Reviewing for Specific Needs

When it comes to Medicare Advantage, coverage varies from plan to plan.

Two key areas were you’ll see differences are going to be prescriptions and providers.

Let’s start with reviewing providers.

You may recall from our Medicare Advantage module in Path 2 that MA plans work with a network of providers.

And regardless of whether your client is required to stick to their network, like in a health maintenance organization plan, or they have a bit more flexibility, like in a preferred provider organization plan, you’re going to want to make sure that your clients’ preferred providers are in network.

Doing so will help make sure that they can keep a trusted relationship with their medical professionals.

If you are looking at a Medicare Advantage plan that includes Part D coverage, you’re going to need to consider prescription medications.

You’re going to need an updated list of your client’s current prescriptions, as well as their preferred pharmacy.

If you are collecting prescription drug information manually, you should try using a CRM to do so.

It allows you to securely store that information, as well as run quick drug cost estimation searches to see what plans might be best for your clients based on their specific prescriptions.

Even if you’re not using Integrity’s MedicareCENTER or PlanEnroll solutions, you could always use the Medicare.gov Plan Finder to estimate drug costs.

Regardless of which tool you use, you’ll be able to review Medicare Advantage plans in the appropriate service area and see the approximate drug costs based on your client’s specific information.

If you added providers to this search, you’ll also be able to review which plans include their preferred providers in network.

Ideally, you’ll find plans that cover their drugs at a reasonable cost, as well as include access to their preferred providers.

Now with this narrowed list, you’re ready to make some plan recommendations.

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