As we enter the Annual Enrollment Period (AEP) for Medicare, it’s crucial for insurance agents to be well-prepared in order to provide the best possible guidance to beneficiaries. AEP, which runs from October 15 to December 7, is when tens of millions have the opportunity to make changes to their coverage. If you work in the space or frankly have family and friends who are Medicare eligible, you know that having the right coverage is foundational to living a long and fulfilling life and safeguarding your hard-earned nest egg.
Here are some valuable tips that I have learned over the years in order to ensure your customers are getting the best possible coverage and that you become the go-to for their needs.
Stay Informed and Up-to-Date
Your book of business is dependent on your understanding of the landscape. The reason that seniors use agents is because of the lack of transparency, and complexity of the products and overall market. It’s critical to stay ahead of the latest updates and changes to Medicare plans including premiums, coverage options, drug formularies, and added ancillary benefits to support overall wellness. Regulations and guidelines continuously evolve, so it’s vital to stay informed to help your clients make the right choices.
Educate Your Clients:
Knowledge is power. AEP is the perfect time to educate your clients about their Medicare options. Explain the differences between original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Prescription Drug Plans (Part D). Ensure they understand the implications of their choices on cost and coverage so they don’t face any surprises later in the year.
Review Medication Needs:
Many beneficiaries rely on Medicare for prescription drug coverage. Your clients should review their current medications and ensure that their chosen plan covers them adequately in advance of enrollment. Changes in drug formularies can have a significant impact on out-of-pocket costs, creating a financial burden.
Assess and Anticipate Healthcare Needs:
Encourage clients to assess their healthcare needs for the upcoming year. Think of this as a health audit. Consider factors such as anticipated doctor visits, planned or suspected hospital stays, and any recent health conditions emerging. This should also include any providers that are out of network as those visits are often the costliest. This evaluation can help them decide on the best and most personalized plan. Take the time to understand their health goals and aspirations, and make sure this is considered when making a plan recommendation.
Compare Plans:
Medicare beneficiaries have a multitude of plan options. Assist your clients in comparing plans based on their specific needs, including cost, coverage, network providers, and additional benefits like dental, vision, or fitness programs. It will help the most if you are able to provide a cheat sheet of benefits and drawbacks as well as make a recommendation based on their personal needs.
Emphasize the Importance of Timeliness:
AEP is a set timeframe, so stress the importance of making decisions promptly. Late enrollment may result in penalties or delayed coverage, which could be financially burdensome at best and detrimental to health at worst.
Be Transparent About Budget Constraints:
Help beneficiaries determine their budget for healthcare expenses, including premiums, deductibles, and co-pays. Seniors can be reluctant to talk openly about finances as that can feel uncomfortable. They should be able to speak with you in the same way they would have a frank conversation with their financial advisor. Understanding coverage needs with budget constraints is important to know up front.
Stay Compliant:
Ensure that you and your agency adhere to all regulatory requirements. Medicare agents have specific guidelines to follow, including ethical standards and anti-fraud measures. As complaints about behavior have risen in the last several years, this is more important than ever, and the consequences of not adhering can negatively impact the agent and the enrollee.
Leverage Technology:
Embrace technology to streamline operations. Use digital tools to compare plans, generate quotes, and assist with enrollment. This not only improves efficiency but enhances the customer experience because you can spend more of your time personally with them getting to understand their holistic needs.
Most important, every beneficiary is a human and you are helping them make one of the most important decisions of their year. We all have seniors in our lives who we love and care about. We are a multigenerational household and I get the joy of having my mother live with me. I know firsthand how vital it is for her to sustain her physical and mental well-being. Be patient and provide exceptional customer service. Building trust and a good rapport will be tantamount to building a good and successful business. Be the agent that you would send your mother to for help with her Medicare.
Anthony Kavouras
Anthony Kavouras is the CEO of OpenMedicare, a platform that helps seniors find the right Medicare health insurance plan. Anthony is passionate about OpenMedicare’s mission to address the need for trust in the search for Medicare and its ability to leverage data and technology to match customers with the right plan. Anthony brings 15 years of leadership experience to the role from companies including GuidedChoice and eHealth.
