Medicare Open Enrollment Season: Best Practices for Employers

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Fall is just around the corner: In the north, you can have the changing leaves while in the south, you can take a break from the heat. Regardless of your region, one season is happening everywhere: Medicare’s open enrollment season.

If you’re a producer and you’re not happy with Medicare enrollment, we’ll give you the reasons why you should — along with tips to make this season a success for you and your customers.

Quick review: What is Medicare open enrollment?

Open enrollment is an opportunity for Medicare beneficiaries to change their Medicare coverage. At the time of registration, those who have Medicare can enter a new Medicare Advantage plan or an independent drug plan (Part D) and / or switch between original Medicare with or without part D plan and Medicare Advantage.

If you’re not sure about the differences between Medicare plans, check out our intro to Medicare piecewhich lays the foundation for what is covered by Medicare.

Finally, the Medicare open enrollment period is for enrollment in Medicare Advantage plans and Medicare Part D, 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 their opportunity to switch to a plan that fits their needs.

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Why should manufacturers pay attention to open enrollment in Medicare?

In 2021, 42 percent of all Medicare beneficiaries — 26 million of the 62.7 million Medicare beneficiaries — will be enrolled in Medicare Advantage plans. And research shows that interest in Medicare Advantage plans is increasing; The Congressional Budget Office predicts that the number of Medicare beneficiaries enrolled in the Medicare Advantage plan will increase to about 51 percent by the year 2030. On top of that, the plan’s presentation and benefit needs can change every year.

Annual open enrollment period – Oct. 15 to Dec. 7 – is an opportunity for these beneficiaries to change in a system that meets their medical needs. They miss out and can face huge fines.

But navigating the murky waters of enrolling in Medicare is enough to deter any beneficiary. Researching plans, understanding changes, checking federal websites; it is no wonder that beneficiaries avoid changing their plans even if they need one.

That’s where the developers come in. For beneficiaries, producers have the opportunity to become insurance professionals. Good producers know the structure of Medicare, listen to the needs of the beneficiary, and *poof* find the insurance plan of the beneficiary’s dreams.

A fairytale ending for all.

But it doesn’t happen magically.

Best ways to make time for Medicare enrollment

There are a number of things manufacturers should keep in mind before, during, and after Medicare to protect beneficiaries and ensure successful enrollment.

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

The fall season may seem like it’s just around the corner, but there are a number of things that designers can – and should – do ahead of time to avoid any problems.

Producers must be ready to sell with carriers before open enrollment begins. So, even if you think you’re ready, it’s important to address a number of requirements and deadlines before disenrolling from Medicare.

2. Before selling Medicare products, manufacturers must first be licensed to sell Medicare Advantage and Medicare Part D products.

If you’re not 100 percent sure if you have a contract to sell shipping products, check! Even if you’re sure you have a deal, it doesn’t hurt to double check. There’s nothing worse than thinking you’ve done well only to find out you’re not enrolled and, as a result, you can’t help beneficiaries or sell Medicare drugs.

3. Once contracted, manufacturers must ensure that they complete the necessary certifications and training to sell Medicare drugs. This includes Medicare fraud, waste, and abuse training as well as carrier-related training.

Again, if you’re not sure if you’ve completed your certification and training, check with the carriers you’ve partnered with. Don’t wait until it’s time to start selling to realize you don’t meet the requirements to participate in the open enrollment period.

Making sure you have the right license to sell Medicare drugs may seem like checking boxes, but remember, this is important to protect consumers and help manufacturers address the needs of beneficiaries. A very good thing, if you ask us.

4. Learn more about Medicare

Although this – gradually – training with the porters mentioned above, it is worth repeating and includes more than one training.

Knowing all about the different Medicare plans will help you understand which ones are most beneficial to your clients. Look for special offers such as those that come with discounts or savings for members and those that come with meal cards (designed for people who are eligible for Medicare and Medicaid). Beneficiaries you work with will appreciate your ability to connect them with a seemingly organized plan and may return in future years when their medical needs change or when there are changes to their plan.

The carriers you work with may have training and support materials such as webinars or printed materials. Some of these will be useful internally to help you learn more about the Medicare environment, others may be good external resources that you can familiarize yourself with and share with the beneficiaries you work with. And remember, understanding the story 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 beneficiaries money and headaches. And yet, historically, less than 10 percent of Medicare beneficiaries switch between plans during enrollment.

A total of 3,550 Medicare Advantage plans are available nationwide, which makes the assessment and comparison of potential impacts burdensome for beneficiaries. Additionally, increased enrollment periods can confuse beneficiaries: Is now the right time to switch Medicare plans?

There is a great opportunity here.

By helping customers to be informed about how and when to make changes, manufacturers can gain new customers. Remember, 90 percent of Medicare beneficiaries do not use the open enrollment period. Developers can start conversations about the open enrollment period by creating a positive experience for one beneficiary, who tells someone about the experience, and another, and another. As such, manufacturers can pave the way for better practices.

6. Inform customers about privacy risks

Con artists and scammers know this and use the open enrollment period as an opportunity to take advantage of vulnerable adults. Producers should emphasize the importance of working with a licensed agent and warn beneficiaries possible fraud they can meet in the process.

Below are a few important things that beneficiaries should keep in mind during open enrollment. Feel free to share this information with customers to help them understand how to deal with the bad guys.

  • Beware of spam calls and solicitations. There are strict rules about how and when the producer can contact the beneficiaries and unannounced showings at someone’s home are not allowed.
  • Always be careful with your personal or financial information. This is what a fraudster follows and can have dire consequences for beneficiaries when in the wrong hands. If in doubt, call 1-800-MEDICARE (1-800-633-4227) or ask Federal Trade Commission.
  • The Centers for Medicare and Medicaid Services (CMS) is issuing new Medicare cards to help combat fraud. But recently, hackers have jumped on the bandwagon by creating confusion around the new cards. Remember: Beneficiaries don’t have to do anything to open their new cards and they don’t have to provide information or pay fees to anyone who wants to start a Medicare card.

Hip, hip, hoorah for the designers

Producers are critical to a successful Medicare enrollment season. Beneficiaries need help managing their options, enrollment documents, and tracking information. We can only imagine what Medicare enrollment would be like without the wise counsel of experienced developers.

Therefore, even though it may appear for many years, we recommend starting the season early. It’s always a good idea to start thinking about how to be more knowledgeable about Medicare and how to deal with any problems that may interfere with the enrollment period. Our section on best practices agencies, carriers, and MGAs/MGs it should also be read. Learn how AgentSync can help you become more productive before enrollment season.