Coverage Needs

Now that we’ve looked back at your client’s past coverage, it’s time to return to the present and look at your client’s current needs. After all, you’re working on finding the right plan for the days ahead. Let’s start with the prescriptions that your client is currently taking. Whether you’re selling a stand-alone Part D plan or a Medicare Advantage plan that includes Part D coverage, you’ll want to ensure that client’s prescriptions are covered in the plan’s formulary at a competitive price.

The first thing you’ll need to gather is your client’s drug list. You’ll need the drug name, dosage, quantity prescribed, and how frequently they fill that prescription.

You’ll also need to note if they have any preferred pharmacies and ask if they’re open to using a mail order pharmacy.

We’ll link a PDF download that you can use for this step in the resources for this module. After you’ve compiled the drug list, use a tool like Ritter’s drug cost estimator or Medicare.gov to input your client’s drug list and review coverage from the plans in their service area.

Both of these tools will allow you to review the estimated costs of your client’s prescriptions, allowing you to better recommend a plan to fit their unique prescription needs and potentially the lowest cost.

As an aside, remember that Ritter’s drug cost estimator is a tool for agent use only and should not be presented to or viewed by the client. But instead used as a tool for your own personal sales preparation.

You can use client facing tools like Medicare.gov to review plan benefits with your client.

Understanding what conditions that your client wants to ensure are covered in their plan.

Take some time to understand their concerns about those conditions.

Do you need to ensure that they have access to a specific provider Does that condition require more doctor’s visits?

Is there a greater likelihood of an inpatient hospital stay due to that condition?

Then as you’re discussing plan options with your clients, you can ensure that you are taking the time to explain how the plan that you’re recommending will cover those needs and provide special attention to your client’s concerns.

Certain concerns, like a family history of cancer or heart problems, may open the door to recommending ancillary products designed specifically to cover those conditions.

You can learn more about those products and our cross-selling module in Path 4.

Now that we’ve discussed coverage needs, let’s move on to look at one more factor to consider. Watch the Next Lesson