In your role as a Medicare agent, you help guide your clients to the right Medicare plan. While 51% of eligible Medicare beneficiaries enrolled in a Medicare Advantage plan in 2023, these plans are not the best choice for everyone. Having Medicare Supplement plans in your portfolio means you can meet the needs of every Medicare client. Medicare Supplement plans can be sold year around and most don’t require annual certification.

1. Know Which Clients are Right for a Supplement Plan

Many people like the simplicity of a Medicare Advantage plan as well as the additional benefits not covered by Original Medicare such as vision, dental and hearing. Choosing the right coverage depends on individual preferences, lifestyle, and healthcare needs. Clients who might be a better fit for a Medicare Supplement plan are clients who:

  • Want the ability to see any doctor or provider who accepts Medicare and who do not want the restrictions of a provider network that comes with a Medicare Advantage plan.
  • Do not want to deal with prior authorizations or waiting periods to receive care.
  • Travel frequently and are away from home for long periods of time.

2. Understand Enrollment Timelines and Underwriting

It’s important to include Medicare Supplement plans when educating your clients on their Medicare options before they turn 65. The best time to buy a Supplement plan is during the Medicare Supplement Open Enrollment Period, a one time, six month period that starts the first month a person turns 65 and has signed up for Medicare Part B.  Ideally, they should sign up one to three months prior their Medicare Part A and B effective date so their Supplement coverage can begin at the same time.

During this Open Enrollment Period insurance companies cannot deny coverage or charge more due to health issues. This is known as guaranteed issue rights. Once this window of time has passed companies in most states can refuse to sell a policy or they may increase premiums due to pre-existing health conditions.

Outside of the Open Enrollment Period there are specific situations where GI rights come into play and applicants have the opportunity to switch or drop Supplement plans. If your client does not fit any of these special situations, you can help them determine their insurability for a Supplement plan and prepare them for underwriting if you believe they can meet underwriting guidelines. Enrollment periods and underwriting rules vary by state. It’s important to know the rules in your state.

3. Know the Carriers and Plans in Your Area

You should be familiar with the carriers and Supplement plans offered in your area. Review your carriers’ Medicare Supplement Agent Guides, their underwriting guidelines and the health questions found on the application. Here carriers will list which chronic health issues will result in a denial, as well as their list of approved and non-approved drugs. This will help you determine potential insurability for clients who are outside their Open Enrollment window.

Make sure you have up to date rate sheets and current applications. While plan benefits are standardized between carriers, rates vary between carriers and states. Submitting an incorrect or incomplete application may result in a rejection or unnecessary delays. Use e-applications whenever possible to save time and reduce errors.

4. Know Which Plans to Offer

There are currently 10 standard Supplement plans, each designated by a different letter A to N with plans C and F no longer available to new enrollees. You should be able to offer a diversity of plans to your clients but may also want to narrow down which plans you present to a specific client based on their budget and needs so they are not overwhelmed by all the plan choices.

5. Include Part D Plans in Your Portfolio

If you are selling Medicare Supplement plans to your clients, you also need to include Part D plans in your portfolio to ensure there are no gaps in coverage. You want to be a one stop shop for all their Medicare needs.

Medicare Supplement Commissions

You will earn a percentage of the premiums of the policies you sell. CMS does not set a maximum commission like they do for Medicare Advantage and Part D plans. Commission rates vary by carrier and contract.

Your clients rely on your knowledge and expertise to educate them on all of their Medicare coverage choices. They may be less familiar with Medicare Supplement plans, but they are an important part of the options available to them.

The dedicated team at PTT Financial is here to support you as you grow your business. Contact us today.