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Medicare dental benefits

Most people have heard about the additional benefits offered on some Medicare plans.  One of the most asked about benefits are Medicare dental benefits.  Although dental care is an integral part of overall health, in the vast landscape of healthcare, dental benefits are often overlooked.

The state of Dental coverage in Medicare:

Medicare plays a crucial role in ensuring individuals over the age of 65 and qualifying individuals with disabilities.  Unfortunately, the comprehensive healthcare coverage Medicare provides is definitely lacking when it comes to dental coverage.

As we have already mentioned, Medicare provides a great deal of coverage for various health services, yet dental care has traditionally held a separate status.  Neither Part A nor Part B (Original Medicare) cover routine dental care.  This includes things like check-ups, cleanings, fillings, and extractions.  These services can be quite expensive and many people on fixed incomes simply do not have the resources to afford the costly dental care they require.  This lack of coverage frequently leaves beneficiaries looking for supplemental options that will cover their oral health needs.

Medicare Advantage Plans with dental benefits:

These days, many people look to Medicare Advantage plans (Part C) to provide some relief from the high cost of dental work.  Medicare Advantage plans are offered by private insurers and often provide additional benefits beyond Original Medicare. Many Medicare Advantage plans include dental coverage.  This coverage usually includes preventive and a few additional services.  In some rare instances, more extensive treatments like root canals or dentures are also covered to some extent.

Learn about some of the plan comparison tools that help clients sort out their options

Stand-alone Dental Coverage:

Many Medicare beneficiaries ask about dental coverage because they understand the importance of dental health.  This is where you need to explain that supplementary (stand-alone) plans cater specifically to dental care needs.  There are many different options available and many dental insurance carriers. Each carrier provides a few different coverage options that include things like checkups, cleanings, fillings and various other dental procedures. It is imperative that beneficiaries understand dental plans only work well if they use an in-network provider for dental care. As an agent, you need to check that their dentist is in network with any plan they are considering.

click here to learn about the NCD metlife dental plans

The Importance of Routine Dental Care:

While navigating Medicare and dental benefits, it’s imperative to understand how important routine dental care is. Oral health can significantly impact overall well-being.  There are several studies that link poor oral health to various systemic conditions. Maintaining regular dental visits preserves a healthy smile and also contributes to overall health and quality of life.

Advocating for Future Changes:

Because of the critical role oral health plays in overall well-being, there’s an ongoing call for expanding Medicare to include comprehensive dental coverage.  Both advocates and policymakers continue to push for changes within the program to include preventive and restorative dental services.  The goal is to provide better access to essential oral healthcare for Medicare beneficiaries.

As the healthcare landscape continues to evolve, understanding the importance of Medicare dental benefits remains pivotal for individuals seeking comprehensive healthcare coverage.  Although the current scope of dental coverage in Medicare has many gaps, exploring supplemental options like Medicare Advantage plans or standalone dental coverage offer some help addressing oral health needs.

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Common Medicare terminology

If you are getting started in Medicare sales, there are plenty of terms that can be confusing. This list of common Medicare terminology can help you moving forward with your Medicare sales career.

Ancillary products 

These are plans are offered by private insurance companies outside of Original Medicare or Medicare Advantage.   Some examples of Ancillary plans include life insurance, LTC policies, stand-alone dental or vision as well as many other stand-alone insurance products.

Annual Enrollment Period (AEP)  

During this time from October 15 through December 7 each year eligible beneficiaries can either enroll in or change their current Medicare coverage.

ANOC (Annual Notice of Change) 

Each year beneficiaries receive a letter from the plan they are enrolled in.  This letter explains any changes that the plan will have in January when the plan year begins. It lets beneficiaries know about cost and benefit changes. This letter arrives each fall so beneficiaries can decide if they want to change plans during the Annual Enrollment Period that starts in October.

Coinsurance 

This is the amount, usually a fixed percentage, the insured must pay toward a covered claim after the deductible is satisfied.

Co-payment 

The set fee a plan charges the insured at the time of each doctors visit or when you purchase prescription medication or other medical service.

CSNP (Chronic Condition Special Needs Plan)  

A type of Medicare Advantage plan for beneficiaries with specific chronic conditions such as end stage renal disease (ESRD).

Deductible 

The pre-determined amount you have to pay before your insurance coverage begins to pay for covered services.

Donut Hole aka the coverage gap 

This refers to a gap in your Medicare Part D prescription drug benefit.  This occurs when your prescription drug expenses exceed the initial coverage limit of your plan but have not yet reached the catastrophic coverage level.

Dual eligible Special Needs Plan (DSNP)

DSNPs are specialized Medicare Advantage plans that provide healthcare benefits to beneficiaries who have both Medicare and Medicaid.

Durable Medical Equipment (DME)  

DME refers to medically necessary, prescription healthcare devices that Medicare Part B usually covers. This includes things like wheelchairs, infusion pumps and blood sugar monitors, to name a few.

Extra Help (LIS, Low-Income Subsidies) 

These terms refer to a program that helps eligible Medicare beneficiaries with limited income pay for prescription drug coverage.

Formulary 

The list of drugs that each Medicare plan covers.  Each plan separates the drugs on the formulary by tier the tier corresponds to the price the plan member pays.

General Enrollment Period (GEP) 

Eligible beneficiaries who miss their Initial Enrollment Period, can use this time to sign up for Medicate.  The GEP runs from January 1 through March 31 and is only available to first-time Medicare enrollees.

HMO (Health Maintenance Organization) 

A type of Medicare Advantage plan that requires the selection of a primary care physician.  Your PCP will coordinate your care and needs to provide a referral if you need to see a specialist.

Hospice  

This is a type of healthcare for terminally ill patients that provides pain management, counseling, hospital care, and more. Coverage for hospice is included in Part B of Medicare.

Initial Enrollment Period (IEP) 

The time when eligible beneficiaries can first sign up for Medicare coverage. It begins three months before your 65th birthday and ends three months after. This is the time that most people enroll in Medicare.

In-network 

When a provider (doctor, hospital, pharmacy, etc.) is in-network, they accept your Medicare plan.  Beneficiaries who use in network providers are covered under their plan when you use in-network providers.

ISNP (Institutionalized Special Needs Plan)  

A type of Medicare Advantage plan for people living in nursing home institutions.

Medicare Advantage (Medicare Part C, MA/MAPD) 

A Medicare plan offered by private insurance companies.  These plans cover everything that Original Medicare covers as well additional benefits like prescription drugs, dental, vision, fitness, etc.  When they are called MAPDs they refer to Medicare Advantage plans that include prescription drug coverage.

Medicare Savings Programs (MSP) 

MSPs are Medicaid-run programs.  These programs help cover Medicare premiums and other cost-sharing expenses for people with low incomes. Eligible Medicare beneficiaries receive help with premiums, copayments, and deductibles.

Medicare Supplements 

A separate, private insurance plan that helps pay deductibles, and copayments for Medicare covered medical services.  These plans work with Original Medicare.

Open Enrollment Period (OEP) 

This enrollment period is available only to Medicare Advantage plan enrollees. It runs from January 1 through March 31. Enrollees can use it to switch between Medicare Advantage plans or to go back to Original Medicare and a PDP plan.

Out-Of-Pocket Limit (MOOP)

Many Medicare plans place a maximum dollar amount beneficiaries can spend out of pocket on their healthcare costs each year. Once they surpass the out-of-pocket limit, Medicare-covered services are 100% covered.

PDP (Part D)

PDP plans provide coverage for prescription drugs and are offered by private companies.

PPO (Preferred Provider Organization)

A type of Medicare plan that provides care through a specific network of medical providers and facilities.  Plan members can seek care outside the network, although it will usually cost more.  In most cases, PPO plans don’t require referrals to see a specialist.

Special Enrollment Period (SEP)

Eligible Medicare beneficiaries with special circumstances are entitled to enroll in Medicare plans outside of the traditional enrollment periods.

TRICARE

This is a healthcare benefit for both active duty and retired service members as well as their families.

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Medicare sales and cross selling

If you are selling Medicare, you should think about how to meet all the coverage needs of your clients. That is why Medicare sales and cross selling go hand in hand.  Before you try and do this, be sure you have the necessary product knowledge on anything you intend to offer.

A great way to get insight into your client’s potential needs is with a client needs assessment.  Each agent should tailor the assessment to include the applicable product lines they are licensed to sell and have a good knowledge of.

If your client understands that you are able to offer them coverage for all their personal insurance needs, they will be inclined to call you when they decide to add to their current coverage.  It is best to take care of their most urgent concerns before talking about additional items.

Watch our quick YouTube video on cross selling during AEP

Medicare sales cross selling – be aware of underlying health issues

If you conduct a needs assessment or spend enough time speaking with your client, you will probably find out if your client has any illnesses that will prevent them for obtaining some types of coverage that they will not qualify for.  If you ask about any recent claims they have had, this may be an indicator if they are a good candidate for some types of coverage.

Some other things to find out from your client

Is the client or their spouse presently working?  If the answer is yes, do they have any employer benefits and if so, what are they?

Have they ever served in the military (are they a veteran)?  Sometimes veterans receive benefits.  You need to find out if they do and what those are.

Medicare sales cross selling – Cancer, Heart attack and Stroke coverage

Because many people have a family history of either cancer, heart attack or stroke, this product is not difficult to sell. This product is sometimes called critical illness insurance.  Be sure you understand the client’s budget before you show them quotes from companies that will fill their coverage need.

Cross selling – Long Term Care Insurance

Most people do not have long term care coverage. Although LTC has changed over the years, there are still some good coverage options available.  There are some short-term care policy options that include home health coverage.  There are also some life policies that include an optional LTC rider.  You can ask your client if anyone in the family has needed home health or nursing home care. If they have, ask them if they know how it was paid for. Do they have a way to pay for it if they need it?

Cross selling – Life Insurance

Life insurance is not like LTC coverage because many clients have at least some life insurance coverage.  If you want to start a discussion about life insurance, you need to find out if the client already has coverage and if so, how much.  Once you get the answer, you can ask questions to determine if they have enough to cover what they need it for.

Here are some reasons people purchase life insurance:

To replace income lost due to the death of a family’s financial provider.

If they want to cover their final expenses.  If they have a policy in place, it may not be enough to cover their final expenses.  This means they may want to consider purchasing a policy that provides a bigger benefit amount.

Policies can help pay any outstanding debts owed by the policy holder.

In some cases, the policy holder wants to leave a financial gift to their chosen beneficiary.

If they do not have a policy, you may be able to help them decide if a policy could benefit their loved ones.

Cross selling – Final Expense

Final expense insurance is a kind of life insurance.  If the client does not have life insurance in place, this type of policy can help family members pay for their final expenses and avoid leaving them with a large bill after you are gone.

Cross selling – Annuities

These days many people want a safe place to invest their savings due to low interest rates at banks and stock market volatility. Simply ask your client if they are happy with their current rate of return on investments. Let them know a fixed indexed annuity can provide a dependable place to invest savings and a better return rate than many CDs.  In many cases, you can offer them an annuity product that will provide a better return that what they currently have.

Now that we have given you a few products to consider adding to your portfolio, it is up to you to decide what will be the best value add.

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Why contract with multiple Medicare carriers

If you are just getting started in Medicare sales it can be overwhelming.  I am sure there are many questions you have including why contract with multiple Medicare carriers. In this post we will provide an answer to that question.

As a Medicare agent, the main reason you chose this business should be to provide the best possible advice to individuals who are looking for Medicare coverage.  In order to do that, you need access to the best options for each individual.  In other words, you need to be able to offer plans from multiple Medicare carriers.

Avoid rapid disenrollment – learn more

Beneficiaries can compare several plans

Providing beneficiaries the ability to compare the benefits of several plans lets them make a well-informed decision on their coverage. Many clients like to see as many options as possible.  If you can provide information on many plans, they know you are giving them the best choices available, and they can feel more confident in their choice.  There is no need to go to other agents to view other options. Contracting with several carriers gives you a broader knowledge of the Medicare market and that is good for both you and your clients. A diverse portfolio ensures potential clients you will truly find the best plan for their personal needs.

Agents who contract with only one carrier, leave clients wondering what else is available and are they getting the best coverage. In this instance, clients do not have all the information available to get the best coverage.

Click here to learn about our quoting tools Sunfire and Connecture – watch a quick YouTube video

Plan pricing

One important factor for Beneficiaries is the cost of the plan they chose.  When you have many options available, it is far more likely to find a plan that offers the desired coverage at an affordable price.  This provides your clients a chance to find the plan that does not stretch the budget too thin once you inform them of all the costs associated with each plan and available benefits.

 Build your book

Medicare beneficiaries need an agent they trust who provides knowledge as well as the best plan options.  If your clients know you are available to address any concerns they have and you offer several great plan choices, they will tell their friends and family. Many Medicare beneficiaries are overwhelmed with information; bombarded by phone calls and mail.  If they have an actual person they can trust for sound advice, beneficiaries appreciate this. If your clients know you available to address any concerns they have and offer several great plan choices, they will tell their friends and family.  This is a fantastic and free way to generate new leads.  A good agent is a valuable asset and provides beneficiaries with peace of mind.

Learn how to make a business plan for you Medicare business

More opportunity to earn commission

Any agent who does not offer multiple carriers is leaving money on the table.  Our job as agents is to provide the coverage beneficiaries want.  If you offer only 1 or 2 carriers, you are letting many opportunities slip through your fingers.   Beneficiaries are presented with multiple plan choices every day and they know what benefits they want.  They also know what they can afford.  You need to be prepared to find them what they are looking for or someone else will.

Watch our YouTube video on how to choose Medicare carriers to contract with

Find out what a good FMO offers 

Medicare commission chargebacks

Medicare commission chargebacks are just a normal part of Medicare sales. If you plan ahead, you can avoid chargebacks turning into a bigger problem.

What is a Chargeback

In Medicare sales, a chargeback is when a portion of an agent’s commission for a sale is lost.  This happens when a client’s policy is terminated early.  This happens when a client either cancels their plan or passes away.  When this happens, the agent must pay back a portion of the commission they received previously.

Many Medicare agents choose to receive commission advances.  This means the carrier pays several months of commissions on the sale of a policy up front, before the client pays the premium payments.  This is great because you do not have to wait to get the payment, however this is also a potential problem if your client cancels their policy, and you incur a debt to the insurance carrier.

Please note: every insurance carrier has their own payment schedule and chargeback rules.

Be prepared for chargebacks

Because there are things you cannot predict, clients pass away or change their mind on their coverage choice, you need to be prepared for at least a few chargebacks each year. It is a good idea to have money set aside for such situations.

Pay Your Medicare commission chargebacks

This is a no brainer.  If you have a bill, you need to pay it.  If you neglect to pay it, you may have a Vector hit against you.  This is a service insurance companies use to report unpaid debts. This will harm your credit score as well as you chance to sell products with some carriers.  Some carriers will not contract brokers with a Vector hit until they pay their debt.

Agents can pay some chargebacks out of the commission the insurance company owes you.  If you do not have enough commission coming in to pay the debt, some carriers will allow you to set up a payment plan to clear the debit.

AEP Enrollments can lead to MA OEP Disenrollments

When enrollments occur during AEP (Oct 15 through Dec 7), agents receive half the commission for each sale in Jan and the other half in Feb.  Because full MA/MAPD compensation is only paid out once on each enrollee, agents receive renewal commission rates for each beneficiary who enrolls in a plan.  Agents receive full commission only if the beneficiary is a first-time MA/MAPD plan enrollee.

When your client decides to either move or drop their MA/MAPD plan during the OEP (Jan 1 through Mar 31), the agent receives a chargeback. Because another agent could talk your client into a plan change during the MA OEP, you may receive a chargeback.

Click here to find out about the MAPD commissions 2024

Medicare commission Chargebacks for Medicare Supplement sales

Luckily chargebacks for Medicare Supplements are a less common occurrence. Usually, carriers pay Medicare Supplement commissions as earned.  In other words, your client pays their monthly premium, then you receive commission.

In some cases, agents have the opportunity to receive advanced commission which are normally 3, 6 or even 12 months ahead of schedule. Because many carriers charge a nominal fee for advancing commissions, most agents opt for commission payments on an as-earned basis.  If you do get a chargeback for a Medicare Supplement sale, the amount is usually not very large.

Communicate with your clients – avoid Medicare commission chargebacks

It is extremely important to stay in contact with your clients.  If they know you are available to answer questions as a trusted and valuable resource, they will call you if they are thinking about a plan change.  This may help prevent them from seeking advice from another agent who may contact them.  If your clients change plans during AEP, it may be good advice to check to see if they are happy with the new plan after words.  If they are not, you will be able to enroll them in another plan instead of them going to another agent.

There is no way to predict losing a client due to death or other unforeseen reasons.  The best thing to do is let clients know you are available even when they are unhappy.  Remember to prepare ahead for a few chargebacks.

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What is a rapid disenrollment

How to prevent rapid disenrollment

If you follow all the CMS guidelines as well as listen to the client and found a plan that best fit their needs, a disenrollment will be unlikely to occur.   Take a look at a few suggested practices below to help you avoid rapid disenrollment.

Enroll clients in the plan that is best for them

The most successful Medicare agents, enroll clients in the plan that best fit the client’s needs.  They do not base their recommendations on the amount of commission they will receive. When you operate in the best interest of the client, a disenrollment is not likely to happen. If for any reason your client changes their mind about the plan they chose, it is in everyone’s best interest to help them switch to another plan.   This helps them to know you are there to provide them with the best service possible and they can contact you with any questions or concerns.

Check all your Clients’ providers

Most clients do not want to search for new doctors each year especially if they are happy with the care they are receiving.  That means it is imperative that you get an up to date list of their current providers and make sure they are in-network with any plan they are considering.  This is also important for hospitals or any other medical facilities they like to use.  Because paper directories are difficult to update in a timely manor, It is best to check the online provider directory of any plan they are thinking about enrolling in.

Get a list of current medications

These days mediations can cost thousands of dollars for each refill, therefore, it is important to get an updated list of medications from each client annually to provide the best possible coverage options.  When you run a plan quote, always look at where each medication falls on the formulary of each plan they are considering as well as the plan that provides them the best total cost.  This means include the cost of the plan as well as the cost of the medications for a total plan cost. Always include the name of the pharmacy your client uses as that also has an effect on the cost of their medications and the plan they choose.  Whenever possible, clients should use a pharmacy that is considered preferred by their plan.

Explain plan benefits and coverage costs

Be sure you understand the clients coverage needs as well as their budget. Be sure they know the cost of monthly premiums, co-pays, coinsurance and deductibles as well as prescriptions costs will be.  Unexpected costs are one reason people disenroll from a plan.

Always be sure your client understands the benefits of the plan they choose.  When they tell you they want a dental benefit; be sure they understand exactly what it covers and doesn’t. The same goes for any benefit that is important to them.  If the plan they choose does not offer all the benefits they are looking for, be sure they still want that plan. Double check that they know what they are signing up for.  If they do not fully understand the benefits package they may decide later that you did not listen to them and put them into an inferior plan.  Don’t forget there may be other ways for them to have all the coverage they want by adding an affordable ancillary plan.

Please be aware, Medicare beneficiaries often get advice from family or friends saying they have a better plan that is less expensive with more benefits. This may cause them to make a switch.  Be sure you provide the best plan to suite their needs and always be available to answer questions.

Review Outbound Education and Verification calls

Agents need to explain that the client may receive an outbound education and verification (OEV) call from the carrier or the new plan.  Unfortunately some clients disenroll when they get this call because they are not expecting it and get confused.  Make sure they are aware of it and what to expect.

One last thing you can do to avoid the disappointment of a rapid disenrollment

We cannot stress enough that your client needs to understand what they signed up for.  Make sure they understand the plan they chose.  Check back in with them to be sure they do not have any questions and to offer your guidance if they do.  They need to feel comfortable with their choice.  If they are not confident it will only take 1 tv commercial or phone call from a telemarketer to get them to change their plan and you will have a rapid disenrollment.

How they affect the agent

Once a client is considered a rapid disenrollment from a Medicare plan, carriers will recover at least part of the commissions that they paid out.  This is known as a chargeback.

Click here to learn about pro-rated Medicare commissions

Do not go on any shopping sprees until you are sure your clients are happily enrolled in their new plans.

Any rapid disenrollment may bring you to both the carriers attention as well as the attention of CMS.  This is not something you want to happen. Agents with a large number of rapid disenrollments may be investigated for compliance issues.   CMS may need to investigate to be sure you are not enrolling clients into plans under false pretenses just to make a quick buck.  That is why, the client’s best interest has to be your top priority.

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Medicare IRMAA 2024

Agents need to understand what the Medicare IRMAA 2024 will be in order to advise their clients accordingly.

IRMAA explained

IRMAA is an additional charge that may be added to a beneficiaries Medicare Part B and or Medicare Part D premium.  An IRMAA applies to certain individuals whose income level is above a pre-determined amount.  Income amounts are decided annually on a sliding scale and include 5 different income brackets.   If the Social Security administration determines a client must pay an IRMAA, they will send a premium notice that includes an explanation of the charge.

The IRMAA amounts are based on the beneficiaries’ income from 2 years before the present year.  For example: a 2024 IRMAA is based on the beneficiary’s income from 2022.  Because income changes from year to year, the IRMAA amount can also change accordingly.

Determination of both Part B and Part D total premiums can be calculated by adding the current Part B premium ($174.70 in 2024) to your IRMAA amount.  This works the same way for your current Part D IRMAA amount and premium.

Part B & Part D IRMAA income brackets & surcharge amounts 2024

Please note:  The IRMAA for married Medicare beneficiaries who file separate tax returns are higher if they lived together for any amount of the year.

How to make your Medicare IRMAA 2024 payment

Because there are 2 separate IRMAAs (Part B & Part D) the payments are handled differently. The IRMAA for Part B is added to your monthly premium bill automatically.

Part B IRMAA

Here are a few ways to pay your Part B IRMAA

1. Send your payment to Medicare through the mail. You can send either a check, money order or credit or debit card information by filling out the coupon attached to the bottom of your bill. If you are sending payment without the coupon, be sure to put your Medicare number in the memo of the check.  Send payments in the return envelope that comes with your invoice and mail payments to Medicare Premium Collection Center, P.O. Box 790355, St Louis , MO 63179-0355.
2. The quickest way to pay is online with your secure Medicare account.  You can use a credit or debit card or pay through either your checking or savings account.
3. Use Medicare Easy Pay to have Medicare deduct your premiums from your savings or checking directly each month.  Please note; it can take up to 8 weeks for automatic deductions to begin.  Be sure you pay the premiums another way until it is set up.  You can also use your bank’s online bill payment service if they offer one.

Part D IRMAA

On the other hand, you must pay the IRMAA for Part D directly to Medicare.  The beneficiary must pay it even if their employer or a third party (e.g., retirement system) pays their Part D premiums. They receive a monthly bill from Medicare for the Part D IRMAA.  This amount can be paid using the same method used to pay for their Part B premium.

Usually, beneficiaries receive the bill the same month it is due.  The premiums are always due on the 25th of each month. In the event that you miss a payment, or it is sent in late, it will be included with the next bill.

Medicare IRMAA 2024- how to request a redetermination

The SSA (Social Security Administration) bases their determination of who owes an IRMAA on the income reported on tax returns from the  2 years before you pay the IRMAA.  If SSA does decide you owe an IRMAA, they send you an initial determination notice.  When you receive this notice, you will also get information explaining how to request a new initial determination.

If Social Security receives a new initial determination, they may revise the amount owed or take the IRMAA away all together.  To request the redetermination, either schedule an appointment with your local Social Security office or submit the following form:

Medicare IRMAA Life-Changing Event form

You need to provide documentation of your correct income or of the life-changing event that has affected your income level in a negative way.

Here are examples of acceptable life-changing events:

1. Death of a spouse, a divorce or annulment or a marriage
2. If either spouse stops or reduces the number of hours they work
3. When either spouse loses a pension
4. Loss of income due to income producing property loss because of a natural disaster, fraud or similar circumstances

If you had an amended tax return, you can call the representatives at SSA +1 800-772-1213 and say you want to lower your (IRMAA) Medicare Income-Related Monthly Adjustment Amount.   Use the fact that Social Security used outdated or incorrect information when calculating your IRMAA.

Learn about the 2024 Social Security increase

Find out what the effects of the 2025 drug cap will be

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Medicare costs 2024

Both agents and beneficiaries need to know what the Medicare costs 2024 are in order to accurately plan for the year ahead.  The CMS announced the 2024 Medicare Part A and Part B premiums, deductibles and coinsurance amounts on Oct 12, 2023.  As you will see, the premium for Part B is higher than last year and so is the deductible.  Although the Part A premium has not increased.

Almost all Medicare beneficiaries (over 99%) receive Medicare Part A premium-free.  A very small number of Medicare beneficiaries (fewer then 1%) must pay their Part A premium.  This is due to the fact that they have not worked for a minimum of 40 quarters in a job that qualifies as Medicare-covered employment.

Medicare enrollees who paid their Medicare taxes fewer than 30 quarters must pay $505 per month for their Part A premium in 2024.  This amount is less than the 2023 premium of $506 per month.  As you can see, this premium has gone down by $1. Medicare beneficiaries who have either paid Medicare taxes for at least 30 quarters or were married to someone who have worked for at least 30 quarters and paid their Medicare taxes will pay $278 for their Part A premium per month in 2024.  This is the same cost as it was in 2023.

The deductible for an inpatient hospital stays (Medicare Part A in 2024, will be $1,632.  In 2023 the inpatient hospital deductible was $1,600.  This is an increase of $32 for 2024.  The benefit period for each hospital stay ends 60 days after your release from care.

Medicare costs 2024 – Part B

Starting in January of 2024, the premium for Medicare Part B will be $174.70.  This is up $9.80 from the 2023 cost of $164.90. The Medicare Part B deductible is also due to increase by $14 to $240 in 2024 from $226 in 2023. The total increase amounts to $14 over the cost in 2023.

Beneficiaries who have income above a certain level will pay an IRMAA in addition to the standard Part B monthly premium of $174.40.  The chart below shows the income limits, the IRMAA amount as well as the Part B premium in each income bracket.

It is important to remain up to date with any information that directly impacts your clients. Any agent who wants to provide his clients with the best service stays informed and educated so clients know they can trust your advice.  This is why some agents get so many referrals and build a large book of business.

Learn about Medicare Part D changes coming in 2025

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Medicare agents’ business plan

If you are considering Medicare sales, you should take a look at the Medicare agents’ business plan for a few suggestions to help you get started.

Decide which market you want to focus on

Although anyone who is eligible for Medicare is a potential client, it is best to focus on a particular group to create an effective business plan when you are getting started.  You should decide if you are going to concentrate your efforts on people turning 65 or perhaps you would rather focus on people who are already 65 and may have a SEP available to them.

Do you want to focus on selling a particular plan type, Medicare Supplement and Prescription Drug plans or Medicare Advantage plans?  It is a good idea to be able to offer all plan types available. Because each client has different healthcare needs.

Do you plan to serve only people within a certain radius?  Do you want to see people in-person or are you planning on strictly selling over the phone and online?  If you plan to serve multiple sates, you will need to maintain the proper licensing for each state.

Set goals for yourself when making a business plan

Make sure you set some attainable goals for yourself.  That way you will fell encouraged each time you reach a milestone.  Make both long- and short-term goals; like enrolling 10 members each month or making 100 sales in a year and so on.  Whatever your goals are, they provide something tangible to work towards.

Be prepared to spend some money to get yourself set up

Starting any business comes with a cost.  You will need to have some money set aside to get yourself started.  Some of the basic things you need are business cards, a decent computer and printer other office supplies.

If you plan to work outside your home, you will need to pay rent.  You need licenses in any state you plan to sell in.  Selling in multiple states will require multiple licenses. Some carriers charge appointment fees for out of state appointments.   A website is a great tool to have but it comes with a small start-up cost.  Agents must have E& O insurance in place before they can sell anything, and the list goes on.

Marketing & Leads

When you are setting up a business plan, decide how to reach your intended market.  You need to find a lead source that works well for you.  Be prepared to try more than one source before you find what works best for you.  When looking for leads, agents sometimes need to be creative.  There are many ways to get leads and they will not all work well for everyone.  Each person has their own strengths and weaknesses.

Some examples of leads include mailers, online leads with the use of Facebook, a website or other service, live transfer leads or other tele sales leads.  There are also educational or sales events and participation in community events just to name a few.  It is always a good idea to have plenty of business cards to pass out or leave in areas where permissible.

Click here to view our YouTube video on Medicare marketing leads

Learn about our Medicare seminar program

Referrals are free leads

Get out in the public and meet as many people as you can.  Build a network of local professionals you can send referrals to each other and help grow everyone’s business.  It is ok to ask your clients for referrals.  If you provide good service to them, they will be happy to tell their friends and family about your service.

If you do not make yourself visible to the public, they have no way of knowing about your business; so, get out there and meet people.  Put business cards wherever you are allowed to and make friends with local pharmacists, doctors office staff and senior center managers.

Medicare agents’ business plan – Make sure people remember you

Because there are many Medicare agents out there., you have to set yourself apart from the competition.  Visibility is key, we cannot stress this enough.  Take the time to learn the products you are offering as well as the needs of each individual.  Knowledgeable agents are a valuable asset to our communities and word does get around when people get good advice.   Thousands of people turn 65 every day and they will need help choosing the proper healthcare coverage.

Do you want to offer other products as part of your business plan

If you are licensed to sell other products, you may want to consider cross-selling opportunities.  You can offer additional products that are a good fit for your clients, such as life insurance, ancillary health products like dental, vision or LTC.  It is natural for clients who trust your advice to request help with other insurance products.

Find a support system

It is a great idea work with a upline that provides the back-office support, training and tools you need to get you where you want to go,

Find out what Crowe and Associates has to offer – watch a quick YouTube Video

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Social Security increase 2024

Each year beneficiaries receive an increase in their Social Security benefit payments.  This is called a COLA.  In 2024, the Social Security increase 2024 will be 3.2%.  This is much less than the 2023 COLA of 8.7%.

The COLA is calculated by the U.S. Bureau of Labor Statistics with data they get from the CPI (Consumer Price Index) the CPI tracks the costs of goods & services.  The CPI stated that there was an increase in the inflation rate of 3.7% from last year.

An annual increase in Social Security benefits is provided to give seniors a little help against the high cost of inflation on their budgets and give them a little more purchasing power year after year.  This in turn helps the overall economy.

What this means to beneficiaries:

The 3.2% COLA increase means that beneficiaries should receive an increase in their Social Security benefit checks.

In most cases, when there is COLA increase, there will also be an increase in Medicare Part B premiums. Because Medicare premiums are deducted from Social Security benefit checks, The slight increase in COLA may not be noticed at all.  This results in very little financial relief.

It is important to note, the federal law has a hold harmless clause that states, “no increase in Part B premiums can reduce a Social Security recipient’s monthly check below what it was in the previous year.”  At least this protects Social Security recipients to some extent.

When will the Social Security payments increase:

The annual payment increase will be received in January of 2024.  Beneficiaries should receive notification in December with their specific benefit details.

If you are a beneficiary whose birthday falls on the 1st through the 10th of the month, you will receive your benefit on the 2nd Wednesday of each month. Beneficiaries whose birthday falls on the 11^th through the 20^th, payments will be received the 3rd Wednesday of each month.  Anyone whose birthday is between the 21^st and 31^st receives their benefits the 4th Wednesday of each month.

Note: An increase to Social Security may impact eligibility for drug help (Medicare Savings Program)

How to find out your benefit amount:

The fastest and most convenient way to keep track of your social security benefit is by creating a my Social Security account.  Use your account to check your Social Security statement, report your wages or change your address and more.

Click here to create an account

As of December, most beneficiaries can access their Social Security COLA notice online. Just go to the message center in your account to view payment details. Notices will still go out in the mail.

You must create an account by November 24,2023 to view the COLA notice online.

Once you have an account, log on and manage your notification preferences.  Just go to “Message Center Preferences” and choose your message options.  You can receive courtesy messages either in your email or by text message.  Once you sign up for courtesy notifications, Social Security will send notifications to the Message Center inbox in your account.   You will get an email or text to tell you there is a message in your account.

sign up for Medicare online

Learn the differences between Medicare HMO vs. PPO Plans