Since 2008, Medicare Advantage, also known as Part C, has been a great alternative for seniors looking to lower their premiums and out-of-pocket costs.
More than 35 million beneficiaries are enrolled in a Medicare Advantage plan, according to KFF. With more than 32 Medicare Advantage plans available for the average beneficiary, your clients have more choice than ever.
It’s your job to figure out which clients could benefit from these senior health plans, but you don’t have to do it alone. Ritter is here to help!
Who Is Eligible for Medicare Advantage?
According to Medicare.gov, someone is generally eligible to join a Medicare Advantage (MA) plan if they:
- Have Medicare Parts A and B* (called Original Medicare)
- Live in the service area of a plan
- Are a U.S. citizen or are lawfully present in the U.S.
*For someone to be eligible for Medicare Parts A and B, they must be 65 or older or have a qualifying disability or End-Stage Renal Disease.
Who Should Enroll in Part C?
Your client might tick all the boxes when it comes to eligibility, but that doesn’t mean they should enroll in an MA plan.
These types of beneficiaries are ideal clients:
People with a Limited Budget
Clients with a small or fixed budget want a reliable Medicare insurance plan that isn’t going to break the bank. People gravitate towards MA plans because they have:
- Enhanced benefits like dental, vision, and hearing
- A limit on annual out-of-pocket costs for Parts A and B
- Low or zero premiums
To help with financial stress, some of these Medicare options have dental benefits and allowances for glasses, hearing aids, and over-the-counter medications, which aren’t covered by traditional Medicare.
The lower premiums that come with MA plans are enticing for clients trying to fit healthcare in their budget.
Approximately 15 percent of older Americans are living in poverty. Even those not considered in poverty live on fixed incomes with little wiggle room. For example, all retirees should be earning around $2,071 after the cost-of-living increase. This monthly amount is considered not enough for seniors to live off, according to financial analysts.
The lower premiums that come with MA plans are enticing for clients trying to fit healthcare into their budget. Offering D-SNPs to clients with lower incomes will help them provide for them and their family without breaking the bank.
People with Medicare Advantage Options in Their Area
MA plans are offered by private insurance companies, and members must reside in the service area of that plan. While this may seem inconvenient, localized plans often provide richer benefits to compensate for the specific provider networks.
If your client has a small group of trusted doctors and those doctors are in an MA plan’s network, this could be the right fit. It’s important to note that some plans charge extra for doctors outside of their network.
If your client has a small group of trusted doctors and those doctors are in an MA plan’s network, this could be the right fit.
People with Chronic Illness or Declining Health
For those dealing with serious conditions, MA plans could provide a higher level of assistance. About 93 percent of older adults have at least one chronic illness, according to the National Council of Aging. Chronic Condition Special Needs Plans (C-SNPs) and other MA plans are also enticing if someone has a pre-existing condition.
Interested in learning more about C-SNPs and adding them to your portfolio? Pop in to our comprehensive eBook, The Guide to Prospecting and Selling C-SNPs, for a better look at why adding these products is a great way to expand your portfolio!
There’s limited discrimination, and if a plan no longer fits, they have the option to switch during the Annual Enrollment Period, a Special Enrollment Period, or via their Medicare Advantage trial right.
There’s limited discrimination, and if a plan no longer fits, they have the option to switch at least once annually.
People Who Don’t Travel Far from Home
It’s important to know your clients’ habits to sell them the right plan. MA plans operate within service areas that are sometimes as small as a zip code, so they’re ideal for someone who likes to stay home. Since members won’t have to worry about filling prescriptions or seeing a doctor out of state, this plan could be the right fit!
MA plans are ideal for someone who likes to stay home.
People Looking for Convenience
Your clients shouldn’t choose a plan solely based on convenience, but it is a perk. A positive thing about MA plans is that they combine Original Medicare and drug coverage. This means one single card is used for everything and the payments are wrapped into one.
A positive thing about MA plans is that they combine Original Medicare and drug coverage.
For a deeper dive into MA plans, take a peek inside our eBook, The Complete Guide on How to Sell Medicare Advantage Plans! There, you will discover everything else you need to know about MA plans.
When seniors turn 65, they are bombarded with a wide variety of plans to choose from that have many different benefits. Your job is to help make sense of all this information and help choose the best plan for their needs. MA plans are great options for many clients. Hopefully, it is easier now to find the best fit!
Ritter is here to help you with just that! Registering with Ritter for free today ensures you have the back-office support, tools, resources, and more that you need to be the best agent you can be for your clients!
Not affiliated with or endorsed by Medicare or any government agency.
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