Medicare Open Enrollment Season: Best Practices for Manufacturers


    This post is part of a series sponsored by AgentSync.

    Autumn is just around the corner: in the north you can have a change of leaves, and in the south you can get a little break from the heat. Regardless of your geography, there’s one season happening everywhere: Medicare Open Enrollment Season.

    If you’re a producer and you’re not already excited about Medicare Open Enrollment, we’re going to give you some reasons why you should be, as well as some tips on how to make the season a success for you and your customers.

    Quick Summary: What is Medicare Open Enrollment Season?

    Fall Open Enrollment is an opportunity for Medicare beneficiaries to change their Medicare coverage. At the time of open enrollment, Medicare members can join a new Medicare Advantage plan or a stand-alone prescription drug (Part D) plan, and/or switch between an original Medicare plan with or without a Part D plan and Medicare Advantage.

    If you’re not sure about the difference between Medicare plans, check out our introduction to part of medicarewhich lays the foundation for what’s what when it comes to Medicare.

    Ultimately, the Medicare open enrollment season is all about enrolling in Medicare Advantage and Medicare Part D plans, which, unlike original Medicare, are sold by private insurers. As a result, there are several different plans that a Medicare beneficiary can enroll in, and open enrollment is an opportunity to switch to the plan that best suits their needs.

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    Why Should Manufacturers Pay Attention to Medicare Open Enrollment?

    In 2021, 42 percent of all Medicare beneficiaries — 26 million of the 62.7 million Medicare beneficiaries — enrolled in Medicare Advantage plans. And studies show that interest in Medicare Advantage plans is growing; The Congressional Budget Office projects that the percentage of Medicare beneficiaries participating in Medicare Advantage plans will increase to about 51 percent by 2030. In addition, plan coverage and beneficiary needs may change from year to year.

    The annual fall open enrollment period, from October 15 to December 7, is an opportunity for these beneficiaries to switch to a plan that meets their specific health needs. Skip it and they can face hefty fines.

    But wading through the extremely murky waters of Medicare enrollment is enough to deter any beneficiary. Researching plans, understanding changes, navigating federal websites; it’s not surprising that beneficiaries avoid switching to their plans, even when they desperately need them.

    This is where manufacturers come in. For beneficiaries, manufacturers have the potential to become the fairy godmother of insurance. Good manufacturers know the Medicare plan landscape, listen to the needs of beneficiaries, and *poof* find the insurance plan that beneficiaries dream of.

    A fairy tale ending for all.

    But it doesn’t happen by magic.

    Best Practices for Manufacturers During Medicare Open Enrollment

    There are several things manufacturers should keep in mind before, during, and after Medicare’s open enrollment season to protect beneficiaries and ensure smooth enrollment.

    1. Don’t wait until Medicare season to start talking about Medicare

    The fall season may seem like a long way off, but there are many things growers should – and must – do in advance to avoid potential problems.

    Manufacturers must be ready to sell with carriers before open enrollment begins. So, even if you think you’re ready, it’s important to meet a few key requirements to have some free time before Medicare enrollment begins.

    2. Before selling Medicare products, manufacturers must first enter into a contract to sell the carrier’s Medicare Advantage and Medicare Part D products.

    If you’re not 100 percent sure if you’re contracted to sell a carrier’s products, check! Even if you’re sure you’ve signed a contract, it doesn’t hurt to double check. There is nothing worse than thinking you are properly contracted, only to find out at the start of open enrollment that you are not and therefore unable to support beneficiaries or sell Medicare products.

    3. Once contracted, manufacturers must ensure that they have the necessary certifications and training to sell these products to Medicare. This includes training on Medicare and fraud, waste and abuse, as well as carrier-specific product training.

    Again, if you are ever in doubt as to whether you have met the certification and training requirements, check with your contracted operators. Don’t wait until it’s time to start selling to find out you don’t meet the requirements to participate in the open enrollment season.

    Making sure you are properly licensed to sell Medicare products may seem like a bureaucratic check-box, but remember that these requirements exist to protect consumers and help manufacturers meet the needs of beneficiaries. That’s pretty good if you ask us.

    4. Improve your knowledge of Medicare

    Although this – in part – covers the carrier product specific training mentioned above, it is worth repeating and covers much more than one training.

    Knowing all about the different Medicare plans will help you understand which ones are the most beneficial for your clients. Watch for special benefits, such as those that come with member discounts or savings, and those that come with grocery cards (intended for people who qualify for both Medicare and Medicaid). The beneficiaries you work with will appreciate your ability to tailor a seemingly individual policy for them, and may return years later when their medical needs change or when there are policy adjustments.

    The carriers you work with will likely have educational materials and resources in the form of webinars or printed materials. Some will be a good internal resource to help you learn more about the Medicare landscape, others may be great external resources that you can review and then share with the beneficiaries you work with. And remember, understanding the material before you share it with your customers will help you help them.

    5. Help customers understand the importance of open enrollment

    Understanding which plans offer the best coverage and switching between private Medicare plans can save beneficiaries money and headaches. And yet, historically, fewer than 10 percent of Medicare beneficiaries switch plans during the open enrollment season.

    There are a total of 3,550 Medicare Advantage plans available nationwide, which tends to make reviewing and comparing coverage options overwhelming for beneficiaries. Additionally, the many different enrollment periods can leave beneficiaries confused: Is this even the right time to switch Medicare plans?

    There is a great opportunity here.

    By helping customers stay informed about how and when to change coverage, manufacturers can tap into a pool of potential new customers. Remember, 90 percent of Medicare beneficiaries do not take advantage of the open enrollment season. Producers can start the open enrollment season conversation by creating a positive experience for one beneficiary that feeds that experience to another, and so on, and so on. This is just how manufacturers can pave the way for a healthy referral cycle.

    6. Educate customers about privacy risks

    Scammers and scammers know this and use the open enrollment season as an opportunity to take advantage of vulnerable seniors. Producers should emphasize the importance of working with a licensed agent and warn beneficiaries against this potential scams they may collide in the process.

    Below are a few key things beneficiaries should keep in mind during the open enrollment season. Feel free to share them with your customers to help them better understand how they can be targeted by bad guys.

    • Beware of cold calling and solicitation. There are strict rules about how and when a producer can contact beneficiaries, and showing up at someone’s home unannounced is of course prohibited.
    • Always be very careful with personal or financial information. This is likely what a fraudster is looking for and can have serious consequences for beneficiaries if in the wrong hands. If you are ever in doubt, call 1-800-MEDICARE (1-800-633-4227) or contact Federal Trade Commission.
    • The Centers for Medicare and Medicaid Services (CMS) is issuing new Medicare cards to help fight identity fraud. However, fraudsters have recently jumped on the bandwagon, causing confusion over the new cards. Remember: Beneficiaries don’t have to do anything to activate their new cards, and they don’t have to provide information or pay a fee to anyone applying to activate their Medicare cards.

    Hip, hip, hooray for manufacturers

    Manufacturers are critical to a successful Medicare open enrollment season. Beneficiaries need help navigating policy selection, enrollment paperwork, and avoiding scams. We can only imagine what Medicare enrollment would be like without the sage advice of seasoned producers.

    So, while it may seem like years away, we recommend starting the season early. It’s always a good idea to start thinking about how to stay on top of the Medicare situation and proactively address any setbacks that threaten a productive enrollment season. Our section is about best practices for agencies, carriers and MGA/MGU also worth a read. Learn how AgentSync can help you attract more producers before the registration season begins.

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