The Annual Election Period (AEP) for Medicare Advantage and Medicare Part D prescription drug plans runs from October 15 to December 7. During this time of the year, Medicare recipients can join an Advantage plan, switch from one Advantage plan to another, or leave their Advantage plan and return to Original Medicare.
If you work with Medicare clients, they may be asking you what the advantages are of joining an Advantage plan. There are several, but here are three that you might want to point out.
#1. Save money
Some Medicare recipients prefer the freedom and peace of mind a Medicare supplement provides. A supplement allows them to go to any doctor that accepts Medicare, and a Plan F supplement fills all of the holes in their Medicare coverage so that they can receive care with no cost sharing. However, Medicare supplements do come at a hefty price for seniors on a fixed income. The cost varies by area, age, and Medigap plan, but most seniors will pay $150 or more for a Medicare supplement. That doesn’t include the cost of their Medicare Part D coverage, which they’ll have to buy separately.
An Advantage plan, on the other hand, often has no additional premium beyond what the member pays for Medicare Part B, and many Advantage plans include the Part D drug benefit. Sure, there are some limitations such as; the member will need to stay within the Medicare Advantage network of providers and some plans will require a PCP to refer them to specialists when necessary. Advantage plans also have cost sharing at the point of service. This can come in the form of flat dollar copayments or deductible and coinsurance.
For those reasons, Advantage plans may not be right for everyone, but they can be a lifesaver (or at least a budget saver) for a senior who sees the need for coverage beyond what Original Medicare provides but who may not be able to afford a Medigap plan.
#2. Extra perks
One of the nice things about Advantage plans is that, in addition to covering everything that Original Medicare does, many plans also include additional perks like dental, vision, or hearing coverage. Some plans might provide transportation to and from the doctor’s office. Other plans include a gym membership with classes specially designed for people over the age of 65.
If you need proof that these extra perks are popular, just ask a carrier that has tried to discontinue them. For example, they often find that canceling the fitness program costs them clients as some seniors switch plans to another carrier that provides the benefit.
#3. Better outcomes
One final reason to join an Advantage plan is that studies show that members actually have better outcomes. A July 2018 report by Avalere Health had four key findings:
- “Medicare Advantage has a higher proportion of patients with clinical and social risk factors shown to affect health outcomes and cost than FFS Medicare.”
- “Despite a higher proportion of clinical and social risk factors, Medicare Advantage beneficiaries with chronic conditions experience lower utilization of high-cost services, comparable average costs, and better outcomes.”
- “Health outcomes and cost savings are significantly better for Medicare Advantage beneficiaries with diabetes.”
- “Dual eligible/low-income subsidy Medicare Advantage beneficiaries with chronic conditions experience significantly better patient outcomes and lower costs savings compared to similar beneficiaries in FFS Medicare.”
The 32-page report goes into significant detail and is worth reading, but if you have these four points memorized, that will be enough for most clients.
At this point, you’ve either made the decision to sell or not to sell Advantage plans during this Annual Election Period. We’re not trying to sell you on the benefits of Advantage plans so that you’ll decide to start selling them (not this year at least). Rather, the purpose of this article is to give you a few selling points that you might want to share with your clients.
There are a lot of positives to an Advantage plan – lower cost, extra perks, and better outcomes just to name a few – but clients will weigh these advantages differently. Since you don’t know what will appeal to a particular client, it’s a good idea to share multiple selling points and see if any of them catch their attention.