AHCP Blog

Finding the Best Medicare Plan for Your Clients

Written by AHCP | 11/10/23 2:46 AM

The Annual Election Period (AEP) is an important time of year for both insurance agents and the clients they serve. The AEP provides clients with an opportunity to review, assess, and make informed choices about their Medicare Advantage and Medicare Part D plans. Unfortunately, many clients view this more as a chore than an opportunity because they are bombarded with ads on TV and by mail and the number of options can make the entire process seem overwhelming.

As brokers, it is imperative that insurance agents employ a strategic and client-centric approach to guide beneficiaries through this process. This includes conducting a thorough fact-finding interview to determine the best-suited plan for each client, acknowledging that there is no one-size-fits-all solution.

Avoiding Superlatives: A Cautious Approach

When presenting Medicare plan options to clients, it is always a good idea to steer clear of using superlatives such as "better" or "best." Describing a plan as "the best in the market" can be misleading, as what may be the best option for one individual may not be suitable for another due to differing needs, preferences, and circumstances. The subjective nature of these terms can create unrealistic expectations and hinder the client’s ability to make an informed decision. Here are a few tips:

  1. Focus on Fit, Not Rankings: Instead of highlighting a plan’s superiority, focus on how well it fits the client’s specific needs, budget, and preferences.
  2. Provide Comprehensive Information: Be sure to provide clients and prospects with all necessary information, including plan benefits, costs, network, and coverage, to make an educated decision.
  3. Emphasize Choice: Encourage clients to explore various options and highlight the importance of choosing a plan that aligns with their unique needs. You’re there to guide them, not to decide for them. And they can only make a decision if they have options to choose from.

Conducting a Fact-Finding Interview

To truly understand a client’s needs and identify the most suitable plan, conducting a comprehensive fact-finding interview is essential. This process involves asking targeted questions to gather information about the client’s healthcare needs, financial situation, and preferences.

  • Healthcare Needs: Inquire about the client’s current health status, including and pre-existing conditions and required medications. While Medicare Advantage plans are guaranteed issue with no medical questions to answer, we can only make a good recommendation if we understand our clients’ medical needs and their preferences regarding doctors, hospitals, and pharmacies.
  • Financial Considerations: Discuss the client’s budget, including their willingness and ability to pay premiums, co-pays, and out-of-pocket expenses. Some may prefer to minimize their required monthly premium, even if it means paying a little more at the point of service. Others are willing to pay more monthly to have most of their medical expenses covered and the freedom to seek care wherever they would like.
  • Lifestyle and Preferences: Consider the client’s lifestyle, including travel plans, as some Medicare Advantage plans may offer broader network coverage than others, or the client’s answers may lead you to recommend a Medicare supplement instead.
  • Future Health Projections: While it’s challenging to predict future health needs, encourage clients to consider potential changes in health status and how that might affect their plan choice. Remember, after the initial six-month window, it may difficult to purchase a supplement if the client has pre-existing medical conditions, so planning ahead is a good idea.

Providing Personalized Recommendations

Armed with comprehensive information from the fact-finding interview, agents are better positioned to provide personalized and accurate plan recommendations.

  • Highlight Plan Features: Emphasize specific plan features that align with the client’s needs and preferences.
  • Explain the Trade-Offs: Clearly communicate the trade-offs of each plan, helping clients understand the pros on cons of each.
  • Facilitate Informed Decisions: Encourage clients to take an active role in the decision-making process, ensuring they are comfortable and confident in their choice.

Final Thoughts

The Annual Election Period is a crucial time for Medicare beneficiaries to reassess their coverage options, and as insurance agents, it is our responsibility to guide them through this process and provide personalized recommendations. While we should avoid saying that one plan is better than another in general, the fact is that there is a best plan for each client based on their own unique needs, and we can uncover those needs by conducting thorough fact-finding interviews.

Yes, this does take some time, and time is at a premium during the busy AEP. Nonetheless, it’s our job, so we should take whatever time is necessary to help our clients make informed decisions that best suit their individual needs; this will help us build trust with our clients and will lead to lasting relationships.