Medicare Blog

why are insurance agents jumping through hoops for medicare policies

by Stevie Graham DVM Published 2 years ago Updated 1 year ago

Do companies pay independent agents/brokers to sell their Medicare plans?

Below is a link to a file containing the amounts that companies pay independent agents/brokers to sell their Medicare drug and health plans. Companies that contract with Medicare to provide health care coverage or prescription drugs typically use agents/brokers to sell their Medicare plans to Medicare beneficiaries.

What is a Medicare broker and how does it work?

Companies that contract with Medicare to provide health care coverage or prescription drugs typically use agents/brokers to sell their Medicare plans to Medicare beneficiaries. Sometimes these agents/brokers are employees of the contracted company.

Why learn Medicare insurance sales and prospecting?

Learn advanced Medicare insurance sales and prospecting techniques, case design, underwriting, audience targeting, and more. Developed to help you build a bigger and more profitable book of Medicare business.

Would you recommend this training to a Medicare agent?

I would definitely recommend this training to any agent in a heartbeat. For agents like myself who have been selling insurance for a few years, but have never worked in the Medicare arena, this is the type of training that is needed! The training content is really good, and really in-depth as well.

Why are Medicare Advantage plans being pushed so hard?

Advantage plans are heavily advertised because of how they are funded. These plans' premiums are low or nonexistent because Medicare pays the carrier whenever someone enrolls. It benefits insurance companies to encourage enrollment in Advantage plans because of the money they receive from Medicare.

Why are there gaps in Medicare coverage?

Most Medicare drug plans have a coverage gap (also called the "donut hole"). This means there's a temporary limit on what the drug plan will cover for drugs. Not everyone will enter the coverage gap. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs.

What are the negatives of a Medicare Advantage plan?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

Are Medicare brokers unbiased?

Working with an independent Medicare insurance agent means you get to choose policy options from different companies. Independent agents and brokers are more likely to give unbiased plan recommendations and advice. But they may not have in-depth knowledge of these plans.

How do I avoid the Medicare Part D donut hole?

If you have limited income and resources, you may want to see if you qualify to receive Medicare's Extra Help/Part D Low-Income Subsidy. People with Extra Help see significant savings on their drug plans and medications at the pharmacy, and do not fall into the donut hole.

What will the donut hole be in 2021?

For 2021, the coverage gap begins when the total amount your plan has paid for your drugs reaches $4,130 (up from $4,020 in 2020). At that point, you're in the doughnut hole, where you'll now receive a 75% discount on both brand-name and generic drugs.

What are the top 3 Medicare Advantage plans?

The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.

Who is the largest Medicare Advantage provider?

AARP/UnitedHealthcareAARP/UnitedHealthcare is the most popular Medicare Advantage provider with many enrollees valuing its combination of good ratings, affordable premiums and add-on benefits. For many people, AARP/UnitedHealthcare Medicare Advantage plans fall into the sweet spot for having good benefits at an affordable price.

Can you switch back to Medicare from Medicare Advantage?

Yes, you can elect to switch to traditional Medicare from your Medicare Advantage plan during the Medicare Open Enrollment period, which runs from October 15 to December 7 each year. Your coverage under traditional Medicare will begin January 1 of the following year.

Where can I get unbiased information about Medicare?

Call 1-800-MEDICARE For questions about your claims or other personal Medicare information, log into (or create) your secure Medicare account, or call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Is United Medicare Advisors a legitimate company?

Yes, United Medicare Advisors is a reputable company offering legitimate services and insurance products. Its licensed agents can provide free, reliable advice as you navigate the confusing world of Medicare supplement insurance so that you can choose the best plans for your needs and budget.

Are boomer benefits free?

We help thousands of people across the nation every month. Our Boomer Benefits Consulting service is entirely free. There is no cost to you for our Medicare help.

What happens to a broker if they don't comply with Medicare?

Agents/brokers are subject to rigorous oversight by their contracted health or drug plans and face the risk of loss of licensure with their State and termination with their contracted health or drug plans if they don't comply with strict rules related to selling to and enrolling Medicare beneficiar ies in Medicare plans.

What is agent broker compensation?

Below is a link to a file containing the amounts that companies pay independent agents/brokers to sell their Medicare drug and health plans. Companies that contract with Medicare to provide health care coverage or prescription drugs typically use agents/brokers to sell their Medicare plans to Medicare beneficiaries.

When do brokers receive initial payment?

Generally, agents/brokers receive an initial payment in the first year of the policy (or when there is an “unlike plan type” enrollment change) and half as much for years two (2) and beyond if the member remains enrolled in the plan or make a “like plan type” enrollment change.

Do brokers have to be licensed in the state they do business in?

Agents/brokers must be licensed in the State in which they do business, annually complete training and pass a test on their knowledge of Medicare and health and prescription drug plans, and follow all Medicare marketing rules.

What is Medicare Training 101?

Medicare Training 101 was created to provide you with all the training, support, guidance, and mentorship you need to take your career to the next level. All for a flat and affordable monthly membership that pays for itself. (Exclusive discounts will save you 3 - 5x more than your first month's membership payment.)

What is MT101 insurance?

MT101 was designed for Medicare focused insurance agents by Medicare insurance agents. Learn advanced Medicare insurance sales and prospecting techniques, case design, underwriting, audience targeting, and more. Developed to help you build a bigger and more profitable book of Medicare business.

Why are there fewer medicaid beds?

The number of Medicaid beds available at facilities is fewer due to low reimbursement and many Medicaid patients are forced to wait on a waiting list for a bed to open.

What is the purpose of medicaid?

While the purpose of Medicaid is to help those who can’t afford health care, many middle to upper-class Americans plan to rely on Medicaid to pay for their long term care needs as well. The program is jointly funded by federal and state governments and run by each state to meet differing needs and policies for eligibility.

Does Medicaid pay back after you die?

Many states have aggressive Medicaid estate recovery programs to get their money back. If the state pays for your long term care and you pass away with a home or property of value, the state may come after your property after you die to be paid back.

What Is a Drug Formulary?

A drug formulary is the list of prescription drugs covered by your plan. It includes both generic and brand name medications.

What Are Drug Tiers?

Medications from the drug formulary are placed on tiers. The lowest tier has the lowest prices, with costs rising along with the tiers.

How Are Drugs Priced on the Tiers?

Prescription drug pricing varies according to the insurer. However, generally speaking, you pay either a co-pay, which is a set dollar amount, or co-insurance, which is a percentage of the drug cost.

Other Prescription Drug Plan Restrictions

In addition to the formulary and tier pricing, your insurer may place other restrictions on coverage. The most common are step therapy and prior authorization.

Why Do PDPs Have These Restrictions?

The goal of drug formularies, tier pricing, and other restrictions is to help lower costs for both you and your insurance company.

What Happens When the Formulary Changes?

Insurance companies add and remove medications from the drug formulary throughout the year, not just during Annual Enrollment. That means that you may suddenly discover a medication you've taken for years is no longer covered.

Saving Money on Your Prescriptions

The easiest way to save money on your prescriptions is to follow your plan's rules. And understanding your PDP's drug formulary, tier pricing, and other restrictions is the first step toward working within those guidelines.

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