fbpx
Oregon Medicare Options

Oregon Medicare Options

Oregon Medicare Options
Comments

Just in 2018 alone, the state of Oregon had close to 900,000 Medicare-eligible people, which could have risen since then as well. Due to the sheer number of Medicare eligibles, Oregon has a diverse number of carrier and product options, such as Medicare Advantage Prescription Drug Plans (MAPD), stand-alone Prescription Drug Plans (PDP), and Medicare Supplements (Medigap)

Something that differentiates Oregon from most states would be their Medicare Supplement birthday rule. Oregon’s birthday rule, which is applicable only for Medicare Supplements, occurs annually and gives clients an opportunity to reevaluate their plan. This can occur 30 days before, and 30 days after their birthday, which allows them to switch to a different plan with no underwriting. For example, if your client has a birthday on May 1st and they reside in Oregon, their birthday rule enrollment period would start on April 1st through the month of their birthday and end on June 1st. You can see more details on Oregon’s healthcare page here. Due to some limited opportunities in Oregon, like in the dual-eligible special needs (D-SNP) market, the birthday rule offers an alternative for agents to grow their Medicare book of business and potentially cross-sell other products.

How much does it cost to sell insurance in Oregon you ask? Oregon offers a $0 residential appointment fee.  So, if you are an insurance agent with your life and health license, you could get appointed at no cost. Here at Pinnacle Financial Services, we have been working around the clock holding webinars teaching Medicare 101, cross-selling opportunities, and how to effectively use our proprietary, online enrollment platform Connect4Medicare. If you would like to access a recorded webinar on Connect4Medicare to see what you are missing, check that out here. Using connect4medicare allows you to still practice social distancing from home while conducting CMS-compliant sales over the phone for all Medicare products (this includes Medicare Advantage and PDP’s). 

Not only is it crucial to have an online enrollment platform like Connect4Medicare, but it is important to have an FMO partner dedicated to your success. COVID-19 (Coronavirus) has changed the way all of us do business but has not altered our approach to helping agents grow their book. Join us now to take advantage of all our free tools and training to get ahead of your competition.

Stay healthy!

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

James Norton

James Norton

Director of Sales - Health

x7797 | jnorton@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

Medicare Advantage Versus Medicare Supplements

Medicare Advantage Versus Medicare Supplements

Medicare Advantage Versus Medicare Supplements

When it comes to selling Medicare products there tends to be a lot of misconceptions. For starters, when your client enrolls into medicare through social security they are enrolling in part A and B coverage, or also called Original Medicare. This coverage is offered by the government and not what medicare agents sell.  Medicare Advantage and Medicare supplements however are plans offered by private companies. These plans provide more extensive coverage from what clients already receive from original medicare in addition to a range of additional benefits such as dental, vision, hearing and drugs coverage depending on which plan your client chooses. I listed a couple of other topics that often get confused when it comes to differences in medicare advantage and supplement products.

Coverage

Medicare Supplements aka Medigap or “Med supp’s” for short, are higher premium plans that clients pay in addition to original medicare. They charge extra premiums to fill in the coverage gaps that clients are exposed to when enrolled in original medicare with Parts a and B.

For information about what falls under Parts A and B

With medicare supplements clients are often left to pay little or no co pays and don’t have to worry about doctor networks as they are always accepted. For example, Plan F or often referred to as “The Cadillac Plan” would cover all services that fall under part A or B without any co pays. 

However, for Medicare clients eligible for medicare after 1/1/2020 plan F is no longer available but there is still plenty of options. If your client was already on medicare or eligible prior to 1/1/2020 they can still enroll in plan F. 

Now you may have noticed we have not addressed part D at all which is drug coverage. Medicare Supplements do not cover part D and need to be pair with a Prescription Drug Plan or PDP.

Medicare Advantage however, covers what they call Part C. Part C combines part A, B and D all in one plan. Medicare advantage plans are usually lower premium plans, often $0. These plans are cheaper monthly but have a lot more gaps in coverage.

For information on how to help cross-sell products to cover these Medicare Advantage gaps

For information on how to help cross sell products to help cover these gaps click here. For these plans you would need to make sure that your clients doctors are in network and compare drug coverage among the available options in your clients residential area. While sounding like a daunting task we have a platform where you can enter in all of this information and it will tell you the best options followed by enrollment options from that same screen. To view more information on this tool watch our webinar.

View more information about Connect4Medicare

Certifications

The most common reason I hear why agents don’t want to sell medicare products is that they don’t want to deal with annual certifications. You do not need to certify in order to sell medicare supplement products. This is important for agents specializing other types of insurance. For example, life and annuity agents who don’t want to spend a lot of time on certifications for medicare can sell medicare supplements by just having their life and health license (which they would already have).  For part D and medicare advantage products however you do need to take the AHIP certifications.

For those life and annuity agents who have sold Medicare Supplements, but cannot sell the Part D without AHIP, they should visit medicare.gov. There, agents can enter their client’s drug information to see the best options, and have the clients enroll. A popular option, this offers lower commissions on drug plans than that of a Medicare Advantage or Supplement plan.

Conclusion

At Pinnacle Finanial Services, our team makes Medicare easy for our agent partners. We provide all of the technology and training necessary for insurance professionals to be successful in selling Medicare products. Consider us your back office!

For more information, contact a Pinnacle Representative today at 1-(800)-772-6881 x7731 or email sales@pfsinsurance.com.

James Norton

James Norton

Director of Sales - Health

1 (800) 772-6881 x7797
jnorton@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

5-Star Medicare Advantage Plan

5-Star Medicare Advantage Plan

5-Star Medicare Advantage Plan

Every Medicare Advantage (Medicare Part C or MA/MAPD) in addition to Medicare prescription drug plans (Part D or PDP) are rated annually by “star ratings” by the CMS or Centers for Medicare & Medicaid Services. These plans are ranked from a 1 Star Plan for low quality up to a 5-Star Medicare Advantage Plan.

Ratings can vary from one star all the way up to five being the highest rating a plan can be awarded. The star rating can change annually. Medicare Advantage, and Prescription Drug plans are rated on the same scale but not given their ratings by the same measurements.

Medicare Advantage Plans are rated on how well they perform in these 5 categories:

  1. Staying healthy: screenings, tests, and vaccines
  2. Managing chronic (long-term) conditions
  3. Plan responsiveness and care
  4. Member complaints, problems getting services, and choosing to leave the plan
  5. Health plan customer services

Prescription drug plans are rated on how well they perform in four different categories:

  1. Drug plan customer service
  2. Member complaints, problems getting services, and choosing to leave the plan
  3. Member experience with the drug plan
  4. Drug pricing and patient safety

Besides how well a plan treats their member that is not all that star ratings have an affect on. If you have a 5 star Medicare Advantage or Part D plan in your area you actually get a one time Special Election Period (SEP) that you would be able to switch. Normally without a 5 star plan in the area of a senior they would have to wait till the Annual Election Period (AEP) to switch Medicare Advantage or Part D plans. This presents a big opportunity for agents in area’s with 5 star plans to create Medicare Advantage or Part D sales outside of AEP.

For more information on 5-star ratings, and all this Medicare, contact the experts at Pinnacle Financial Services today.

James Norton

James Norton

Director of Sales - Health

x7797 | jnorton@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail