How to Prepare Your Clients for Medicare Carrier Plan Changes


In July, carriers usually release information about new Medicare Advantage and Part D plans for the next contract year to brokers and agents. But some carriers may be planning to drop coverage in certain markets, end contracts with certain providers, or leave the Medicare program. Medicare carrier plan changes can present both challenges and opportunities for you and your clients. So what can you do to prepare for the upcoming Annual Enrollment Period (AEP)? Excelsior shares some helpful tips to get you started.

Start by Organizing Your Book of Business

Don’t wait until AEP kickoff to start organizing your client list. Have a system in place that keeps track of your clients’ contact information and the plans they’re enrolled in. An online client relationship management (CRM) tool is an effective way to do this. Being able to easily access your client information can help you be more prepared when it comes time to start sending out annual coverage review letters and marketing for AEP.

How to Prepare Your Clients for Medicare Carrier Plan Changes

Medicare beneficiaries who have a relationship with an insurance agent are s, according to a Kaiser Family Foundation study. Using these strategies to prepare your clients for Medicare carrier plan changes can help enhance your AEP sales and client retention.

Send Your Clients an Annual Coverage Review Letter

Carriers must send out Annual Notice of Change (ANOC) letters to beneficiaries by September 30 of each year. Also send your clients a personalized letter to let them know you will be contacting them to review their Medicare coverage options. As long as you’re not marketing any plans that will be offered for the new contract year prior to October 1, notifying your clients about Medicare changes will not violate the Medicare Marketing Guidelines.

Let Your Clients Know Their Rights

If your clients are enrolled in a Medicare plan that will end its contract with a preferred healthcare provider, increase cost, or drop coverage in their area, they have certain rights to access other coverage options. Explaining these rights can make it easier for your clients to deal with Medicare carrier plan changes. Make sure your clients are aware of the following:

  • Right to a Special Enrollment Period. In addition to changing Medicare plans during AEP (October 15 to December 7), beneficiaries who will lose coverage under a Medicare Advantage (MA), Medicare Part D, or Medicare Cost plan get a Special Enrollment Period (SEP) from December 8 through February 28 of the following year. This gives you and your clients more time to review suitable coverage options.
  • Right to Join Another MA Plan or Return to Original Medicare. Beneficiaries have the right to join another MA plan that’s available in their area. They may also choose to return to Original Medicare and add Part D coverage. If beneficiaries don’t enroll in another MA plan by December 31, they will automatically go back to Original Medicare on January 1. But they still have time to make plan changes through the end of February.
  • Guaranteed Issue Right to Buy a Medicare Supplement (Medigap) Plan. If your clients are enrolled in an MA plan that will leave the Medicare program or discontinue coverage in their region, you may determine that switching back to Original Medicare and enrolling in a Medigap plan will best meet their needs. If clients choose to go back to Original Medicare, they have a guaranteed-issue right to enroll in Medigap plans A, B, C, F, K, or L. Beneficiaries must enroll in a Medigap plan within 63 days after their MA coverage ends to take advantage of their guaranteed-issue rights. Insurance carriers must follow these rules for guaranteed-issue rights:
    • Enrollees cannot be denied coverage based on their health.
    • All pre-existing conditions must be covered.
    • Enrollees cannot be charged more because of their current or prior health conditions.

Narrow Down Plan Options That Can Best Meet Your Clients’ Needs

Many beneficiaries find the process of comparing Medicare plans . So you want to make it as easy as possible for your clients to choose a plan that will meet their healthcare and prescription drug needs. Here are some things to keep in mind when identifying plan options:

  • Look for plans that can help clients keep their current healthcare providers. Seniors generally don’t have a positive outlook on switching plans during AEP because they , according to the Kaiser study.
  • Look for plans that can help clients reduce out-of-pocket costs. Beneficiaries within the Kaiser study were also concerned with having an unexpected increase in out-of-pocket expenses because of a disruption in healthcare.
  • Look for plans that offer similar, or better, drug coverage and access to preferred pharmacies. Having access to coverage for current medications is, of course, a priority for Medicare beneficiaries. But they also want access to .

Identify Additional Coverage Needs

You should take advantage of the opportunity to ask your clients questions that can uncover additional coverage needs and increase your cross-selling. But you also want to stay compliant when conducting sales activities for MA and Part D plans. If you want to market health-related products, such as Medicare Supplements, cancer, or vision insurance, you can do so as long as this is being requested on the Scope of Appointment. However, you can’t market a non-health-related product during an MA or Part D sales activity.

Get Support On Navigating Medicare Carrier Plan Changes

Excelsior’s senior market experts can help leverage your time with access to proven strategies on how to handle Medicare carrier plan changes to meet your clients’ needs. If your business will be affected by the upcoming 2019 Medicare changes to Cost Plans, we can help you with that, too. You can also access our month-by-month business plan to prepare for AEP. Want more solutions? Contact us today to discover how our proprietary quoting and proposal platform, cross-selling strategies, and regional sales director support can help expand your business.


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References
https://agentsurvivalguide.com/5-tips-to-make-the-most-of-aep
https://www.rbi-group.com/medicare-book-of-business/
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/CY2019_Medicare_Communications_and_Marketing_Guidelines.pdf
https://cahealthadvocates.org/medicare-advantage/when-medicare-advantage-plans-terminate-coverage/
https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances/join-plan-special-circumstances.html#collapse-3212
https://www.medicareinteractive.org/get-answers/medicare-health-coverage-options/changing-medicare-coverage/options-for-those-whose-medicare-advantage-or-part-d-plan-is-ending-at-the-close-of-the-year
https://www.medicare.gov/supplement-other-insurance/when-can-i-buy-medigap/guaranteed-issue-rights-scenarios.html#collapse-4690
https://kaiserfamilyfoundation.files.wordpress.com/2014/05/8589-how-are-seniors-choosing-and-changing-health-insurance-plans.pdf

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