how to sell medicare Archives

How to sell Medicare Advantage plans

By Ed Crowe | General Articles | 0 comment | 26 February, 2024 | 0

How to sell Medicare Advantage plans

Learning how to sell Medicare advantage plans can take time. There are certain steps an agent should take when getting started. This includes contracting with the most competitive carriers in the areas you plan to sell, having a full understanding of Original Medicare, Medicare Advantage plans, Medicare supplements and part D plans and understanding enrollment rules. Read below to see how to get started.

Contracting with Carriers

CLICK HERE TO GET CONTRACTED WITH CARRIERS

Agents need to find the most competitive carriers in the areas they plan to market in. We suggest taking time to study the carriers plans to determine which ones offer the best overall benefits. This can be done by comparing plans on Connecture or Sunfire. Agents that do not have access to either system may compare on the Medicare plan finder. It is suggested agents access Connecture or Sunfire at some point as it is a better way to quote, compare and enroll prospects long term.

Learn how to choose the right Medicare carriers; watch a YouTube video

Here are some of the benefits to consider when if you are trying to see which carriers offer the most competitive plans:

Out of pocket maximum
Primary and specialist copays
Inpatient hospital copay
Ancillary benefits: Ancillary benefits have become very important when it comes to comparing plans. It can certainly be argued that people should not be picking plans based on ancillary benefits such as dental. The reality however is that people do tend to focus on those benefits more than they should so they need to be taken into consideration
- Dental
- Vision
- OTC
- Transportation
- Additional benefits that provide monthly allowances from various expenses
Network is important when it comes to offering plans. Selling a plan with a limited network can lead to a lot of client turnover. It takes time to determine the strength of a carriers network. We suggest reaching out to the broker managers with each carrier to get a better understanding of the network strength of the plans they represent.

Certifications

Annual certifications are a reality with those that offer Medicare Advantage and Part D plans. Annual completion of the AHIP certification is also required. New agents should be aware they will need to complete certifications for every carrier they plan to get appointed with and sell.

How to sell Medicare Advantage plans: Education

It is critically important to put the effort in to fully understand Medicare benefits. All aspects of Medicare benefits. This includes Original Medicare benefits, enrolment periods and rules for getting Medicare A and B, Medicare advantage benefits, Medicare Supplement benefits and Medicare Part D benefits. In addition, a strong knowledge of the enrolment periods and special elections for the above listed products is also needed. Agents selling Medicare supplements in underwritten states need to understand when prospects can apply using guaranteed issue vs. policies applications that will need to go through underwriting.

Getting in front of enough prospects: Leads, marketing, referrals and maintaining a book of business

The absolute most important part of succeeding in Medicare sales is having a strategy to get in front of enough prospects. This is the number one reason Medicare producers do not make it in the business. Finding a reliable lead source is critical to success. Agents need to be aware of the reality regarding leads. None of them are easy. Working leads is anything but easy and requires thought, time, effort and tracking to make them work. Learn about various types of Medicare leads

In addition to leads, agents need to focus on multiple aspects of building a book of business. Examples would be obtaining referrals from existing clients, building referral sources with centers of influence, passive marketing through a website and social media and a number of other avenues. How to grow and manage a Medicare book of business

There is a common tendency for agents to put in time, effort and money into writing new clients without thinking about their current clients. It is far less expensive and time consuming and expensive to keep existing clients vs. writing new ones. As a result, it makes sense to focus on maintaining existing clients.

How to sell Medicare Advantage plans: How Medicare commissions work

Cash flow is commonly a problem for new agents. More than 50% of new agents start a career in Medicare and do not fully understand how Medicare Advantage commission pay out. CMS lists the max allowable commission for Medicare Advantage and Part D in every state. The maximum is not always paid out depending on the scenario. Agents should take time to understand when they will be receiving full commission vs. partial payments. Renewals are a main driver when getting into the business. It is prudent to understand renewals and factor them into the overall cash flow equations. Video on how commissions pay

How to sell Medicare Advantage plans: Selling other products for more immediate cash flow

Successful Medicare producers make substantial income due to the amount of renewal payments involved vs. other product lines. The most difficult part for new producers is managing lack of cash flow in the early years while they build up a large renewal stream. It is wise to write other products that have more front loaded commissions while writing Medicare cases. Examples of other product lines would be hospital indemnity plans, cancer, critical illness, dental and vision plans. Non health related products such as final expense, standard life, annuities and disability insurance can also be Incorporated. Lastly, ACA business can not only be an additional source of revenue but can be a great lead source for Medicare production.

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Medicare sales event guidelines

By Ed Crowe | General Articles | 0 comment | 6 November, 2023 | 0

Medicare sales event guidelines

The following Medicare sales event guidelines will help ensure you have a successful and complaint event. Sales events can be a great way to present the benefits of Medicare plans in a location where beneficiaries can interact with you and others. It is a way to educate individuals and provides an opportunity to answer any questions that arise.

Meeting in a group setting can provide information and guidance to several people at one time. This can be a good option during AEP where many people have questions.

Click here to view a quick AEP planning video

Before you plan a meeting, it is extremely important to understand how to conduct meetings within the CMS guidelines.

What defines a sales or marketing event:

There are 2 kinds of sales events:

One type of sales event is a formal sales event. The agent will conduct the event more as a presentation to the audience.

The second type of sales event is informal. It is less structured and is sometimes held at a staffed kiosk or table and potential clients can initiate contact and direct the flow of information.

Whether you call it a sales or marketing event, it is held to highlight a specific group of plans with the idea of convincing potential enrollees of the benefits of choosing one of the suggested plans.

During a sales event, an agent can offer some educational information as well as discussing the benefits of the highlighted plans. No matter what is discussed it must remain compliant with the rules set by CMS.

To view the CMS rules for Medicare marketing events, click here.

Medicare sales event guidelines, things you Must do:

Notify the carriers you plan to represent at your meeting.

Once you have your meeting plan in place, you need to report it to any carrier you are representing. Each carrier has its own way to file your event. Make sure you follow the procedures of each carrier very carefully. It is advised that you file at least a month before you plan to have your event. After you have done this, the carrier will file your event with CMS. If you plan to host an event for AEP, it is a good idea to put a plan in place as early as August to be ready to go in October.

You must host your event in a public venue.

Sales events must be held in a public venue. You can use places like, private rooms in a restaurant, a library, a senior center or a conference room of a hotel. You can also use a common area in a healthcare setting.

Do not use restricted areas where any type of treatment could take place or providers may give medical advice. Privacy must be respected at all times. This means you cannot hold events near a pharmacy counter where personal information is discussed.

Do not require attendees to provide contact information.

It is acceptable to provide a sign in sheet at your event, but providing personal information is completely optional.

A Scope of Appointment is not required.

If you are holding a sales event, you do not have to collect Scopes because these are not individual appointments. You are presenting the information to a group.

Be sure to bring all the required materials.

In order to present a complaint sales meeting, you need to provide the following:

You must have a sales presentation video. Make sure you present this at the start of your sales seminar. This will cover many of the required points that secret shoppers look for.
Sales kits. These will include a summary of benefits as well as a STAR ratings.

Optional materials that could be good to have with you:

Applications in case someone decides to sign up for a plan.
A Scope in the event that an attendee would

like to schedule a personal meeting.
Drug formulary and provider directory, you can access these through a personal computer. This is important if anyone is thinking about enrolling in a plan.
Most application packets come with pre-paid envelopes. These are a great help for individuals who may want to send in applications pre- AEP.
You may want to provide nominal gifts as a thank you to attendees. The value of this gift must not be over $15. You can provide gifts with a $10 value and not push the boundaries. Attendees still appreciate it. This can also be a snack with a value of $15 or less.

Click here to download a copy of the CMS Medicare marketing guidelines

When hosting a sales event, you can:

Make business cards available to attendees or other giveaways that may contain your contact information.

Hand out sales and marketing materials. This will help when you discuss the plans you are offering.

Distribute and collect Scopes in the event you may have a future marketing meeting.

You can provide enrollment applications to anyone who wants to enroll in a plan.

Keep in mind; you are hosting this meeting as a means of marketing yourself as a potential agent. Be sure to present yourself in the best possible light.

Be aware of the 12-hour rule:

If you are hosting both educational and marketing events, be sure you do not hold them in the same location within 12 hours of each other.

Please note; the same location includes the entire building or any adjacent buildings.

If you need to cancel your event:

In the off chance that you need to cancel your event; be aware that each carrier has a process in place, and you must follow their rules. Even if you do cancel within the minimum time, it is best to have a representative in the area to notify attendees who show up. That representative should stay at least half an hour after the scheduled start time.

A couple final thoughts:

Be aware that secret shoppers do sometime show up at these events. Make sure you start your event on time. Present your entire sales video. Do not use pressure to make a sale. Present your information in a clear and understandable manner. Be sure you cover the full summary of benefits, provider network and prescription drug coverage. You also need to include the enrollment period options.

If you follow the rules, and present yourself in an intelligent, caring and approachable manner, you can reach your audience and provide the advice they need.

Watch our Video on AEP Marketing rules

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Medicare Advantage Advertising

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

2024 CMS Regulations Compliance: Medicare Advantage Advertising

Agents must stay abreast of the yearly changes to the Center for Medicare and Medicaid Services’ (CMS) regulations. For the coming year, 2024, there are new regulations to observe in the realm of advertising and marketing.

For Third Party Marketing

TPOs submit all marketing materials for Medicare Advantage and Prescription Drug Plans, or Part D plans to CMS before use.
Use only Marketing materials approved by CMS.
Online videos or television advertisements used in marketing are subject to a 45-day review period by CMS.
Allow carriers to preview and approve materials before submitting to CMS’ Health Plan Management System (HPMS).

These new guidelines mean that even advertisements that do not mention any specific plans by name are considered marketing materials and must be submitted to the CMS HPMS for approval prior to their use.

What Agents Need to Know

Use either carrier-created advertising materials or create communications rather than marketing materials. Communications are defined as ads that do not have intent or content. These are compliant with CMS, state, and federal guidelines. Because communications are not marketing materials, they do not need to be submitted to CMS prior to use.

CMS will withdraw any marketing materials that are no longer in compliance.

Agent-created multi-plan marketing materials will need to be submitted separately to compliance. Send these to the carriers listed for review and possible approval. After approval, file the materials with CMS’ HPMS. The insurance carriers will conduct their own reviews. All submitted materials will need a Standard Material ID on them (SMID), and agents and their agencies are responsible for creating and tracking those IDs.

Disclaimer Requirement

Include an additional disclaimer on all marketing materials. This is required for the 2024 contract year Agents who do not sell for all carriers in a service area must include the following on their materials on and after September 30:

We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

For agents who do sell for all of the insurance carriers in a service area, the following disclaimer is required:

Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.

These disclaimers must be written on printed marketing materials, visible on email communications, and visible in any television or internet ads, as well as displayed on websites.

FAQs:

Q: Are all marketing materials impacted?

A: Yes. All partners who create or use multiplan marketing materials must submit their materials to the compliance email address. Use the carrier created ad materials.

Q: Can I market new plans prior to October 1st?

A: No, agents cannot market new plans for the coming contract year prior to October 1st.