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Life is unpredictable, and a sudden diagnosis of a critical illness can bring both emotional and financial stress. The value of critical illness insurance is the financial protection it provides by offering a lump sum payout if an individual is diagnosed with a covered condition. This lets them focus on recovery rather than worrying about medical bills and lost income. Here’s why investing in critical illness insurance is a smart decision.

What is critical illness insurance

Critical illness insurance is a policy that pays a tax-free lump sum upon the diagnosis of a severe health condition such as cancer, heart attack, stroke, or organ failure. Unlike traditional health insurance, which covers only medical expenses, this policy provides funds beneficiaries can use for various needs, including:

1. Medical treatments not covered by health insurance
2. Travel for medical care
3. Mortgage or rent payments
4. Household bills and daily living expenses

Benefits of critical illness insurance

1. Financial Security During Recovery
   A serious illness can impact the ability to work, leading to lost income. The payout from critical illness insurance can help replace lost wages and maintain your standard of living.
2. Coverage for Non-Medical Expenses
   Although health insurance covers hospital and medical bills, it doesn’t pay for things like home modifications, transportation to treatments, or additional caregiving needs. Critical illness insurance fills this gap.
3. Protection from Rising Healthcare Costs
   The cost of treating serious diseases continues to rise. Even with health insurance, high deductibles, copays, and out-of-network charges can be overwhelming. A critical illness policy ensures additional financial resources to cover these costs.
4. Peace of Mind
   Knowing that you have financial support in the event of a major illness allows you to focus on recovery rather than stressing about expenses. This provides stability and reassurance to the patient and their loved ones.

Learn about Mutual of Omaha Critical Illness insurance – watch a detailed video

Critical illness insurance is beneficial for

Individuals with a family history of one or more critical illnesses should consider adding this coverage. Those who are self-employed or do not have employer-provided coverage may want to enroll in a plan. In some cases, the individual has coverage with a high-deductible and needs help with out of pocket expenses.

Watch a YouTube video on the value of ancillary product sales

Medicare agents who want to add these products to your contract, click here

Anyone who wants to protect their savings from financial strain due to a major illness. Critical illness insurance serves as an important financial safety net, helping families navigate the challenges of a serious diagnosis.

By investing in this coverage, enrollees can ensure financial stability and peace of mind during difficult times. A licensed insurance agent can help review your current insurance portfolio to determine if critical illness insurance is a the right option for you.

Why use a Medicare agent

If anyone asks why people use Medicare insurance agents, we have a few good reasons below.

To start; Medicare agents complete hours of training on both compliance regulations.  They also complete hours of study and testing on the Medicare products available in their area.  They must be well versed on the plans and provide detailed information to clients. A good agent can provide comparisons of several plans and help find the Medicare plan to best fit their needs.

learn the difference between Medicare Advantage and Medicare Supplements,

Compare plan choices

Because health insurance coverage is such an important decision, it is important for clients to understand all their choices. Choosing the wrong plan can be a very costly mistake.  For this as well as many other reasons, the help of a licensed Medicare agent is essential. A Medicare agent can go over the client’s list of wants/needs for coverage and find plan options that are right for them. Agents help clients weigh the benefit of each plan. Medicare plan benefits, rules, and exceptions may be overwhelming to sort out without a trained professional.

To find out about our quoting tools, Connecture and Sunfire, click here

Consider the client’s current coverage

It is important to consider the client’s current Medicare coverage and find out what about the plan works or does not work for them.  With this information in mind, it is easier to find help them decide whether they should stay in their current plan or if there are better options available to them.

Agents do not charge for their service

As a Medicare agent, you cannot take money from the client for the advice you provide.  This means clients receive expert advice at no cost.  This service is provided for free.  That is one deal you cannot beat!

Medicare agents receive payment through a couple different ways depending on the type of agent they are.  Agents who are employed by and insurance company receive payment based on their agreement with their employer.  Many other agents who are not captive with a carrier, receive payments through the commissions they earn.  They may receive this payment directly from the carrier or if they are LOA, they receive payment from their up-line.  Either way, the amount they make is based on their total number of sales made.

Please note: commission amounts vary based on the plan type and carrier as well as the level each individual agent is contracted at.

Find out about commission levels for 2025

How clients choose a Medicare agent

Here are some things clients may consider when they choose a Medicare agent.

1.  The first way clients choose an agent is usually word of mouth.  If you have done a great job helping their friends, relatives or co-workers, believe me they will hear about it.  People love to tell their friends about an agent who really did a good job for them.  That is why all your clients need to know that you are there to answer any questions or concerns they have.
2. Clients feel better knowing they are working with an experienced agent someone who understands the plan benefits and how they work.  Be sure you are up to date on all the plans in the areas you sell in as well as what the rules for enrollment are.
3. Offer many different carries and plan types for each area you sell in.  Clients want to work with an agent who has access to all the best plans in their area.  Each client is an individual and one plan type may not be the best choice for every client. Do not offer only Medicare Advantage plans as some clients are better off with a Supplement and PDP plan.

Click here for a scope of appointment

A knowledgeable and caring Medicare agent is a very valuable resource for the community. If you make sure you are well informed and truly enjoy helping those who need advice on Medicare coverage, you can become a successful agent with the right amount of time, effort & training.

Ancillary Health Insurance

Ancillary health insurance coverage can provide an additional layer of protection for those who need it.  Unfortunately, most health care plans do not cover every need a client has. Ancillary health products address gaps in coverage and offer additional benefits not included in a primary insurance policy.

Ancillary products include things such as, dental and vision, home health care as well as life products.  These plans provide a diverse array of coverage options.  Beneficiaries can find coverage options tailored to meet their healthcare needs.  In this post we will go over some ancillary health coverage options and why it is a good idea to contract to offer them.

See why ancillary products are a great addition to your business, watch our YouTube video

Dental & Vision Insurance

One of the most requested ancillary health products is dental insurance. Regular dental care, including check-ups, cleanings, fillings, and major procedures such as; root canals and crowns, are not usually covered by standard health plans. In most cases, when these benefits are are included in a Medicare Advantage plan, the coverage is minimum at best.  This leaves the client with a huge bill if they require dental care beyond cleanings. Dental insurance can offset the cost of these services, especially when beneficiaries use an in-network provider. Dental coverage makes it possible for individuals to maintain good oral health without financial burdens.

Vision insurance works similar to dental insurance. It covers routine eye care services such as, routine exams, prescription glasses, and contact lenses. Because many individuals need vision correction and regular eye exams to maintain good vision health. Vision insurance makes these services more accessible and affordable.

Long-Term & Short -Term Care Insurance

Long-term care insurance helps cover the costs associated with extended care services, such as nursing home care, assisted living facilities, and in-home healthcare. Medicare Supplement and Medicare Advantage plans provide limited coverage for long-term care, making long-term care insurance essential for individuals concerned about potential future care needs. Long-term care insurance policies vary in coverage options, benefit amounts, and eligibility criteria.

Learn more about short-term vs long-term care coverage

Short-term care insurance is very similar to long-term care in what it covers.  The real differences are in the amount of time the policies cover.  These policies cover care for a period of 1 year or less depending on the coverage option each beneficiary chooses.  It is also much easier to qualify for coverage, there are no waiting periods, and the cost is much more affordable than a long-term care policy.

Cancer, Heart Attack & Stroke Insurance

If an individual is diagnosed with cancer or had a heart attack or a stroke, they already have enough to worry about, they do not need to add paying bills to that list.   When it comes to the costs associated with Cancer, Heart Attack and Stroke, insurance that provides coverage for these conditions takes that concern away so beneficiaries can focus on recovery.

Once a beneficiary is diagnosed with any of these conditions, this coverage provides a lump-sum benefit amount. Beneficiaries receive payment in addition to other health coverage you already have.  The amount of the benefit depends on the plan purchased and provides a benefit of up to $50,000.  More than half the costs incurred with cancer can be non-medical.  Patients may need help paying bills if they or a spouse is unable to work.  The coverage may also provide financial assistance to receive out of network care with other providers.

Critical Illness Insurance

Critical illness insurance provides a lump-sum payment in the event of a serious illness or medical condition covered by the policy. This coverage helps individuals manage expenses not covered by their primary health insurance, such as lost income, medical bills, and additional caregiving costs. Critical illness insurance offers financial protection and peace of mind during challenging times, allowing individuals to focus on their recovery without financial strain.

If you want to add any of these products to your offerings, click here for online Crowe contract

Crowe agents who want to add a carrier, click here

Accident Insurance

Because accidents are unpredictable, it is not easy to guess if or when you need the coverage. Accident insurance is beneficial for anyone who lives an active lifestyle which can increase the possibility of an accident.  When this happens, you may lose pay due to injury especially if you are not eligible for workers compensation.  Accident insurance can help cover costs beneficiaries incur from medical treatments, injuries, hospitalizations, accidental death, dismemberment, or other loss.

Hospital Indemnity

Although accident insurance is a good choice to cover an emergency room visit, hospital indemnity insurance provides another option to cover costs if the beneficiary requires an extended hospital stay or several visits for rehabilitation or other care.  Once the beneficiary receives acre, they can submit a claim and, if it is valid, they receive a payment.

Click here to learn more about hospital indemnity plans

Disability Insurance

If a beneficiary is injured and it results in a covered disability, this insurance provides either short-term or long-term protection.  The amount of coverage, like other plans depends on what the beneficiary chooses.  This coverage gives the beneficiary a way to avoid the financial stress that comes from not being able to work. Beneficiaries may receive weekly payments for three months up to a year, depending on the policy. Get more information on disability insurance and what it covers.

Final Expense Insurance

Due to the high cost of funerals, many people choose to purchase a Final expense plan.  This can alleviate at least some of the stress that comes from losing a loved one.  A Final Expense plan can provide financial relief for your client’s family. Crowe and Associates’ agents have access to contracts with several top final expense carriers who offer level, graded and guaranteed issue types of plans. in all 50 states.  A few of the carriers we are contracted with are: AIG, Foresters, Mutual of Omaha, TransAmerica, Cigna, Baltimore Life, Columbian Life, Royal Neighbors, and Gerber.  Learn more about Final Expense plans.

Life Insurance

Although some employers offer life insurance coverage, the benefits usually rely on your employment.  In the event a beneficiary loses a job or stops working, they may opt to add a supplemental life plan.  There are many choices of life insurance, including term life insurance, whole life insurance and universal life insurance.

There are a wide variety of ancillary coverage options.  Each individual has their own needs.  A professional insurance agent can provide several options within a client’s budget tailored to supplement primary healthcare coverage.  Adding ancillary products is a great way agents can add a steady stream of revenue to their business.  Agents can add these products to their existing client’s coverage and both agent and client benefits.

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Medicare leads

If you are a Medicare agent, one thing that you are always looking for is Medicare leads.  There are many places you can find leads. The most valuable leads are T-65 leads.  These leads are the best to get because insurance carriers pay the highest commissions for new to Medicare enrollments.

Watch a YouTube video on Medicare commission payments

Individuals turning 65 are also a great lead to get because an agent that does their job well, now has a new client on his books for quite a long time to come.  As long as the agent provides useful guidance to the beneficiary and ensures they are happy with their plan choice, they can develop a mutually beneficial relationship.

Before you contact anyone, it is very important to understand the CMS rules of how to do it.  Click here for details.

Click here to find out about our Medicare lead program.

In reality, many leads sources like online leads, inbound calls and pre-set leads do not produce many T-65 prospects. What they do provide is the contact information for current Medicare beneficiaries.  In reality, many of the people already have an agent and are not seeking guidance, although agents may find individuals who are unhappy with their current plan and/or their agent.  If you find a valid enrollment period, you can provide the assistance and coverage that the beneficiary is looking for.

If the potential client decides to enlist your assistance as an agent, you may need them to list you as their AOR.  Some Insurnace carriers allow clients to designate an agent as AOR even if they do not write a plan at that time.  When this happens, you have a client added to your book and can help them change their plan at a later date if it is appropriate. Learn how to make AOR changes.

T-65 Seminars

A great way to meet several individuals turning 65 is by hosting an educational event.  Our seminar selling program is an effective tool to provide needed information to the people who need it. This is truly a turn-key program that guarantees agents get in front of T-65 leads. Find out more about the seminar program.

Watch a video on the T-65 seminar program

If you decide to host an educational event, it is important to follow CMS guidelines for hosting an educational event.  If you decide to do a sales event, there are specific guidelines to follow as well.

Additionally, Crowe agents can access to a preset lead program.  This program provides leads at a very good close ratio.

Watch a video on our preset lead program.

Free leads

Agents who put in the effort to ensure their clients are happy with their coverage choices can easily earn referrals.  In order to ensure clients are happy, agents must be in contact with their clients and go over new plan options each year during the AEP.  As well as other times during the year to maintain the relationship and ensure clients are happy and do not seek answers to Medicare questions elsewhere.

Read more about how to get Medicare referrals

Establish relationships with other local professionals

It is a great idea to introduce yourself to healthcare professionals, doctors and clinics in your area as well as other professionals who work with clients that may need your advice.  Once they know you and are aware of the services you provide, it is easy to build a partnership and open doors to new lead prospects.  This will help establish you as a knowledgeable resource for anyone who needs advice.

Take a look at a few more Medicare marketing ideas

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Medicare special enrollment period

If you have a client that needs a Medicare plan outside their IEP, you need a Medicare special enrollment period to get them the coverage they need.  In this post, we go over the different special enrollment periods and how clients qualify.

Understanding Medicare Special Enrollment Periods

Medicare Special Enrollment Periods are designated times outside of the IEP (Initial Enrollment Period) or the AEP (Annual Enrollment Period) when individuals can make changes to their Medicare coverage. These periods are only allowed under specific circumstances.  The SEP provides an opportunity for individuals to enroll in a Medicare plan or change their existing coverage.

Watch a YouTube video on SEPs

Qualifying Events for SEPs

There are several life events that provide Medicare beneficiaries an opportunity for a Special Enrollment Period. We have listed some of the more common events that qualifying for an SEP below.

Moving

If a beneficiary moves to a new location that isn’t served by their current Medicare plan, they are eligible for an SEP.

Losing employer coverage

When an employee or their spouse loses their existing employer-sponsored health coverage, they qualify for a SEP to enroll in Medicare.

Qualifying for Extra Help

If a beneficiary qualifies for either their state’s  Extra Help program or Medicaid, they qualify for an SEP and have the ability to change their plan as much as 1 time per quarter for the first 3 quarters of each year.

Click here to view more SEP details

Maximizing Special Enrollment Periods

If your client qualifies for a Special Enrollment Period, it’s essential to act promptly to make sure they get the coverage they need within the time limits for the SEP. Here’s what you need to know to use the SEPs:

Know the deadlines

Each Special Enrollment Period has a specific deadline, so be sure to understand when the enrollment window opens and closes.

Review all plan options

Agents should take the time to review their client’s Medicare coverage options carefully. Consider factors such as premiums, deductibles, copays, network of providers as well as prescription drug coverage (when applicable) to find the plan that best fits their personal needs.

We provide many benefits to all our agents, including free quoting & enrollment tools.  These quote engines make it easy to look at the top plans side by side for your clients review.

Learn about Connecture & Sunfire

Explore Additional Benefits

Medicare Advantage plans offer additional benefits beyond Original Medicare, such as dental, vision, otc benefits, and much more. Show the client a side by side comparison of the top plans and see e which one fits their needs.

Stay Informed

Keep yourself informed about changes to Medicare rules and regulations, as well as any updates to coverage options. Staying informed helps agents remain compliant and provide the best advice to their clients.

Find out about SEPs for Emergencies or Disasters

Medicare Special Enrollment Periods are valuable opportunities for individuals to changes their coverage outside of typical enrollment periods. By understanding who qualifies for a Special Enrollment Period and how to use it, you ensure that clients have the coverage they need.

It is important to review all the options available to your clients and be sure they make an informed decision.  Click here to learn why you should contract with multiple Medicare carriers.

Hospital Indemnity plans

If you are a Medicare agent, it is a good idea to consider adding hospital indemnity plans to your product offerings.  In the event someone becomes ill and is hospitalized, these plans provide clients an additional layer of coverage.  Hospital Indemnity insurance provides policyholders a chance to protect their savings and lower their out-of-pocket costs.

It is important to note; when it comes to hospitalization, there are limits to what Medicare Advantage or Medicare supplement plans cover.  When that happens, a hospital indemnity plan can provide an extra peace of mind for beneficiaries.

What is hospital indemnity insurance

Hospital indemnity insurance is additional health coverage that individuals can purchase and add an extra layer of protection. These plans have a monthly premium like other insurance coverage. If the beneficiary has to stay in the hospital, they receive a fixed payment amount they can use to cover any out-of-pocket costs members incur.  Beneficiaries can use the payment to cover whatever they need such as, deductibles, co-pays, medication or for things like rehabilitation or home care expenses.

Unlike other insurance plans, hospital indemnity policies send payments directly to the policyholder.  This gives beneficiaries more freedom to choose where their money goes.  A good hospital indemnity plan should be easy to get, has no deductible or pre-certification and is not difficult to get payments from when you need them.

What hospital indemnity insurance covers

The coverage provided by a hospital indemnity plan depends on the plan chosen and the riders added.  We have listed a few basic things these plans cover below.

1. When a beneficiary has a hospital stays weather or not surgery takes place.
2. If they are confined in an ICU (intensive care unit).
3. In the event they are confined in a CCU (critical care unit).

Additionally, there are plans that offer coverage of all or some of the items listed below.

1. If a beneficiary has medically necessary outpatient surgery , as opposed to an elective outpatient surgery.
2. If they require outpatient diagnostic imaging procedures, x-rays or lab procedures.
3. Some plans include payments for ambulance services.
4. There are plans that event pay for emergency room visits or specific doctors office visits (not routine annual checkups).

Waiting periods for benefits

In most cases, there is a 30 day waiting period for illnesses that result in a hospital stay.  The waiting period varies by carrier and the plan chosen.  However, some plans will not have a waiting period for hospitalization for an accidental injury. It is important that enrollees understand all benefits of their plan choice, including waiting periods, before they decide on a policy.

Hospital Indemnity plan cost

Hospital indemnity plans charge a monthly premium like any other health insurance. The cost depends on several factors including the plan & company choice, as well as age, gender and location.

It is important to consider if hospital indemnity insurance is worth getting or not.  The beneficiary needs to consider what their current health plan covers, their out-of-pocket cost including deductibles and co-pays and co-insurance and the cost for an average hospital stay.  They also have to take into account their personal financial situation and if they can better afford the coverage or payment for the out-of-pocket expenses.

Opportunity for cross sales

Hospital indemnity plans provide a great opportunity for Medicare agents to make a cross sale.  Many of your current clients could benefit by purchasing one of these plans. Clients who enroll in a Medicare advantage plan without a premium ($0) may want to add an affordable hospital indemnity plan that adds that extra layer of protection. Their Medicare advantage plan may leave them paying high co-pays or deductible for a hospitalization. Be sure to go over their budget and possible value of adding the coverage.

Agents should go over the average cost of a hospital stay and the possible out-of-pocket cost as compared to the cost of adding a hospital indemnity plan.  Do the Math for them.  Make sure it is a viable option before they sign up.

Are you an agent who wants to offer these plan to your clients; click here for online contracting.

Rules for hospital indemnity insurance sales

It is important to remember, there are rules to follow when you offer a hospital indemnity plan to a client.  Agents cannot mention this or any other product at a Medicare appointment if it is not included on the scope of appointment.

Watch a YouTube video on the scope of appointment rules.

Medicare enrollment dates

If you are either getting close to your 65th birthday or are in Medicare sales, you should understand the Medicare enrollment dates.

Enrolling in Medicare can be confusing for beneficiaries and understanding the enrollment process is crucial to access the benefits your clients need. From IEPs to SEPs, the Medicare system is designed to accommodate various life circumstances. In this post, we go over several of the Medicare enrollment periods and how beneficiaries can use them to get the healthcare coverage they need.

Initial Enrollment Period (IEP)

The Initial Enrollment Period (IEP) is the first opportunity for most individuals to enroll in Medicare. IEP is a 7 month time frame that starts 3 months before the month of your 65th birthday, includes your birthday month, and ends three months after the month you turn 65.  During this period, individuals can sign up for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) if they choose to.

Learn more about enrollment periods

Special Enrollment Periods (SEPs)

Special Enrollment Periods (SEPs) are designated times outside the initial enrollment period when individuals can sign up for Medicare due to specific qualifying events. Some of the most common qualifying events include:

Loss of Employer Coverage

If a beneficiary is covered under a group health plan through their own  or their  spouse’s current employment, they are eligible for an SEP when they lose the employer coverage.

Moving out of the plans service area

When a client moves out of their plan’s service area, they qualify for an SEP to enroll in a new Medicare plan.

Becoming Eligible for Extra Help

Individuals who become eligible for Extra Help with Medicare prescription drug costs qualify for an SEP to enroll in a Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan (Part C) that includes prescription drug coverage.

General Enrollment Period (GEP)

For individuals who miss their initial enrollment period, the General Enrollment Period (GEP) provides another chance to enroll in Medicare. The GEP runs each year from January 1st to March 31st. Coverage obtained during this period begins the first of the month after you enroll.  it’s important to note, beneficiaries who wait until the GEP may have to pay a late enrollment penalty.

Click here to learn about late enrollment penalties LEPs

Annual Enrollment Period (AEP)

The Annual Enrollment Period (AEP), also known as the Medicare Open Enrollment Period, runs each year from October 15th until December 7th. During this time, Medicare beneficiaries can make changes to their Medicare coverage.  This includes; switching from Original Medicare and Medicare Advantage plans, as well as joining, dropping, or switching prescription drug plans.

How to best use the Medicare enrollment dates

1. Stay Informed: Keep track of your eligibility and enrollment periods to ensure you don’t miss important deadlines.
2. Review Your Coverage Needs: Regularly assess your healthcare needs to determine if  current coverage is still suitable or if changes are necessary.  Agents make sure you contact your clients regularly, especially during AEP to go over coverage options for the following year and ensure they are happy.
3. Seek Assistance if Needed: If you have questions or need guidance regarding Medicare enrollment, it is best to reach out to a licensed insurance agent.

Medicare agents be sure to maintain your book of business, click here for some ideas.

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Understanding Medicare enrollment dates is essential for to ensure beneficiaries have access to the healthcare coverage they need. By familiarizing yourself with the various enrollment periods and their significance, you can navigate the Medicare system with confidence and peace of mind. Remember, staying informed and proactive is key to making the most of your Medicare enrollments.

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Medicare Supplement Free Look Period

If you are an agent who offers Medicare plans, it is important to understand opportunities to provide clients with the coverage they deserve.  For those enrolled in Medicare, supplement plans offer an additional coverage option.  Because choosing the right supplement plan is an important decision, sometimes a client may change their mind. To safeguard against errors, Medicare offers the free look period.  In this post, we discuss the Medicare supplement free look period, why it’s important, and how beneficiaries can use it.

Learn the difference between Medicare Supplement and Medicare Advantage plans

What is the Medicare Supplement Free Look Period

The Medicare supplement free look period is a time beneficiaries can review their new Medicare supplement plan and, if unsatisfied, make changes without penalty. This period typically lasts for 30 days after the plan’s effective date.

If the client buys a Medicare Supplement policy during their 6-month Medicare Supplement OEP and are unhappy with it, they can change to another Medicare Supplement policy. When the client gets a new (second) Medicare Supplement policy, they have 30 days to decide if they are going to keep it.  This time period is called the 30-day free look period. The client shouldn’t cancel the first Medicare Supplement policy until they are sure they want to keep the second Medicare Supplement policy. Unfortunately, they have to pay both premiums for the month they have both.

Reasons to change a supplement plan

1. Paying for benefits you don’t need.
2. Client needs more benefits.
3. Do not like the insurance company
4. They need a lower cost plan

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Why Does the Free Look Period Matter

Peace of Mind

Because choosing a Medicare supplement plan is overwhelming, sometimes beneficiaries make decisions in haste or without full understanding.  This can lead to dissatisfaction. The free look period offers reassurance to beneficiaries, allowing them to thoroughly evaluate their plan and its benefits at their own pace.

Risk Mitigation

Mistakes in selecting a Medicare supplement plan can be costly, both financially and in terms of coverage gaps. The free look period serves as a safety net, enabling beneficiaries to rectify any errors or misunderstandings without facing financial penalties or being locked into a plan that doesn’t meet their needs.

Consumer Protection

The free look period is designed to protect Medicare beneficiaries from being pressured into purchasing plans that may not be suitable for them. It empowers individuals to make informed decisions about their healthcare coverage without feeling rushed or coerced.

Medicare supplement plan comparison – click here

Making the Most of the Free Look Period

Thoroughly Review the Plan

It is important to go over all aspects of the Medicare supplement plans your client is considering.  Please remember, this not only includes coverage but all costs involved.

Compare Plans

To ensure the client has made the best plan choice, agents should comparing it with other available plans. This can help you identify any discrepancies or better alternatives.

Seek Guidance

Beneficiaries should reach out to a licensed insurance agent for assistance. They provide valuable insights and help navigate the confusing landscape of Medicare coverage.

Document Everything

Important: clients should keep detailed records of their conversations with insurance provider representatives.  They need to include any changes made to their plan or communications regarding the free look period. This documentation serves as evidence in the event there are any disputes or discrepancies.

The free look period is an opportunity for beneficiaries to ensure they have the right coverage for their healthcare needs. Individuals who take advantage of the free look can make informed decisions.  They can also, rectify mistakes, and achieve peace of mind regarding their healthcare coverage. Remember, health is invaluable, and the right Medicare supplement plan can make all the difference in accessing quality healthcare.

What is a Medicare Trial Right

Because there are so many Medicare enrollment periods, there are some that may get overlooked.  One of the lesser-known  yet significant enrollment opportunities is the Medicare Trial Right. We will go over what a Medicare Trial Right entails, and who qualifies.

When an agent has a client enrolled in a Medicare Advantage (MA/MAPD) plan and they wan to change back to Original Medicare, they may be eligible for a trial right.  If this is the case, they have an opportunity to change their plan without having to wait for the AEP (Annual Enrollment Period). This enrollment period allows beneficiaries a chance to go back to Original Medicare or original Medicare and a Supplement and /or PDP plan.  This gives beneficiaries a way to get the coverage they need if the plan they chose is not a good fit for their current healthcare needs.

How does a Trial Right work

Trail Rights apply to beneficiaries who enroll in a Medicare Advantage plan for the first time. The enrollee has a 12 month time frame to try a MA/MAPD plan. This enrollment period is very similar to the Medicare supplement free look although they each have their own qualifying rules and the time you have to use each one is different.  New MA/MAPD beneficiaries have a Trail Right period of  12-months.  On the other hand, enrollees of Medicare Supplement plans are entitled to a free look period of 30 days.

Watch a YouTube video on the differences between Medicare Advantage vs. Medicare Supplement plans

Who qualifies for a Trial Right

Beneficiaries Who Enrolled in an MA/MAPD plan when they first signed up for Medicare

It is important to understand the timelines associated with the Medicare Trail Right.  If a beneficiary enrolls in a Medicare Advantage plan during their Medicare Initial Enrollment Period (IEP), they can change to Original Medicare anytime during the first 12 months of enrollment in the Medicare Advantage plan.  Here’s an example: if a client turns 65 and chooses a MAPD plan for November 1st, the trail Right period runs until December 30 of the next year.  This means they can opt to disenroll form the MA/MAPD plan and go back to Original Medicare anytime during those 12 months.

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Medicare Supplement beneficiaries who chose to enroll in a MA/MAPD plan for the first time

When Medicare Supplement plan enrollee decides to try a MA/MAPD plan for the first time.  If they decided they do not like the MA/MAPD plan,  they have 12 months to go back Original Medicare.

Important:  beneficiaries who use the Trial Right can choose to enroll in a PDP plan as well as a Medicare Supplement plan. They do not have to go through underwriting for the Medicare Supplement plan.

Benefits of Medicare Trial Right

1. Flexibility: It provides enrollees the ability to explore Medicare Advantage Plans or switch back to Original Medicare without penalty.
2. Tailored Healthcare: Enables individuals to find the best plan for their healthcare needs, preferences and budget.
3. Peace of Mind: Offers peace of mind in the event the chosen plan doesn’t meet expectations, the beneficiary can change their plan.

What to consider before using the Trial Right

1. Beneficiaries need to understand their current plan, including coverage, costs, and provider network.
2. Research alternatives: Compare coverage, costs, provider networks, and additional benefits.
3. Make an informed decision: Assess healthcare needs, preferences, and budget to determine the best course of action.
4. Enroll in the new plan: Once enrollment in the new plan is confirmed, inform your current Medicare Advantage plan that you are disenrolling.

Other enrollment periods

Please remember, beneficiaries can only use the Trial Right one time.  However, there are several other options that provide an opportunity for a client to change plans.

Learn about other Medicare election periods

Disenroll from a Medicare plan

Enrollees can disenroll from a Medicare Advantage plan by contacting the provider directly or contacting your local Medicare office 1-800-MEDICARE (1-800-633-4227).

Many beneficiaries do not know about the Medicare Trial Right period. It is up to the agent to make sure clients are aware that they have options if they are unhappy. It is always important to be sure the client gets the healthcare they need.

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