Tell Your Clients How Medicare Advantage Plans Are Changing

Best Practices October 19, 2018 at 12:42 PM
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Medicare Advantage is a very large insurance market that is continuing to see major growth, with more Baby Boomers moving into retirement age every day. Enrollments are projected to grow by 2.4 million in 2019 to 22.6 million, or 36.7% of expected total Medicare enrollees.

This is the perfect time to sell—or get into selling—Medicare Advantage. People are looking for an expert to show them the plan that can best match their needs. If you have a book of business of clients who are turning 65, now is the time to get in front of them.

The Centers for Medicare & Medicaid Services (CMS) has been busy making changes to Medicare Advantage programs. Enrollment for 2019 is projected to be a more-complicated-than-usual process, so existing and new clients will need guidance.

The Medicare annual enrollment period opened Sunday and will continue through Dec. 7.

Understanding of the changes can help you provide better service to your clients, during and after the annual enrollment period, and sell enhanced policies.

More Plan Options and Benefits for 2019

CMS has overseen a substantial expansion in Medicare Advantage plans, allowing carriers more flexibility to get more creative with what they can include in their Medicare plans. This flexibility translates into extra benefits for consumers to enable them to live healthier lives.

Recognizing this as their chance to differentiate themselves in the Medicare market, carriers have built significantly more robust plans that include added medical and non-medical supplemental benefits like hearing, dental, limited long-term care expenses, transportation to medical appointments, healthy meal delivery, bathroom grab bars and other devices that make seniors' homes safer.

Agents should learn more about the different Medicare Advantage plans carriers are offering to help their clients make good decisions for 2019 and look ahead into 2020, when even more differentiated products will become available.

Agents should make it a point to present their senior clients with 2019 plan costs and major plan changes (contained in the annual notice of change document) and an overview of what their plan covers (according to the evidence of coverage (EOC) document). This may be the year that clients want to evaluate their plan coverages against new products available to them. Clients with a Medicare Part D drug plan should also review their plan's covered drug list and which drug costs are covered.

Some Costs Are Decreasing

According to CMS, there will be some key cost reductions that your clients should be aware of.

  • The average Part D premium in a basic drug plan will be reduced.
  • Those in the catastrophic phase of Part D drug plans will pay less—enrollees will now pay just a few dollars for generic and formulary prescriptions and only up to five% of the cost for expensive drugs.
  • Premiums will remain flat or decrease for Medicare Advantage.
  • Caps on outpatient therapy—which have been in place for several decades—are going away. Some claims will still be reviewed, but for those proven to need the therapy will be approved.

In the past, with few changes to Medicare, people simply renewed the insurance plan to which they'd become accustomed. However, with this expansion and so many new options for additional benefits and cost-savings, your clients may find it compelling to find a better solution for 2019.

Working in the senior insurance sector comes with the privilege of serving those who are the most vulnerable and being able to give them the knowledge they need to get the very best benefits. It's what gets me up in the morning and motivates me to do my best.

The annual enrollment period is your opportunity to help seniors, too—and to help your own bottom line.

— Connect with ThinkAdvisor Life/Health on LinkedIn and Twitter.


Brent Ehlers (Photo: Ehlers)

Brent Ehlers is vice president, sales and marketing, at Premier Marketing, an Integrity Marketing Group Company. Ehlers oversees Premier's sales distribution for the Medicare market. He has served on a number of carrier advisory councils.

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