How Should I Educate my Clients on Medicare? | Lead Concepts

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How Should I Educate my Clients on Medicare?

An image of an insurance agent meeting a senior couple.

Everyone has heard of Medicare, but few people know what it is and how it is offered. Unfortunately, the lack of this knowledge is the trend among seniors in the U.S., which may explain all of the enrollment blues reports.

Luckily, there’s something you can do about this: educate your clients on Medicare. This task is difficult, as Medicare is hard to explain and understand. However, doing so is essential because many seniors are otherwise struggling.

Read further if you’re wondering how to educate your clients on Medicare. We will explain just how you can do that.

Meet Them Where They Are

This doesn’t mean physically going to your client’s current location. It means putting yourself in his or her shoes and understanding what they know about Medicare. It’s easy to think that seniors could educate themselves about Medicare by doing their own research. This is true in theory, but you must remember that some seniors struggle with technology. And without the internet, thousands of resources are stripped from them.

It’s also possible that you have a client who is younger than 65 who was once healthy but just discovered that he or she has long-term kidney failure. In this instance, you have a client who hadn’t expected to enroll in Medicare for many years and is now swarmed with multiple sources of information.

Meeting your clients where they are will help you determine how to begin educating them. You should start by explaining the core basics to your clients and not move on until they know what you told them.

Get To Know Their Needs

Everyone interested in enrolling in Medicare needs it because they want healthcare coverage for their senior years. However, the coverage that your clients will need will be different from one another. In this situation, you must understand what your clients seek in their Medicare plans. If a client wants additional coverage for vision or dental work, then you may suggest the client consider a Medicare Advantage plan. Or if a client wants to be covered in any doctor’s office rather than a network, then he or she may be more interested in the Original Government Medicare (OGM) plan.

Each client will have a different range of needs, so it’s up to you to analyze these needs to determine the best solution for him or her. Everything has advantages and disadvantages, so you must remind your client that there is no “perfect” plan, but one will best fit his or her needs.

Explain The Differences In Medicare Plans

The two most popular Medicare plans are the Original Government Medicare (OGM) and Medicare Advantage plans. Each plan comes with separate benefits that are unavailable on the other plan. For example, a Medicare Advantage plan provides vision, dental, hearing, and wellness care not offered by the OGM plan. Medicare Advantage may also offer counseling for major life conflicts, personal emergency response systems, bathroom safety devices, and more.

OGM, on the other hand, has low monthly premiums and is widely accepted when selecting a healthcare provider. In other words, almost every hospital or doctor’s office will accept OGM as a healthcare service. Additionally, Medigap plans are available to those interested in Medicare Part D but need additional help paying for some of the prescription costs.

Although there are differences within each plan, there are also similarities, and that is what you will want to start with. Within each Medicare plan is Parts A and B. Part A is in-patient hospital insurance, and Part B is out-patient medical insurance. Part A is free for many Americans because they have covered Part A by paying into Social Security throughout their working history. Still, everyone is expected to pay for Part B premiums. The amount that clients owe varies on their income. Additionally, Part D is for prescription drug coverage and, therefore, optional in any Medicare plan, whether Medicare Advantage or OGM.

You will also want to explain where it gets tricky, and while you are explaining this, make sure to break it into chunks as you see fit. Part C is the Medicare Advantage plan that is not part of the OGM plan. This is your opportunity to explain the difference between the two plans and their advantages and disadvantages.

Explain Important Enrollment Dates

There are a few enrollment dates that apply to your clients. The first, and one of the most important, is the initial enrollment period (IEP). A client’s IEP will last for six months and begin three months before he or she turns 65, remaining open until three months after his or her 65th birthday. This means that each client’s IEP will be different. It’s important to emphasize to your clients that they must enroll during this timeframe.

GEP

If clients miss their IEP, explain to them that there are a few enrollment periods that they can use, like a General Enrollment Period (GEP), a Special Enrollment Period (SEP), or the annual enrollment period (AEP). However, if this is the case, then your clients must expect to see a 10% penalty fee that will be upheld for each entire 12-month period that they have put off enrolling in Part B. Explaining this to your clients will let them know that they do not have much time to spare and need to enroll.

According to Medicare.gov, if your client’s IEP ends, he or she can enroll during the GEP every year between January 1 and March 31. In this instance, you may have to pay a higher premium for late enrollment in Part A and a higher premium for late enrollment in Part B. Your client must also wait for coverage to begin until July 1.

SEP

There is also a chance your client can enroll during SEP if he or she has special circumstances, like being enrolled in a group health plan or still working, as well as his/her spouse. The month after your client’s employment ends, or the month after the group health insurance ends, begins an eight-month period in which your client can sign up for Medicare Parts A and B. In this instance, you should not be penalized.

AEP

AEP is another option for your clients who miss their IEP. However, it is also available to those wanting to switch their Medicare plan. Each year, AEP begins on October 15 and lasts until December 7. Whenever a client enrolls in a plan or switches to a new one, his or her coverage will not begin until January 1.

Help Them Apply

The best thing you can do for your clients is help them apply for Medicare. This will help ease any typical jitters or concerns that they may be experiencing. After all, they don’t want to mess up and accidentally select the wrong plan. Take this opportunity to build trust with them by being there to help them apply. And, if they are still unsure about their plan, take the time to reiterate that they can change it if they aren’t happy with what they currently have. Explain that the AEP is designed for those looking to switch plans to something more accommodating to their lifestyles.

Social Security

In many cases, your client may be automatically enrolled if he or she received Social Security Benefits or Railroad Retirement Benefits (RRB) for at least four months before his/her 65th birthday. If your client is disabled, he or she may still be automatically enrolled if he/she has been receiving “disability benefits from Social Security for at least 24 months or certain disability benefits from the RRB for 24 months,” according to Medicare.gov. If your client must manually enroll, there are three ways in which he or she can do so. However, in this case, your client must go through the Social Security Administration (SSA) to begin applying for Medicare.

He or she can apply for Medicare by:

  1. Going online by visiting the SSA.
  2. Calling the SSA’s toll-free number at 1-800-772-1213 (TTY 1-800-325-0778).
  3. Applying in person through his or her local Social Security office.

Remind your clients that they must prove they are eligible for Medicare, no matter how they apply. The proof typically lies within documents that verify their age, citizenship, work history, and, if applicable, military service history. Your clients should also expect to have certain information with them, like their Social Security number. What each person is expected to have will vary by his or her history, so make sure to go over other things your clients may need with each of them. The SSA can retrieve any copies that your clients may no longer have.

If your clients have questions about the application process, refer them to the SSA. You can find multiple PDFs that will walk your clients through applying for Medicare.

Open The Floor To Questions

You want to let your client know that you are there to help them understand their Medicare plan because this is something that will, quite literally, directly affect them. As a result, you will want to assure your clients that they can contact you anytime if they have any questions. The best way to get the ball rolling is to open the floor to any questions while meeting with them, whether on the phone, over Zoom, or in person.

If your clients ask questions, be as honest and transparent as possible. Talk to them like you are an enrolling senior, not their agent. This will make them feel more at ease when discussing the subject because they will trust the information you tell them. Remember: you are the expert on this. It isn’t a matter of whether you know the subject but how you can explain it and answer any questions for your client.

If your clients do not have questions, make sure they have your contact information if they come up with any. Typically, some of your clients won’t have any questions because they will likely be exhausted and/or overwhelmed with the information you relay. And that is entirely understandable because, as we’ve stated, Medicare is a complicated subject to explain and even more challenging to understand. This is especially true for those learning about Medicare for the first time.

Summary

Everyone will want to consider Medicare at some point in their lives, including you. That’s why you must speak with your clients about it so that they can learn more about it and ask questions as needed.

You can educate your clients on Medicare by:

  • Meeting Your Clients Where They Are
  • Getting To Know Their Needs
  • Explaining The Differences In Medicare Plans
  • Explaining The Important Enrollment Dates
  • Helping Them Apply 
  • Opening The Floor To Any Questions They May Have

These simple tasks will greatly impact your client’s understanding of Medicare enrollment.

For more tips on helping clients with Medicare, check out the rest of Lead Concept’s blogs.

 

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