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Medicare Open Enrollment Season: Best Practices for Producers



This post is part of a series sponsored by AgentSync.

Autumn is almost here: in the north you can have changing leaves while in the south you can get a little break from the heat. Regardless of your geography, one season happens everywhere: Medicare open enrollment season.

If you’re a producer and you’re not already excited about Medicare Open Enrollment, we’ll give you some reasons why you should be—along with some tips on how to make the season successful for you and your customers.

Quick Summary: What is Medicare Open Enrollment Season?

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

If you’re unsure about the difference between Medicare plans, check out our Introduction to Medicare, which lays the groundwork for what’s what when it comes to Medicare.

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

Learn how AgentSync can help

Why do producers need to pay attention to Medicare open enrollment?

By 2021, 42 percent of all Medicare beneficiaries—26 million of the 62.7 million total Medicare beneficiaries—enrolled in Medicare Advantage plans. And research shows that interest in Medicare Advantage plans is increasing; The Congressional Budget Office predicts that the percentage of Medicare beneficiaries enrolled in Medicare Advantage plans will increase to about 51 percent by 2030. Additionally, plan coverage and beneficiary needs can change from year to year.

The annual fall open enrollment period – October 15 to December 7 – is the opportunity for these beneficiaries to switch to the plan that meets their specific medical needs. Miss it and they can be fined heavily.

But wading into the extremely murky waters of Medicare enrollment is enough to put off any beneficiary. Research plans, understand changes, navigate federal websites; it’s no wonder beneficiaries avoid switching to their plans even if they desperately need one.

That’s where the producers come in. For the beneficiaries, the producers have the potential to become the fairy godmothers of insurance. Good producers know the Medicare plan landscape, listen to the beneficiary’s needs, and *poof* find the insurance plan of the beneficiary’s dreams.

A fairytale ending for everyone.

But it doesn’t happen by magic.

Best practices for producers under Medicare open enrollment

There are a few things producers should keep in mind before, during and after Medicare’s open enrollment season to protect beneficiaries and ensure enrollment runs smoothly.

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

Fall enrollment season may seem eons away, but there are many things producers should — and must — do ahead of time to avoid any hiccups.

Producers must be ready to sell with carriers before open enrollment begins. So even if you think you’re ready, it’s important to handle some important requirements with time to spare before Medicare enrollment rolls around.

2. Before selling Medicare products, producers must first be contracted to sell a carrier’s Medicare Advantage and Medicare Part D products.

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

3. Once contracted, producers should be sure to complete the necessary certifications and training to sell these Medicare products. These include Medicare and fraud, waste and abuse training and carrier-specific product training.

Again, if you are ever unsure whether you have completed your certification and training requirements, check with the carriers you contract with. Don’t wait until it’s time to start selling to discover that you don’t meet the requirements to participate in the open enrollment season.

Making sure you’re properly licensed to sell Medicare products can seem like red tape, but remember that these requirements exist to protect consumers and help producers meet the needs of beneficiaries. A resounding good thing, if you ask us.

4. Brush up on your Medicare knowledge

While this is – in part – covered by the carrier-specific product training mentioned above, it is worth repeating and covers much more than a single training.

Knowing all about the different Medicare plans will help you understand which ones are most beneficial to your clients. Look for special benefits such as those that come with discounts or savings for members and those that come with food stamps (designed for people who are both Medicare and Medicaid eligible). The beneficiaries you work with will appreciate your ability to match them with a seemingly tailored policy and may come back in later years when their medical needs change or when there are adjustments to their insurance coverage.

The carriers you work with will likely have training materials and resources in the form of webinars or printed materials. Some of these will be a good internal resource to help you become more aware of the Medicare landscape, others may be great external resources that you can familiarize yourself with and then share with the beneficiaries you work with. And remember, understanding the material before you share it with 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 you money and headaches. And yet, historically, less than 10 percent of Medicare beneficiaries switch plans during the open enrollment season.

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

There is a huge opportunity here.

By helping customers stay informed about how and when to switch coverage, producers 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 open up the conversation about the open enrollment season by creating a positive experience for one recipient, who communicates that experience to another, and another, and another. Just like that, producers can pave the way for a healthy referral cycle.

6. Keep customers informed about privacy risks

Fraudsters 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 of potential scams they may encounter in the process.

Below are some important things beneficiaries should remember during the open enrollment season. Feel free to share these with customers to help them better understand how they can be targeted by bad actors.

  • Beware of cold calling and canvassing. There are strict rules on how and when a producer can contact beneficiaries and showing up at someone’s home unannounced is absolutely not allowed.
  • Always be very careful with personal or financial information. This is likely what a fraudster is after and can have serious consequences for beneficiaries when in the wrong hands. If you are ever unsure, call 1-800-MEDICARE (1-800-633-4227) or contact the Federal Trade Commission.
  • The Centers for Medicare and Medicaid Services (CMS) is issuing new Medicare cards to help deal with identity fraud. Recently, however, fraudsters have jumped on the bandwagon of the change by creating confusion about the new cards. Remember: Beneficiaries do not need to do anything to activate their new cards and should not provide information or pay a fee to anyone claiming to activate Medicare cards.

Hip, hip, hooray for producers

Producers are business critical to a successful Medicare open enrollment season. Beneficiaries need support navigating policy choices, registration paperwork and avoiding scammers. We can only imagine what Medicare enrollment would look like without the sage advice of experienced producers.

So even though it may seem ages away, we recommend starting the season early. It’s always a good idea to start thinking about how to stay informed about the Medicare landscape and proactively address any setbacks that threaten a fruitful enrollment season. Our post on best practice for agencies, operators and MGAs/MGUs is also worth reading. Learn how AgentSync can help you onboard more producers before the open enrollment season.


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