Medicare Advantage Annual Notice of Change letters are going out to your clients, and this is a good time to be in contact with clients as they may need assistance and guidance.
The deadline for insurers to have ANOC notices to current members is next week – Sept. 30. This is roughly two weeks before enrollment begins.
These notices explain upcoming changes to a client’s Medicare Advantage plan. Things like premiums, copays, deductibles, provider networks, and prescription drug coverage may be changing. These changes will start Jan. 1 so your client has time to prepare, which is a good opportunity for agents to shine and really assist seniors.
The key is to be in contact with your clients and prepared to help. You need to have a copy of the information the client has been sent. Preparation means not being surprised if you are contacted by a concerned client but instead being able to help.
Let’s look at ways agents can get prepared during the ANOC period:
What Will Be the Largest Impact?
Start with premiums for your client. Will the monthly premium go up or down? Perhaps the plan is going to “no premium.” Premium increases can be a big deal for those on fixed incomes. If you have a premium increase, this alone could trigger the need to search for another provider.
The next thing to look at are deductibles. Are they going up or down? Maybe the monthly premium remains unchanged, but your client’s out-of-pocket costs may be going up. For some, deductibles are a concern if they are getting current medical care and paying deductibles.
Changes in co-pays is another pocketbook issue that needs to be analyzed for financial impact. If your client regularly encounters co-pays, then an increase would be undesirable.
The economics of a plan change are usually the biggest issue for a senior, so address this first. And look at the whole mix — monthly premium, copays, and deductibles — when calculating the best financial option.
#Meds and Doctors
This may be as big as finances. People don’t want a disruption of care. They are going to ask, “Are my prescriptions still covered? Is my doctor on this plan?”
To work through these issues, you must have access to the current provider directory and the one proposed after Jan. 1 when changes kick in. It is likely your client was mailed this information and it makes comparisons easy.
With this information handy, you can determine coverage and explain what is coming up.
Remember that Medicare offers a plan comparison tool that will assist with prescription costs and coverage.
Supplementals
Many seniors enjoy MA plans because of the perks offered. Gym memberships, over-the-counter med benefits, dental, vision, and hearing coverage can be items people want.
These benefits can also change from year to year so they need to be checked in case they have been reduced, increased, or remade.
Ask Questions
Looking at plans and analyzing what’s changed is important. But remember, it will likely be a combination of factors that point to staying on a plan or switching. You need to know just exactly what you client needs from a plan.
These questions will help you guide your client to a good decision:
- Do you see specialists regularly?
- Has your health changed in the last year?
- What prescriptions do you take?
- Are you expecting a major surgery or change in care next year?
- What supplemental benefits are you using?
- What does your current plan not provide that you need?
- Are increasing premiums and costs a concern, something you cannot afford?
Stay Compliant
It is always good to review compliance measures and make sure you are complaint in every area as we embark on a new enrollment period. Use approved plan materials, don’t promise savings without verification, follow permission-to-contact rules, document client interaction, and make sure your client understands the plan they are choosing.
CMS maintains Medicare Advantage enrollment and marketing guidance, and agents should consult current requirements for the applicable contract year.
How Pandora Insurance Helps
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- Freepre-license courses for our contracted agents
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