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Home Posts tagged "Medicare supplement" (Page 4)
Understanding Medicare Trial Right

Understanding Medicare Trial Rights

By Ed Crowe | General Articles | 0 comment | 10 March, 2025 | 0

Medicare offers several options for health coverage, including Original Medicare and Medicare Advantage (Part C). Choosing the right plan can be challenging, especially if you’re trying a Medicare Advantage plan for the first time. Fortunately, Medicare provides trial rights that allow beneficiaries to switch back to Original Medicare under specific conditions. Understanding Medicare trial rights helps beneficiaries make informed decisions and avoid being locked into a plan that may not meet your needs.

What are Trial Rights

Medicare trial rights are special protections. They allow beneficiaries to return to Original Medicare if they are dissatisfied with their Medicare Advantage plan. These rights apply in two primary situations:

Those who enroll in a Medicare Advantage plan when first eligible for Medicare and decide within the first 12 months that it’s not the right fit, can return to Original Medicare. You can also enroll in a Medicare Supplement (Medigap) plan without facing medical underwriting restrictions.


Beneficiaries who had a Medigap plan and dropped it to join a Medicare Advantage plan for the first time, can switch back to Original Medicare anytime within the first 12 months. Additionally, they have the right to re-enroll in the same plan they had previously if it is still available. If it is not, they can purchase a different Medigap plan.

    Why are Trial Rights important

    Medicare Advantage plans may not always work out as expected. They typically have provider networks, may require referrals for specialists, and can come with different costs than Original Medicare. If the beneficiary’s preferred healthcare providers are not in-network, or the coverage does not suit their healthcare needs, trial rights provide a way to switch back without penalty.

    Click here to watch a video on what you need to know before a Medicare sale

    Understanding how to use a Medicare Trial Right

    Those who decide to use the trial right should:

    • Contact a Medicare agent, if possible to get the best plan options to fit coverage needs. Those who don’t have an agent; call Medicare at 1-800-MEDICARE or visit Medicare.gov to change their plan back.
    • Be sure to apply for a Medigap policy within the 12-month window, if they want supplemental coverage. This helps ensure coverage without going through underwriting.
    • Because Original Medicare does not include prescrption drug coverage, it is also important to enroll in a standalone PDP plan.

    Things to remember

    • Medicare trial rights allow beneficiaries to return to Original Medicare within 12 months of enrolling in a Medicare Advantage plan for the first time.
    • Those who switched from a Medigap policy to a Medicare Advantage plan for the first time may be able to reinstate their Medigap policy. If it is not available anymore, they can or get a new one.
    • These rights help protect beneficiaries from being stuck in a plan that does not meet their healthcare needs.

    Agents who want to see what Crowe has to offer; click here.

    Ready to join the team at Crowe; click here for online contracting

    It is important to understand the rights of your clients to ensure they have the flexibility to choose the best coverage for their healthcare needs. If a client enrolls in a Medicare Advantage plan for the first time, explain the time available should they want to go back to Original Medicare. To take advantage of these protections, act within the trial period.

    Tips for in person Medicare sales

    Tips For In Person Medicare sales

    By Ed Crowe | General Articles | 0 comment | 21 February, 2025 | 0

    Selling Medicare plans face-to-face can be very effective, but it requires the right approach to ensure a successful client interaction. Unlike online or phone-based sales, in person meetings allow agents to build trust, address concerns directly, and provide a more personalized experience. Our tips for in person Medicare sales will help agents formulate a sales strategy and expand their book of business.

    Do your research

    Before meeting a potential client, take the time to understand their specific needs. Having clients fill out a well designed fact finder can provide a roadmap for agents to identify client needs and preferences. Being prepared demonstrates professionalism and allows you to provide relevant options.

    Ask questions to help determine the best coverage options

    • What are the preferred doctors and hospitals?
    • Do they take any prescription medications?
    • What is the monthly budget for healthcare expenses?
    • Do they travel frequently or spend part of the year in another state?

    This goes back to the fact finder suggestion. These insights help tailor recommendations to the unique needs of each individual.

    Create a professional first impression

    First impressions matter. Dress appropriately, arrive on time, and maintain a friendly yet professional demeanor. Be aware of the client’s needs and preferences and follow all CMS guidelines. Bring all necessary materials, such as brochures, plan comparisons, and enrollment forms, to ensure a smooth meeting.

    Form a personal connection

    Medicare decisions can be overwhelming for clients. Establish rapport by engaging in friendly conversation and showing genuine interest in their concerns. Building trust makes it more likely they will rely on your guidance and even recommend you to their friends or family.

    Learn how to maintain your book of business

    Educate rather than sell

    Instead of trying to push a specific plan, focus on educating the client about their coverage options. Explain the differences between plan types (Medicare Advantage, Supplement plans, and Part D) in understandable terms. Do not use industry jargon that may confuse clients.

    Do not pressure clients to enroll in a plan. Be transparent with all plan benefits and costs. Let prospects consider all information and enroll if they are comfortable. If they choose not to enroll, respect their decision and let them know you are available if they need assistance in the future.

    What you need to know before a Medicare sale – Watch a quick YouTube video

    Use visual aids and examples

    Many clients understand information better when it is presented visually or in a practical context. When possible, use plan comparison charts, benefit breakdowns, and real-life scenarios to illustrate coverage differences and potential costs.

    Address concerns

    It is very common for clients to have concerns about cost, coverage limitations, or provider networks. Be prepared to address objections with clear explanations of plan benefits, potential cost savings, and alternative options.

    Follow all CMS and carrier guidelines

    Always adhere to CMS (Centers for Medicare & Medicaid Services) and carrier regulations when discussing plans. Avoid misleading statements, ensure proper documentation, and provide all required disclosures to maintain ethical and legal compliance. This helps protect both the client and the agent in the event questions arise later.

    Learn about the Medicare Scope of appointment

    Follow Up

    A simple follow-up call or email reinforces your commitment to client satisfaction. Check in to see if they have additional questions or need further clarification before making a decision. Agents should also follow up after the enrollment to be sure clients know they are available if any concerns arise later. This helps reinforce the relationship and the client’s confidence in choosing an agent.

    Continue learning

    Because Medicare plans and regulations change every year, it is important to stay updated on plan details, industry news, and new regulations. This helps you provide the best service to your clients.

    Subscribe to our YouTube channel for free training and informational videos

    In-person Medicare sales provide agents with the opportunity to build meaningful relationships and offer personalized guidance. By focusing on trust, education, and professionalism, agents can build their book and become valued members of the community.

    Are you interested in joining the Crowe team – click here for online contract

    What Are Medicare Rapid Disenrollments

    What Are Medicare Rapid Disenrollments

    By Ed Crowe | General Articles | 0 comment | 20 February, 2025 | 0

    Understanding rapid disenrollments and their impact on agents

    If you are in Medicare sales, you may hear the term rapid disenrollment. Newer agents may wonder; what are Medicare rapid disenrollments. We explain a little about this term and how it affects agents below.

    Although you may have done your best, not every enrollee remains satisfied with their plan choice. When a beneficiary quickly disenrolls from a Medicare Advantage plan, this is known as a rapid disenrollment. While this can be frustrating for the beneficiary, it also has significant repercussions for agents who sell these plans.

    What is a rapid disenrollment

    A rapid disenrollment occurs when a beneficiary leaves their Medicare Advantage plan within the first three months of enrollment. This happens for a variety of reasons, including dissatisfaction with provider networks, unexpected costs, confusion about benefits, or an agent not properly explaining the plan’s details.

    Rapid disenrollments can take place during the Medicare Advantage Open Enrollment Period (January 1 – March 31) or via ann SEP (Special Enrollment Period) if the beneficiary has a qualifying life event.

    Why rapid disenrollments matter

    For agents, rapid disenrollments can have significant financial and professional consequences:

    1. Chargebacks – When a beneficiary disenrolls early, agents often face a chargeback, meaning they must repay some or all of their earned commission from that sale. This can significantly impact an agent’s earnings, particularly if multiple rapid disenrollments occur.
    2. Compliance scrutiny – High disenrollment rates may trigger compliance audits by CMS (Centers for Medicare & Medicaid Services) or plan sponsors. If an agent is found to have misrepresented a plan or failed to properly educate the enrollee, they could face penalties or even be barred from selling Medicare plans.
    3. Reputation damage – If beneficiaries frequently disenroll from an agent’s recommended plans, it can damage the agent’s reputation in the industry. Clients may leave negative reviews or hesitate to trust the agent in the future.

    Join the team at Crowe – fill out an online contract

    Reduce rapid disenrollments

    • Conduct thorough needs assessments – Before enrolling a client in a Medicare plan, agents should take the time to understand the client’s healthcare needs, budget, and provider preferences. Making sure the plan chosen aligns with these factors reduces the likelihood of disenrollment.
    • Explain all costs and coverage – Unexpected costs, such as high copayments or out-of-network charges, often lead to disenrollment. Agents should clearly explain all costs associated with a plan so beneficiaries can make informed decisions.
    • Follow Up with Clients – A simple follow-up call after enrollment can address any concerns early and prevent clients from making hasty disenrollment decisions. Providing ongoing support builds trust and reduces confusion.
    • Stay Educated on Plan Changes – Medicare plans change annually. Agents who stay updated on plan benefits, provider networks, and formulary adjustments can better guide their clients toward the most suitable options.
    • Ensure CMS Compliance – Agents should always follow CMS marketing guidelines to avoid misleading beneficiaries. This includes proper documentation and full disclosure of plan details.

    Watch a quick video on the FCC one to one consent rule

    Although disenrollment can sometimes be unavoidable, agents who are well educated, transparent, and ethical can reduce its occurrence. By following the rules and understanding clients’ needs, they can protect their commissions, maintain a good professional reputation, and, most importantly, ensure beneficiaries receive the best possible coverage for their needs.

    How to Avoid Commission Chargebacks

    How to Avoid Commission Chargebacks

    By Ed Crowe | General Articles | 0 comment | 9 February, 2025 | 0

    Unfortunately, chargebacks are sometimes a part of Medicare sales. However if you follow the advice below, you can get some tips to help teach you how to avoid commission chargebacks.

    What are chargebacks

    When we refer to Medicare sales, an agent receives a chargeback if the client terminates the plan you enroll them in early. When this happens, a portion of an agent’s commission for the sale is lost.  This occurs if a client either cancels their plan or passes away.  When this happens, the agent must pay back a portion of any advanced commission payments they received.

    In many instances agents choose to receive commission advances.  In other words, the carrier pays several months of commissions on the sale of a policy up front, before the client makes their premium payments.  Most agents like this because they do not have to wait to get the payment. Although, this can cause potential problems if the client cancels their policy. In that case, the agent incurs a debt to the insurance carrier.

    Watch a YouTube video on how Medicare commissions pay

    It is important to note: each insurance carrier has its own payment schedule and rule for chargebacks.

    Don’t be surprised by chargebacks

    Because most of us do not own a crystal ball; clients pass away or change their mind on their coverage choice, agents must prepare for a few chargebacks each year. It is helpful to set money aside to take care of any debt you may incur.

    Pay your chargebacks

    This is obvious.  If you have a bill, you need to pay it.  Agents who do not pay their debts may end up with a Vector hit against them.  Insurance companies use this service to report unpaid debts. This will damage the agent’s credit score and can affect their ability to offer products with some carriers.

    In certain situations, there are carriers who will not contract brokers with a Vector hit until the debt is paid.

    Agents can pay some chargebacks directly out of their commissions if the insurance company owes them enough money to pay it.  If there is not enough commission due to pay the debt, some carriers allow the agent to set up a payment plan to clear the debit.

    AEP Enrollments

    In some cases, enrollments that take place during AEP, are paid to agents in halves, The first half in January and the other half in February.

    When the client either moves or drops their Medicare Advantage plan during the OEP, the agent receives a chargeback. That is a good reason to make sure that you are available to your clients and they do not seek another agent to answer their questions. Another agent could talk your client into a plan change during the MA OEP ending in a chargeback for you.

    Find out about the 2025 Medicare commissions

    Medicare Supplement chargebacks

    Medicare Supplement chargebacks are much less common than MA chargebacks. In many cases, carriers pay Medicare Supplement commissions as earned.  This means when the client pays their monthly premium the agent receives their commission. Sometimes agents receive commission advances anywhere from 3-12 months ahead. Because many carriers charge a small fee for advances, most agents decide to receive payments as earned. However when agents receive a chargeback for these plans, it is nominal.

    Stay in touch with your clients

    It is extremely important for agents to stay in contact with their clients.  Agents who build a good relationship with their clients have a much lower chance of losing them to another agent. This ensures they will call you if they are considering a plan change.  It is always a good idea to check in and make sure clients are happy with their coverage so you can solve any issues that come up of change their plan if necessary.

    Get some tips to maintain your book of business

    Some times you can’t predict losing a client due to death or other unforeseen circumstances.  The best option is to make sure clients know you are available even when they are unhappy.  Remember to be ready for a few chargebacks.

    Watch a few Medicare agent training videos on our YouTube channel

    Medicare Supplement Commissions 2025

    Medicare Supplement Commissions 2025

    By Ed Crowe | General Articles | 0 comment | 9 February, 2025 | 0

    Medicare Supplement (Medigap) insurance is one of many great products for Medicare agents to offer their clients. They continue to provide a good source of income to agents with their stable commission structure and renewal income. The Medicare Supplement commissions 2025 remain the same as they have been in prior years. We will explain what to expect regarding payment of these commissions below.

    How Medicare Supplement Commissions Work

    Medigap commissions are structured differently than Medicare Advantage (MA) or Part D plans. Instead of receiving a one-time upfront payment, Medigap agents typically earn level commissions over multiple years. Here’s an overview of the commission structure:

    1. Initial Year Commission – Agents earn a commission based on a percentage of the first-year premium, typically between 20 and 22%.
    2. Renewal Commissions – In most cases, Medigap policies pay renewal commissions for a period of 6 years.
    3. Varying Payouts by State – Some states and carriers impose limits on commission percentages, affecting how much agents can earn.

    How Agents Receive Medicare Supplement Commissions

    Agents typically receive their commissions through one of the following methods:

    Direct Deposit – Most carriers pay commissions electronically on a monthly or biweekly basis.

    Advanced Commissions – Some insurers offer advance payments of commissions (e.g., 9 or 12 months upfront) based on projected renewals.

    As-Earned Commissions – Commissions are paid out as the policyholder pays their premium.

    General Payment Structure

    A typical Medigap commission structure follows this breakdown:

    First-Year Commission: about 21% – 22% of the annual premium

    Renewal Commission (Years 2-6): percentage rates vary by area and carrier.

    Payment Frequency: Monthly, biweekly, or advanced lump sums based on carrier agreements

    Learn more about commission payment structures

    Factors That Influence Commission Rates

    Several factors determine how much an agent earns from selling a Medigap policy. These factors include; carrier-specific rates; each carrier sets its own commission structure (unlike PDP & MA/MAPD plans). Each state has its own regulations; some have specific commission caps (CA & FL). In other instances, commission rates are based on age of enrollee and plan type.

    Medicare Supplement vs. Medicare Advantage Commissions

    Medicare Supplement commissions are generally lower in the first year compared to Medicare Advantage, but the long-term renewal structure and coverage type make them more sustainable. Medigap policies also tend to have lower attrition rates, meaning agents can build a long-term residual income.

    Click here to watch a YouTube video on MA & PDP commissions 2025

    Example using 22% commission and 12-month advance:

    For agents selling Medicare Supplement plans, commissions remain a steady and reliable income source. While initial-year payouts may be lower than Medicare Advantage, the ongoing renewal structure provides financial stability.

    Join the team at Crowe- click here for online contract

    Please note: These payment amounts vary by carrier and product. Not all carriers pay 22% for enrollments. This amount varies quite a bit. Be sure you check each carrier’s rate in the specific area you plan to market the plans in.

    What is the Medicare GEP

    What is the Medicare GEP

    By Ed Crowe | General Articles | 0 comment | 6 February, 2025 | 0

    To answer the question; what is the Medicare GEP; The Medicare GEP is an opportunity for individuals who missed their initial chance to sign up for Medicare Part A and/or Part B to enroll. It runs from January 1 to March 31 each year. This allows eligible individuals to enroll in Medicare coverage, though late penalties may apply.

    Who needs the GEP

    The GEP is for individuals who did not sign up for Medicare during their IEP (Initial Enrollment Period) and do not qualify for an SEP (Special Enrollment Period).

    When does coverage begin

    As of 2023, individuals who enroll in Medicare during the GEP will have their coverage begin the month after they enroll. Prior to 2023, coverage did not begin until July 1, which led to significant delays in accessing benefits.

    Late enrollment penalties

    Individuals who sign up during the GEP may have to pay an LEP (late enrollment penalty). This can increase monthly Medicare costs:

    Part A penalty

    For those who must pay a premium for Part A, the monthly premium could increase by 10%. This will be in place for twice the number of years they were eligible but didn’t sign up.

    Part B Penalty

    The monthly Part B premium will increase by 10% for each full 12-month period the beneficiary was eligible but didn’t enroll. This penalty is permanent and remains in place for as long as they have Part B.

    Medicare Advantage, Part D and Supplement enrollment

    If an individual enrolls in Medicare during the GEP, they can sign up for a Medicare Advantage (Part C) or a Medicare Part D prescription drug plan at this time. Coverage for these plans begins on the month following the enrollment. Although late enrollment in Part D or Medicare Advantage plans that include prescription drug coverage may include a lifelong penalty.

    Medicare supplements can be a little more difficult to get after the individual’s Medigap open enrollment has passed. When this is the case, some states require enrollees to undergo underwriting which can lead to denial or higher premiums.

    Avoiding the need for the GEP

    Beneficiaries can avoid using the GEP (General Enrollment Period) and getting potential LEPs:

    Sign up for Medicare during the Initial Enrollment Period, which starts three months before the 65th birthday and ends three months after.

    Those who have employer-sponsored coverage should confirm whether they qualify for a Special Enrollment Period (SEP) when that coverage ends. If they do, be sure to enroll before the SEP ends.

    The Medicare GEP is an important opportunity for those who miss their initial chance to enroll in Medicare. However, because of potential late penalties and delays in coverage, it’s best to sign up during the Initial Enrollment Period or a Special Enrollment Period when possible. Understanding enrollment deadlines helps ensure that beneficiaries get the healthcare coverage they need and avoid unnecessary costs.

    What Medicare supplements cover

    What Medicare Supplements Cover

    By Ed Crowe | General Articles | 0 comment | 28 January, 2025 | 0

    Medicare Supplements, also called Medigap plans, are insurance policies private insurance companies offer to fill the “gaps” after Original Medicare pays it’s portion of approved medical expenses. Understanding what Medicare Supplements cover is essential for Medicare agents and anyone considering enrollment in a Medigap plan to reduce healthcare costs and enhance Medicare benefits.

    Medicare Supplement plan overview

    Medicare Supplement plans are standardized by the federal government, meaning the coverage provided by each plan of the same name (Ex. all Plan Ns) is the same across all insurance carriers. However, premiums vary based on provider and service area. There are 10 standard Medigap plans available in many states, labeled A, B, C, D, F, G, K, L, M, and N. Each plan letter provides a different level of coverage to meet varying healthcare needs and budgets.

    Learn about Medicare premiums & deductibles

    What Medicare Supplements cover

    Medicare Supplement plans provide coverage once Original Medicare pays its portion of the cost for approved healthcare costs. See below for what Medicare supplements cover:

    Medicare Part A coinsurance for hospital costs

    All Medigap plans cover the coinsurance for hospital costs under Medicare Part A for up to an additional 365 days after Medicare benefits are exhausted.

    Medicare Part B Coinsurance or Copays

    Many Medigap plans cover the 20% coinsurance for outpatient services under Medicare Part B. Plan K and Plan L provide partial coverage, while Plan N may require a small copay.

    Blood (First 3 Pints)

    Original Medicare does not cover the first three pints of blood needed for some medical procedures. Medigap plans cover this expense.

    Part A Hospice Care Coinsurance

    Hospice care is covered by Medicare, but beneficiaries may have to pay coinsurance for certain medications and respite care. Medigap plans cover these costs.

    Skilled Nursing Facility (SNF) Coinsurance

    After 20 days in a skilled nursing facility, Medicare requires a daily coinsurance payment. Most Medigap plans cover this expense.

    Medicare Part A Deductible

    The Part A deductible for hospital stays can be substantial. Many Medigap plans, including Plans B, C, D, F, G, and N, cover this deductible.

    Medicare Part B Deductible (Only for Plans C and F)

    Plans C and F cover the Medicare Part B deductible; however, these plans are only available to beneficiaries who were eligible for Medicare before January 1, 2020.

    Medicare Part B Excess Charges

    If a healthcare provider does not accept Medicare’s approved amount as full payment, they may charge an additional amount of up to 15%. Plans F and G cover these excess charges.

    Foreign Travel Emergency Care

    Some Medigap plans (C, D, F, G, M, and N) provide coverage for emergency medical care during international travel, up to plan limits.

    What Medicare Supplements don’t cover

    Although Medigap plans cover many out-of-pocket expenses, there are some services they do not cover:

    Prescription Drugs

    Medigap plans do not include drug coverage. Beneficiaries must enroll in a Medicare Part D plan for prescription drugs.

    Long-Term Care

    Supplements do not cover services like custodial care in a nursing home or assisted living facility.

    Dental, Vision, and Hearing

    Routine dental, vision, and hearing services are not included in Medigap coverage.

    Private-Duty Nursing

    Typically, these services are not covered.

    Watch a YouTube video on Medicare enrollment periods

    What to consider when choosing a supplement

    It is important to evaluate current healthcare needs and potential medical expenses to help determine the level of coverage needed. Budget is another big consideration before choosing a plan. One more important factor before enrollment is eligibility. Some plans require underwriting for anyone who is outside a guaranteed issue period. There are plans (C & F) that are no longer available to anyone who turned 65 after Jan 1, 2020.

    Medicare Supplements provide invaluable financial protection by covering the out-of-pocket expenses left by Original Medicare. By understanding what these plans cover and how they work, you can make an informed decision that ensures peace of mind and comprehensive healthcare coverage. For those considering enrollment in a Medigap plan, a licensed Medicare agent can help provide guidance and compare options to find the plan that best meets coverage needs.

    Medicare and working past 65

    Medicare and Working Past 65

    By Ed Crowe | General Articles | 0 comment | 25 January, 2025 | 0

    There are a some important things to think about for those on Medicare and working past 65. This can be a tricky question to answer. Do you need Medicare Part A or Part B?  Will you have a penalty for taking them later?  What counts as a valid reason not to take Medicare?  Read below for the details.

    Medicare Part A

    We will keep Medicare Part A brief as it is free to most people as long as they have worked and paid Medicare taxes for a period of 40 quarters (10 years). In other words, why would you not sign up for it; it is free and can be sued in addition to employer coverage. You can sign up for premium free Part A up tp 3 months before turning 65 or any time after you turn 65.

    Those who do not qualify for premium free Part A will follow similar rules as enrollment into Part B. Please read below to learn more:

    Do you need part B if you are still working

    Many people need to enroll in Medicare Part B when they turn 65.  Although there are some exceptions. One of the most common exceptions is for individuals working past 65. Because Part B is not free to most people, there are a few things to consider when making this decision:

    Those who are working or have a working spouse and getting coverage through their employer can delay Part B enrollment in most cases.  The key is that the individual must be working and getting coverage.  Both must be happening in order delay enrolling in part B.

    Receiving coverage through an actively working spouse is also a valid reason not to enroll in Medicare Part B. 

    The number of employees matters

    Additionally, the employer must have 20 or more employees.  In either situation above, the person must be receiving coverage through an employer of 20 or more employees.  If the employer has less than 20, Part B of Medicare should be elected at age 65.

    The 20 or more employees has always been the rule. although in the past, it was rarely enforced. As a result, people working with coverage through an employer of less than 20 often waived part B without issue.  In the last few years, this rule has been enforced. This can lead to the denial of medical claims.

    Click here to sign up for Medicare online

    Working past 65 with Medicare: Cobra and other mistakes

    It is very common for people to think they do not need to enroll in Medicare Part B if they have COBRA.  COBRA is not a valid waiver for delaying Part B enrollment.  Keep in mind, either the individual or their spouse must be working as well as getting employer coverage.  People with COBRA are not actively working.

    Getting coverage through an employer without actively work for them is also an issue.  Those who work and have coverage or coverage through a working spouse, must be covered through their current employer.  For example, if John is working and loses his job and enrolls in COBRA and then immediately gets a job somewhere else.  Although he is actively working and has coverage, it is not through the employer he is currently working for.

    VA coverage

    VA coverage is a waiver for Medicare Part D.  It is not a waiver for Medicare B.  The standard rules apply for those with VA coverage.

    What happens if someone neglects to enroll in Part A and or Part B

    Those who do not enroll in Medicare when they should are likely to pay a penalty. The penalty is 10% of the Medicare Part A or Part B premium for each year they didn’t sign up and did not have creditable coverage (through employment).

    Watch a YouTube video on Medicare enrollment periods to learn more

    Those who lose coverage due to retirement or a loss of group coverage qualify for an SEP. The special election period for Medicare runs 8 months from the date individuals either retire or lose group coverage. 

    Individuals who miss their IEP and SEP for either Part A and or Part B have to wait for the Medicare general election period .  This enrollment period runs from January 1 through March 31 each year. Medicare benefits begin the month following the month of enrollment.

     

    Medicare Supplement Plan F vs Plan G

    Medicare Supplement Plan F vs Plan G

    By Ed Crowe | General Articles | 0 comment | 23 January, 2025 | 0

    Why Switch from Medicare Supplement Plan F to Plan G

    There are some good reasons to switch from Plan F to Plan G. We will compare Medicare supplement Plan F vs Plan G to help illustrate. For years, Medicare Supplement Plan F has been a popular choice for beneficiaries seeking comprehensive coverage. However, recent changes and market trends have led many to consider switching from Plan F to Plan G. While both plans offer great benefits, Plan G provides similar coverage at a lower premium cost.

    Key Similarities Between Plan F and Plan G

    Both Plan F and Plan G are Medigap plans designed to fill the gaps in Original Medicare (Part A and Part B). Both plans offer comprehensive coverage, including:

    1. Medicare Part A deductible
    2. Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are exhausted)
    3. Medicare Part B coinsurance or copayments
    4. Part B excess charges (the amount a provider can charge above Medicare’s approved amount)
    5. The first three pints of blood
    6. Skilled nursing facility (SNF) care coinsurance
    7. Foreign travel emergency coverage (80% up to plan limits)

    The only difference is that Plan F covers the Medicare Part B deductible, while Plan G does not.

    Why Switch to Plan G

    Plan F Is No Longer Available to New Beneficiaries

    As of January 1, 2020, Plan F is no longer available to individuals who became eligible for Medicare after that date. This change, part of the Medicare Access and CHIP Reauthorization Act (MACRA), was implemented to reduce overall healthcare costs.

    Due to the fact that Plan F is closed to enrollees who turn 65 after Jan, 1, 2020, its risk pool is aging. This can lead to higher premiums over time as the pool becomes more expensive to insure.

    Lower Premiums

    Plan G often has significantly lower monthly premiums than Plan F does. While Plan G requires beneficiaries to pay the Medicare Part B deductible out-of-pocket ($257 for 2025), the savings in premiums can more than make up for this cost.

    For example, if Plan F costs $50 more per month than Plan G, you’d save $600 each year by switching to Plan G. The savings would easily offset the $257 deductible.

    Similar Comprehensive Coverage

    Aside from the Part B deductible, Plan G provides identical coverage to Plan F. After meeting the deductible, Plan G covers all Medicare-approved expenses just like Plan F does.

    Premium Stability

    Because Plan G is open to new enrollees, its risk pool is younger and more diverse compared to Plan F. This dynamic helps keep premiums more stable over time.

    In contrast, Plan F’s closed risk pool may lead to disproportionately higher premium increases as it’s enrollee population ages.

    Making the switch sooner rather than later ensures you can take advantage of Plan G’s cost savings without disruption to your coverage.

    Things to consider

    Health Underwriting

    Beneficiaries outside their initial enrollment period or guaranteed-issue period, may need to go through medical underwriting to switch plans. This means, insurers evaluate health status and may deny coverage or charge higher premiums based on pre-existing conditions.

    Evaluate Your Healthcare Needs and budget

    All potential enrollees should carefully calculate out-of-pocket costs, including the Part B deductible, to ensure Plan G is a cost-effective choice.

    Enlist the help of a licensed agent

    Because navigating Medigap plan changes can be complex, a licensed Medicare agent can help compare premiums, evaluate options, and explain the implications of switching plans. Agents can help submit the application to ensure it is done correctly as well as advise clients when to cancel their current coverage.

    It is very important to confirm eligibility to enroll in or change plans and be aware if underwriting will apply.

    Learn about Medicare enrollment periods – watch a quick YouTube video

    More thoughts on Plan G

    Switching from Medicare Supplement Plan F to Plan G is a practical choice for many beneficiaries seeking to reduce their healthcare costs without sacrificing coverage. With lower premiums, stable pricing, and nearly identical benefits, Plan G offers exceptional value especially for those who don’t mind paying the Part B deductible.

    Those considering the switch should consult a licensed Medicare agent to ensure a seamless transition and take advantage of the savings and benefits Plan G has to offer. Making an informed decision now can lead to significant cost savings and peace of mind in the years to come.

    Click here for online contracting and join the team at Crowe!

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    Why Sell Medicare Supplement HDG

    Why sell Medicare Supplement HDG

    By Ed Crowe | General Articles | 0 comment | 23 January, 2025 | 0

    The question; why sell Medicare supplement HDG is easy to answer. As healthcare costs continue to rise, more Medicare beneficiaries are looking for affordable yet comprehensive medical coverage. High Deductible Plan G (HDG) has emerged as an attractive choice, combining the robust benefits of traditional Medicare Supplement Plan G with significantly lower premiums. For insurance agents, promoting HDG can be a win-win offering value to clients while providing a competitive edge in the Medicare market.

    Understanding High Deductible Plan G

    High Deductible Plan G works in a similar way to standard Plan G. Both plan options cover the same benefits once the beneficiary meets an annual deductible. For 2025, the deductible for HDG is set at $2,870. In other words, beneficiaries pay out-of-pocket for Medicare-covered expenses until they meet this threshold. Once the beneficiary reaches the deductible, the plan covers:

    1. Medicare Part A coinsurance and hospital costs.
    2. Medicare Part B coinsurance or copayments.
    3. The first three pints of blood
    4. Skilled nursing facility (SNF) care coinsurance.
    5. Part A hospice care coinsurance/copays.
    6. Foreign travel emergency coverage (up to plan limits).

    The other difference between a standard Plan G and a HDG plan is the premium. HDG premiums are significantly lower than those for standard Plan G, making it an appealing option for cost-conscious beneficiaries.

    Why agents should sell HDG

    1. Appeal to cost-conscious clients: HDG is an excellent solution for beneficiaries who want comprehensive coverage and are willing to pay a higher deductible in exchange for lower monthly premiums. Many retirees on fixed incomes consider this a good option, especially those in good health who do not expect many healthcare expenses.
    2. Growing market: With healthcare costs on the rise, there is a growing trend toward high-deductible health plans. Educating clients about HDG allows agents to tap into this expanding market of budget-conscious Medicare beneficiaries.
    3. Competitive edge: Offering HDG plans show the agents ability to provide diverse options tailored to individual financial and healthcare needs. Agents who can explain the cost-benefit analysis of HDG effectively are more likely to earn trust and build long-term client relationships.
    4. Cross-selling opportunities: Beneficiaries who choose HDG may still need assistance with other healthcare expenses. Agents can use this opportunity to cross-sell ancillary products such as dental, vision, and hearing plans, hospital indemnity or cancer heart attack and stroke coverage.
    5. Client Retention: The affordability of HDGs are an excellent option for clients who might otherwise drop supplemental coverage due to cost concerns. By proactively offering HDG, agents can retain clients who might otherwise feel Medicare Supplements are unaffordable.

    Click here to get some tips to maintain your book of business

    How to Sell HDG Effectively

    1. Be sure you educate potential clients. Clearly explain how HDG works. Be sure to emphasize the trade-off between lower premiums and the higher annual deductible. Use understandable examples to illustrate potential cost savings.
    2. Explain the flexibility of the plans. Emphasize that HDG offers the same benefits as standard Plan G after the deductible is met. Clients can enjoy peace of mind knowing they’re protected against catastrophic expenses.
    3. Put the focus on the plan’s affordability. Compare HDG premiums with standard Plan G and other Medicare Supplement plan premiums. Showcase how the premium savings can outweigh the deductible for clients who have minimal healthcare needs.
    4. Use calculators or other tools to demonstrate potential savings with HDG, tailored to the client’s unique circumstances. This personalized approach can make the benefits of HDG more understandable.
    5. Be prepared to address common objections, such as concerns about meeting the deductible. Highlight strategies for managing out-of-pocket costs and reassure clients about the plan’s comprehensive benefits.

    Watch a quick YouTube video on selling ancillary products

    Agents to join our team or existing agents who want to add a product or carrier – click here

    A few more things to consider

    Medicare Supplement HDG Plans offer a winning combination of affordability and comprehensive coverage, making it a valuable option for many Medicare beneficiaries. For agents, HDG plans provide an opportunity to meet the needs of cost-conscious clients, differentiate themselves in a competitive market, and build lasting client relationships.

    By focusing on education, affordability, and personalized service, agents can successfully position HDG plans as a smart choice for Medicare beneficiaries.

    23456

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