A large number of Medicare beneficiaries find Medicare confusing. They are overwhelmed by their choices and find it difficult to pick the best plan for themselves. Once enrolled in a plan, they often don’t understand their out-of-pocket costs or benefits. Some beneficiaries stay with the same plan year after year, even though it may not be the right fit for them, simply because finding a new plan feels like an ordeal they would rather avoid.
As a Medicare agent, you play a crucial role in educating your clients about Medicare and the factors that go into selecting the best plan. Reassure your clients that you’ll help them understand their choices and guide them to make the right decision for their healthcare needs. Knowledge is power. Informed clients feel more confident about their choices and more appreciative of your guidance, which can lead to increased customer retention and loyalty.
Understanding the Basics of Medicare
Whether they are new to Medicare or already enrolled in a plan, many of your clients likely do not understand the basic components of Medicare – i.e., Parts A, B, C, and D. Since seniors often don’t want to admit they don’t understand Medicare, it’s important you reassure them that they are not alone in finding Medicare confusing and that you are here to help. This will create an atmosphere of respect and trust.
Understanding Enrollment Periods and Deadlines
Educating your clients on Medicare includes a review of Medicare’s different enrollment periods and important deadlines as well as the risk of late penalties if a client misses a deadline. Make clients aware of enrollment periods when they can change plans and let them know you will help them review their coverage each year to determine if their current plans are still ideal.
Many factors go into choosing the right plan. Reviewing these with your clients will help them understand why certain plans are a better fit than others. This also creates transparency into why you are recommending one product over another.
- Providers – Review which doctors and hospitals a client uses. Discuss the importance of staying within a plan’s network if a client is choosing a Medicare Advantage plan as well as the difference between HMO and PPO plans.
- Drugs – Review clients’ prescriptions and compare insurers’ drug formularies. Explain how the tiers work and how this determines the cost of their medications. Review any special requirements, such as PAs, quantity limits, and mail order. Confirm that clients’ pharmacies of choice are in the plans’ networks.
- Chronic Health Conditions – Ask about any diagnoses that require ongoing treatments and compare coverage between plans.
- Affordability – Help clients compare the costs between plans and understand the full picture when it comes to affordability. For example, a $0 premium may sound good, but it may not be the best choice when you consider out-of-pocket costs such as deductibles, copays, and coinsurances. If clients are having trouble paying for their healthcare, help them determine if they qualify for financial assistance through programs such as Extra Help and Medicare Savings Programs.
- Travel – Ask clients how often they travel and for how long and if they travel internationally. Determine if they want the option to receive medical care or fill prescriptions while they are out of town.
- Supplemental Benefits – Determine how important additional benefits like vision, dental, and hearing coverage as well as wellness benefits such as gym memberships are to clients.
Understanding Benefits and Out-of-Pocket Costs
Your ultimate goal is to educate your clients to help them maximize their benefits and minimize their out-of-pocket (OOP) costs. When comparing plans, discuss all OOP costs – including premiums, deductibles, copays, coinsurance, and OOP maximums – for both medical services and prescription drugs. Reiterate that clients will still pay their Part A (if they have one) and Part B premiums in addition to these costs. It’s important to eliminate any surprises, such as unexpected medical bills.
It is not unusual for beneficiaries to miss out on covered benefits because they weren’t aware of what was available to them. Review all covered benefits, including preventive services. If a client is choosing a Medicare Advantage plan, review the supplemental benefits included with the plan. Mention any limitations or caps on benefits.
Empower Clients with Self-Service Tools
Once your clients have enrolled in the plan of their choice, educate them on how to be proactive in managing their healthcare by setting up an online account and/or mobile app with their insurers. Some of your clients may be unsure about how to do this and will welcome a brief tutorial. These tools give clients 24/7 access to their benefits, claims, the provider search tool, and their drug formulary. They can also order new ID cards and set up automatic payments for their premiums. Teaching clients how use Medicare technology is just one more way you can empower them to feel more in control of their healthcare.
Drive Client Retention and Loyalty
When you take the time to educate your clients about Medicare, you build a reputation as someone who cares and has clients’ best interests at heart. Your clients will consider you a trusted advisor who is there for them throughout the year to address any questions or concerns. Not only will this lead to increased loyalty, but your clients will also become your best resource for referrals.
The dedicated team at Western Asset Protection is committed to your success. Contact us today.