Medicare Advantage plans, which are the most regulated plans and cause the most headaches for Medicare beneficiaries and the agents trying to help them, involve two major categories of health plans sponsored by the private insurance industry and regulated by the federal government: (1) integrated health plans and (2) prescription drug plans. Much of your creativity as a Boomer agent centers around remaining compliant and helpful, two goals that often feel at odds with each other. We can help.
The integrated health plans encompass the benefits of Original Medicare Parts A and B as well as, optionally, Part D, the prescription drug coverage. The plans can be designed to omit prescription drug coverage in some cases, since that coverage may have been assumed by, say, the Veteran’s Administration. The integrated plans are often called Medicare Part C or Medicare Advantage Plans or MA Plans or MAPD plans. They were originally intended to offer good benefits at a lower premium offset by higher cost-sharing than Medigap plans. The notion was to help out people who could not afford high premiums. Ironically, in a few states, carriers no longer offer the plans in rural counties where incomes are lower. In such cases, talk with us. We can suggest alternatives.
The prescription drug plans, often referred to as Medicare Part D or PDP‘s, are stand-alone plans that can be purchased by a Medicare beneficiary using Original Medicare or Original Medicare with a Medigap plan. In special cases, the PDP’s may be used with MA plans. Legally, Medicare beneficiaries may opt out of purchasing prescription drug coverage, but opting out will involve penalties if the beneficiary ever changes his/her mind.
The compensation for both types of Medicare-Advantage plans is standardized by the federal government. It is standardized across most states, with a few states granted an increase in compensation, states like California. The purpose of the standardized compensation is to help agents put their clients in the best plan regardless of compensation. Compensation can vary from year to year, going up and down. Check with us, and we can let you know what it is state by state for this year.
Offering Medicare-Advantage plans is a necessary component of being a well-rounded Boomer agent. It is also an important part of the Stone Hill Full Spectrum sales approach, a way of developing and maintaining client loyalty to you, the Boomer agent.