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Preparing for 2023 AEP Season

Preparing for 2023 AEP Season

Preparing for 2023 AEP Season
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Medicare Advantage Annual Enrollment Period is quickly approaching! Are you prepared?

Medicare’s Annual Enrollment Period (AEP) runs from October 15 to December 7th every year. This is the time when all Medicare beneficiaries can make changes to their Medicare Advantage and Part D prescription drug plans for the upcoming coverage year.

Be prepared for AEP so that you can best serve your clients below is a checklist for you:

1) Complete AHIP Certification

You must have current certification in order to sell Medicare Advantage plans. The caveat is a very small amount of insurance carriers will allow you to take their compliance test in replacement of AHIP but that is not the majority. Also, check with your FMO as they and or the carriers may offer a discount on the AHIP $175 fee. Some carriers even cover the entire cost if you are a top seller of their plans!

2) Review Carrier Plans

Every year, Medicare carriers make changes to their plans. Some plan benefits may change while others may be discontinued altogether. As such, it’s important that you review the plans offered by each carrier in your state or states you chose to sell in so that you can best advise your clients on which plan is right for them. In addition, you may find NEW plans or NEW carriers popping up keep those in mind as a possible great addition to your portfolio.

3) Complete Carrier Certifications

In order to sell Medicare plans, you must also be certified by each carrier. The certification process is different for each carrier, so be sure to check their individual requirements. As a note, this is also required in order to keep your renewals!

4) Anticipate Your Client’s Needs

Medicare beneficiaries have a lot of options when it comes to their coverage. It’s important that you take the time to understand your client’s needs so that you can advise them on plan changes and suitability. If you know there will be a plan disruption, be prepared and think of how to get in front of it.

5) Retention

Depending on the concentration of your clients, you may want to host a Plan Review Meeting. This works really well if you have a large demographic within a certain carrier plan and radius. However, if your client book is scattered and has many varying plans this really wouldn’t make sense. You can host a breakfast or lunch to review the current plan the group is on and any changes coming down the pike. I recommend doing this AFTER October 1rst when everyone has received their Annual Notice of Change (ANOC) and you can compliantly discuss plans. You would review the plan outlines and can ask the carriers for materials such as side-by-side comparisons. Just remember while you can TALK plans you can NOT take any enrollment forms until October 15th.

6) Prospecting

There are many ways to branch out and grow your business. Working off referrals, Retail table opportunities such as Walmart’s & CVS, health fairs, RV street marketing, and seminars. Seminars seem to be very popular so let’s talk about those a bit more.

There are two types of Seminars, let’s clarify them for you now below:

  • Medicare Educational Event (Medicare 101): Remember this is NOT planned-specific, your intention is to educate on the basics of Medicare. You can hand out educational material and many carriers have educational pieces you can use. While you can NOT take enrollments or discuss plan specifics at this event you CAN book follow-up appointments to do so. Another point to remember is the setting must not be one on one or in someone’s residence. Remember if serving a meal, it must be $15 or less. We have a great program to drive attendance talk with me today about it!
  • Sales Presentation: During AEP, many carriers will support or even request agents to present their products. This is a great opportunity to grow your client base and lean on some carrier support. Many times, they will advertise the events and provide you with all the materials and giveaways you need. Each carrier will review expectations but it is common to review the basics of Medicare as an opener, then dive into the plan specifics they offer.

This is quite a bit to review and understand so why not reach out to us to help you!

Work with one of the best Medicare FMOs in the business! Click here to get started

For more information, contact a Pinnacle Financial Services representative today

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

Serena Tippett

Serena Tippett

Regional Vice President

x7715 | sbugryn@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.

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Medicare Client Events

Medicare Client Events

Medicare Client Events
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So many different types of Medicare Client Events that can be held but most importantly the rules that apply to each vary. Let’s break it down for you!

Medicare Client Appreciation Events:

This is a nice touch to thank your clients for their business and touch base in person. When you have a larger book, it can be hard to visit and call everyone regularly but by hosting an event like this you can reach your masses. Most common is hosting a breakfast and giving a short talk on what you and your agency offer to them, then allowing the rest of the time to eat and mingle. Many of your current clients may not be aware of the other product lines you represent so this is a great way to put that out there. It is a good idea to put together a folder of materials you would like them to go home with and staple your business cards to the folders. When sending out the invitation you may want to add “Bring a friend” as more people will feel comfortable not coming alone and you may even drum up a nice referral from that! Since with this you are working with your current members the compliance rules are less stringent. However, if they do bring a friend keep any gift at the “nominal” amount CMS recommends or even just use carrier giveaways to be sure you are compliant.

Medicare Plan Review Meetings:

This works really well if you have a large demographic within a certain carrier plan and radius. However, if your client book is scattered and has many varying plans this really wouldn’t make sense. You can host a breakfast or lunch to review the current plan the group is on and any changes coming down the pike. I recommend doing this AFTER October 1rst when everyone has received their Annual Notice of Change (ANOC) and you can compliantly discuss plans. You would review the plan outlines and can ask the carriers for materials such as side-by-side comparisons. It may make sense to tie this into the Client Appreciation Event and host one meeting for your members at this time of year to both touch base and review plan changes. Just remember while you can TALK plans you can NOT take any enrollment forms until October 15th.

Medicare Educational Event (Medicare 101):

This is typically well-received when trying to book venues such as Senior Centers and Libraries as they many times do NOT want anything sales-specific on site. Remember this is NOT planned specific your intention is to educate on the basics of Medicare. You can hand out educational material and many carriers have educational pieces you can use. A good practice is to bring business cards, the scope of appointments, and business reply cards (BRC’s). While you can NOT take enrollments or discuss plan specifics at this event you CAN book follow-up appointments to do so. This is a great opportunity to book in the future. You can request attendees sign in but it must be clear that it is NOT required only OPTIONAL. I always put them at the top of my sign-in sheets in big bold letters OPTIONAL. Another point to remember is the setting must not be one on one or in someone’s residence. Remember if serving a meal, it must be $15 or less.

Medicare Sales Presentation:

During AEP many carriers will support or even request agents to present their products. This is a great opportunity to grow your client base and lean on some carrier support. Many times, they will advertise the events and provide you with all the materials and giveaways you need. Each carrier will review expectations but it is common to review the basics of Medicare as an opener, then dive into the plan specifics they offer. It is best practice to NOT discuss other competitors’ products while there but if you have a prospect that wants to do so discuss it after the presentation time has ended or at a future appointment. There are rules around what is compliant and the carriers will review those with you to make sure everyone is in line. While no meals are allowed a light snack is okay. I oftentimes presented at the local fitness centers that participated in the carrier’s fitness programs and would serve granola bars, waters, and orange juice (the fitness theme)!

This is quite a bit to review and understand so why not reach out to us to help you! We can review your event and determine if it needs to be filed with CMS or not as well as make sure you are compliant and prepared.

Work with one of the best Medicare FMOs in the business! Click here to get started

For more information, contact a Pinnacle Financial Services representative today

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

Serena Tippett

Serena Tippett

Regional Vice President

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.

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DSNP: Dual Special Needs Plans

DSNP: Dual Special Needs Plans

DSNP: Dual Special Needs Plans
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Here is another acronym to throw your way DSNP. This stands for Dual Special Needs Plan and is defined as Medicare Advantage plans which “Enroll individuals who are entitled to BOTH Medicare (title XVIII) and medical assistance from a state plan under Medicaid (Title XIX).” As a reminder Advantage plans will combine Medicare Part A (Hospital services), Medicare Part B (Medical health care), and Medicare Part D (Prescription Drug) through a single plan. That is no different in a Dual Plan the only difference is who qualifies.

(Click here to learn more.)

To help differentiate below is an explanation of the two terms:

Medicare:

Federal Health Insurance Program for people 65 years of age or older, some people under age 65 with certain disabilities, and people with end-stage renal disease (kidney failure).

Medicaid:

JOINT Federal AND State government program that helps with medical costs for certain people with limited incomes and resources. Medicaid coverage varies depending on the state and the type of Medicaid level. Each state decides what counts as income and resources as well as determines eligibility. While states can decide how to run their program they have to follow federal guidelines. Example: Some people with Medicaid get help paying for their Medicare premiums and others will get coverage for additional services and drugs not covered by Medicare.

When someone qualifies for both at the same time they are referred to as Dually Eligible.

Why sell a DSNP policy? Many reasons!

These plans typically offer additional coverage such as Dental care, Hearing exams, Vision exams as well as allowances toward eyewear and hearing aids. A big attraction is the Over Counter benefit (OTC). Many carriers provide catalogs to order OTC items with a monthly or quarterly allowance. These are items not covered under the drug plan such as vitamins or first aid supplies. Many carriers have added grocery benefits via meal delivery services or with a specific food card to use in-store. Transportation services to healthcare-related visits are also many times added into the advantage plans.

Besides the added benefits many carriers offer care management in an effort to keep their claims cost down by keeping members healthy. Some examples may be nurse/navigator outreach calls to coach in weight loss, diabetes prevention, hospital discharge instructions as well as making sure members are taking their medications as prescribed. I have even seen social workers help this population find assistance for heating oil as well as discounted durable medical equipment through community services. Many carriers will also have a Health Risk Assessment (HRA) tied to these plans. You can many times earn an additional payout by encouraging your clients to take these surveys which help the carrier identify where managed care may be needed. It is a benefit to your client to be healthy and have assistance and an additional income for you!

Medicaid is still in place and will pick up the left-over copays designated by the carriers. It is important members show both their DSNP ID card AND Medicaid card to their providers and pharmacy. These members will have little to NO out of pocket expense so enrolling in a DSNP policy will only provide them additional benefits and you a commission

Additional Selling Opportunity outside of Open Enrollment!

A benefit as a broker with working this population is they can make plan changes and enroll outside of open enrollment. This will allow you to sell year-round and not be as limited in your selling season. There is a specific Special Election Period (SEP) for those that receive any type of assistance from Medicaid in addition to Medicare. This SEP allows an individual to enroll in or disenroll from an MA/MAPD plan once per calendar quarter and can be used ONCE during each of the following periods:

  • January-March
  • April-June
  • July-September

No SEP is offered during the 4th quarter, however.

Working the DSNP Market

The most common and effective approach to reaching this market is via Grassroots marketing. Involve yourself in community events, soup kitchens, housing authorities, senior centers if you are lucky enough to get into one, and so on! As a benefit to working with Pinnacle, you have retail opportunities which would be a great way to grow your network, (click here to learn more).

Let us help you market and grow this segment!

For more information, contact a Pinnacle Financial Services representative today

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

Serena Tippett

Serena Tippett

Regional Vice President

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.

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