Premier Insurance Partners (PIP)
Medicare Advantage: Make this your best year ever
By jhraban1
It's the time of year that thousands of agents live for -- the Medicare Advantage selling season. Just as the major box stores love the holiday season, insurance producers love the selling opportunity that comes with the Medicare Advantage season.
This is the fourth big year for Medicare Advantage. Medicare Advantage producers have developed a love/hate relationship for this season. Agents love the season, as it creates a buying frenzy by the public. The consumer has a very limited number of days to make a decision, so activity is very high and a tremendous number of sales are made in a very short time. On the other hand, Medicare Advantage has another player, besides the insurer, agent and consumer. That other player is our federal government, led by The Center for Medicare and Medicaid Services (CMS). CMS has taken the lead on all aspects of Medicare Advantage plans, including: design of products, commission amounts, how/when commissions are paid, issuance of plans, and of course, when plans can be purchased. The involvement of CMS has totally changed how agents and insurers have intertwined. CMS has been known to change the rules as the game is played, thus causing the "hate" in an otherwise terrific product and selling opportunity.
Most agents recognize November 15 through December 31 as the "season of choice." However, the entire selling season is much longer than these coveted 46 days; in fact, the actual season can be year round. Let's look at the calendar for Medicare Advantage:
This is the fourth big year for Medicare Advantage. Medicare Advantage producers have developed a love/hate relationship for this season. Agents love the season, as it creates a buying frenzy by the public. The consumer has a very limited number of days to make a decision, so activity is very high and a tremendous number of sales are made in a very short time. On the other hand, Medicare Advantage has another player, besides the insurer, agent and consumer. That other player is our federal government, led by The Center for Medicare and Medicaid Services (CMS). CMS has taken the lead on all aspects of Medicare Advantage plans, including: design of products, commission amounts, how/when commissions are paid, issuance of plans, and of course, when plans can be purchased. The involvement of CMS has totally changed how agents and insurers have intertwined. CMS has been known to change the rules as the game is played, thus causing the "hate" in an otherwise terrific product and selling opportunity.
Most agents recognize November 15 through December 31 as the "season of choice." However, the entire selling season is much longer than these coveted 46 days; in fact, the actual season can be year round. Let's look at the calendar for Medicare Advantage:
- November 15-December 31: This is the "door buster" period, called the Annual Enrollment Period by CMS. At this time, consumers can buy anything and everything Medicare Advantage.
- January 1-March 31: These three months, called the open enrollment period, are ignored by a portion of agents, typically the ones that are new to Medicare Advantage. They simply don't realize that the season remains in full swing. There are some definite guidelines during this time period that are not applicable in the annual enrollment period. For example, one must be cognizant of the Part D. If a consumer owns a Part D element to their Medicare Advantage plan, they must not delete it from any new plan. However, they can switch to a new Medicare Advantage plan as long as it contains Part D. On the other hand, if a person does not have a Part D element to their Medicare plan, they cannot suddenly add Part D during this open enrollment period. In summary, if a person has Part D, the agent must make sure the new plan also has Part D. If the consumer doesn't have Part D, they can still buy a new Medicare Advantage plan; it simply can't have Part D attached to it.
- Special enrollment period: There are no dates attached to this portion of the selling season. There are multiple ways a person can qualify for a special enrollment, including:
- Moving out of a service area
- Termination of the plan by the carrier
- Ageing-in: When a person turns 65, they have six months prior to and six months after their birthday to join a Medicare Advantage plan
- Special needs
- Moving out of a service area
- Low income
- Dual eligible
- Chronic illness
