Assessing Needs to Recommend a Plan
Learning to Sell | Lesson 3

Considering Costs

One of the biggest factors when it comes to making a health care decision is the cost of the plan.

So, this is another great place to start when assessing your clients’ needs!

When considering the costs of a plan, we’ll be looking at monthly premium costs and out-of-pocket expenses.

Let’s start with monthly premiums.

You may ask your clients open ended questions like, “what are you comfortable spending monthly to stay in a plan?” Or, “do you have a specific amount budgeted for monthly health care expenses?”

These questions will allow you to better gauge if higher premium options should be considered.

Next, we also need to consider the out-of-pocket exposure in the plans.

Here, you want to assess how much they are willing to spend on things like deductibles, copays, and coinsurance amounts when they use various services.

Keep in mind, that your clients may be unfamiliar with some of these health care terms. During your conversation, ask if they’d like more information on these terms and keep the door open for their questions.

You may want to present these options with cost estimates based on different services. For example, you could ask, “how would you feel about paying $10 every time you see your primary care provider?”

“Would you be able to afford a $500 copay if you had an inpatient hospital stay?”

These questions will help you get a better sense of their ability and comfortability with paying for their health care.

As you’re reviewing the numbers, you may also find success asking some questions that combine both elements.

Think questions like, “would you rather pay a higher premium with limited out-of-pocket costs?” Or, “would you rather keep your monthly costs lower and pay more out of pocket?”

If they’d rather keep their premium costs lower, and are comfortable with out-of-pocket exposure, a Medicare Advantage plan could be a good fit!

If they’d rather reduce their out-of-pocket expenses, even if it costs additional premium, well then, a Medicare Supplement might be the way to go.

That’s just a general rule, but keep in mind there are variations like higher premium Medicare Advantage plans and Medicare Supplement plans with some out-of-pocket exposure.

Costs are an important part of assessing your client’s needs, but what else should we consider?

Find out in our next lesson!

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