to them. Here are the top five things that healthcare consumers are looking for now:
Convenience
Life is busy, and it’s only getting busier. People rely on convenience. Automated tasks and obligations are necessary. Healthcare is no exception. Additionally, some are available online. If a task is not convenient, it is often put off. And when healthcare decisions or services are put off, there are often disastrous consequences. Luckily, increasing technology is making healthcare more convenient to access even as our lives get busier. Some of the ways healthcare companies are making their services more accessible are the following:
-
Online scheduling
-
Telehealth appointments and remote appointments are less time consuming.
-
Automated prescription refills
-
X ray and other scan access from a cloud rather than in person
-
Online pharmacies that can deliver medications to the patient’s home address
What Do Healthcare Customers Want? – Transparency
Health insurance is hard to navigate for most. No one likes to feel like the wool is being pulled over their eyes. Today’s consumers want transparency from their healthcare. There is increasing demand for more clarity in billing. Many beneficiaries do not know what they will be charged up front in a doctor’s office or facility. It is also not only about costs – beneficiaries want their medical advice to be transparent, too. This can include the pros and cons of a particular procedure, prescription alternatives, and second opinions. Transparency on all levels is about building trust.
Good Bedside Manner
Overly authoritative, dismissive, or just plain rude doctors and facilities can no longer sneak under the radar in the age of the internet. Negative reviews can have real adverse effects on a business or practice. Patients have special insights into their own bodies. As a result, their own concerns and symptoms need to be listened to carefully and seriously and considered in the diagnosis and treatment process.
Access To Information
Beneficiaries want to know the answers to their questions and concerns – point blank. They expect information about their healthcare and supplemental plans to be readily available. Some ways insurance companies are beginning to provide online portals that allow beneficiaries access to their information from anywhere at any time. Consumers also want more accessible information regarding coverage. They need to understand any potential coverage gap in their supplemental plans. The Medicare world is over flooded. Provide access to solid information. Teach clients to discern accurate information from marketing schemes.
What Do Healthcare Customers Want? – Options For Care
Beneficiaries want to be included in their insurance company’s deliberation processes. Customer feedback is imperative. They prefer to make collaborative decisions about their care, not simply be told what is covered and what is not. Healthcare providers and companies who take these desires seriously are more likely to have happier, more loyal consumers for a longer period of time.
Turning Back the Clock
Learn a brief history of Medicare and Medicaid.
Here is a history of Medicare RX plans.
How did Medicare Advantage come about?
Work with a better FMO.
Get $500 monthly lead dollars. Learn how by clicking here.
Click here to view just a few of the benefits we provide agents.
Click To Access Our Training Library
Or, click here to subscribe to our YouTube Channel.
Watch a webinar on building a Medicare agency
Click here to view more images by this artist
What is a Medicare Appeal?
Sometimes, beneficiaries’ insurance plans can deny them coverage. A Medicare appeal is the action they can take if they disagree with a decision or payment by their Medicare plan. Beneficiaries can appeal if their Medicare plan denies them the following:
-
A request for a health care item, supply, service, or drug that the beneficiary thinks that Medicare should cover.
-
A request for a payment for a service, supply, drug, or health care item that the beneficiary already received.
-
A request for a change of the amount the beneficiary must pay for the service, supply, drug, or health care item.
How to File an Appeal:
A beneficiary can start their appeal process through their plan if they have a Medicare Health Plan. The following are generic directions to follow to begin an appeal:
-
The beneficiary, their representative, or their doctor will ask for an appeal within 60 days of the date of the coverage decision. If the deadline is missed, a reason for the delay must be provided.
-
Include the following required information in the written appeal:
-
The beneficiary’s name, address, and the Medicare Number on their Medicare card [JPG]
-
The items or services for which they’re requesting a reconsideration, the dates of service, and the reason(s) why they are appealing.
-
The name of the beneficiary’s representative and proof of representation, if applicable.
-
Any other information that may help the beneficiary’s case.
-
-
Beneficiaries can request a fast or expedited decision from their appeal if they think their health could be seriously harmed by waiting the standard 14 days for a decision. This means that the plan must provide a decision within 72 hours of their receipt of the appeal if they agree that the beneficiary’s health would be seriously harmed by waiting the time period for the standard decision.
- Submit online. Click here to begin.
How long an insurance plan has to respond to a beneficiary’s Medicare appeal depends on the type of request:
-
Expedited (fast) request—72 hours
-
Standard service request—30 calendar days
-
Payment request—60 calendar days
Work with a better FMO.
Click here to view just a few of the benefits we provide agents.
Click To Access Our Training Library
Or, click here to subscribe to our YouTube Channel.
Watch a webinar on building a Medicare agency