10,000 baby boomers turn 65 every day and become eligible for Medicare. The problem is not signing up for Medicare; it is making choices on Medicare Part A, B, C, and D, and finding the best Medicare insurance supplemental plan.
The easiest way to determine the best medical insurance for your client is to review their lifestyle and needs. Help them to understand what Medicare does and does not cover.
A 65-year old couple who chose retirement in 2020 will spend about $295,000 on medical care throughout their retirement.
This does not include the cost of any long-term care. A private room in a nursing home costs about $105,852.
Your job is to advise your client on what they need, show them their options, and provide them with the best policy for their needs.
Advise Your Client
Make sure your client understands that Medicare does not cover long-term care. Ensure they know that if they do not have a Part D prescription drug policy, their medications are not paid by Medicare.
According to the Health Policy Institute, the average annual amount Medicare beneficiaries pay out-of-pocket is $581 for prescriptions. Because of the expense, 23% of seniors skip doses to make their medication last longer.
Original Medicare Parts A and B do not provide coverage for dental or vision, but Medicare Advantage plans usually do. This means your client needs to budget for those costly needs or purchase insurance to cover those areas.
Medicare Advantage is available through private insurers who are Medicare-approved. They generally provide the same coverage as Original Medicare plus Part D prescription coverage. Some plans also include vision, dental, and hearing in their Advantage plans.
When reviewing your client’s needs, you will want to make sure they have access to medical insurance for all their needs. This may include the need to purchase stand-alone dental insurance needed.
Long Term Care Insurance
While Medicare does not cover long-term care, you may advise your client they can fill the gap by purchasing a long-term care insurance policy. Your client may select a specific number of years the policy covers or purchase lifetime coverage.
Even if your client has private health insurance, it most likely will not cover long-term care. This type of coverage assists with daily activities, such as getting dressed and eating meals. Long-term care policy may cover the cost of adult daycare, home health care, and nursing homes.
Pro Tip: Considering the types of coverage available, next is to look at the company’s history and ratings, pricing, and discounts.
Watch Enrollment Deadlines
The initial enrollment period for Medicare starts three months before age 65 and runs three months after their birthday. If your client does not sign up within that period, their premium will have a surcharge of 10% for every twelve months beyond that period they wait before enrolling.
Make sure your client knows they can not wait and sign up for Medicare later because they are healthy. It will be costly when they do sign up. The only exception is if they are working and their employer’s health care plan meets specific criteria.
- The employer has 20 or more employees
- Employer plan is not a retiree or COBRA plan
- The plan must meet Medicare requirements for prescription drug coverage
If your client is still working and receiving Social Security retirement benefits, that will automatically trigger Medicare when they turn 65. They will be enrolled into Parts A and B, which cover medical and hospitalization.
The Best Medicare Insurance Plans
Now that you have an idea of your client’s needs and understand what Medicare does and does not cover, you can present them with options that fit their needs.
Medicare Advantage plans are sometimes referred to as MA Plans or Part C plans. They are an all-inclusive option rather than original Medicare. These plans include:
- Medicare Part A—hospital coverage
- Medicare Part B—medical insurance
- Medicare Part D—prescription drug coverage, but not all include prescriptions, so check to verify.
These plans generally have low monthly premiums, but the deductibles and copays may be higher than Medicare supplemental plans.
The client must select a provider within the plan network to take advantage of the lower costs. You'll want to help your client look at the benefits that best fit their needs and concerns.
Medicare Supplement Plans
If your client is looking for the best cheap medical insurance, you may want to offer them a Medicare supplement plan, also known as Medigap. These additional health care policies cover the gaps in Medicare coverage.
Pro Tip: This includes coinsurance, copays, and deductibles that are part of original Medicare policies.
If your client has only original Medicare, they may incur numerous deductibles, pay for regular medical coverage out-of-pocket, and find themselves encountering unexpected health care costs. The best supplemental plan for your client is one that fills in the gaps of their existing coverage and provides them with the best benefits.
For example, the deductible is $1,484 for Medicare Part A in 2021. Some supplemental policies do not cover this deductible. That means your client will need to pay the deductible out-of-pocket before their coverage kicks in.
If the client selects Medigap Plan G, that entire deductible will be paid by the supplemental policy. Explain to your client is that the cost of Plan G is more expensive than Medicare Plan A.
New Medicare enrollees cannot purchase Plan C and Plan F, so Medicare Plan G is their best option. This plan covers almost everything except for the Plan B deductible, which in 2021 is $203 per year. Plan G does typically have a higher premium, so you will need to consider that when covering their options with them.
Best Cheap Medicare Supplement
Plan K is the cheapest Medigap policy available. It only provides 50% coverage for Part A hospice, skilled nursing, deductible, and Part B blood and coinsurance.
Pro Tip: If there is any possibility of the client needing skilled nursing, this is a serious consideration as this supplement would only cover 50% of those costs.
The monthly premiums are considerably less costly than other supplement policies. The monthly premium generally falls between $62 to $135.
Medicare Supplement Companies
Medicare supplement policies are standardized.
This means that the benefits of each plan are the same regardless of which company your client obtains coverage from.
While the coverage is identical, the rates change from company to company based on that particular company’s pricing structure for supplement plans.
You need to consider the price of each company’s policies when offering your client options. The provider’s financial strength and their rate increase history must be given serious consideration. Ensure you know which companies offer cheap rates and then increase the cost of premiums as they grow older.
Knowing What Is the Best Medical Insurance for Your Client
Now that you know how to help your clients purchase the best Medicare insurance take your independent sales to the next level. When you partner with T R King Insurance Marketing, you get the training and support you need to become successful as an independent agent.
Knowing how to sell Medicare supplements and Medicare advantage plans is easy when you have access to top-rated contacts, can use online contracting, and can offer clients exclusive agent discounts.
T R King Insurance Marketing has online contracting software for several Medicare supplemental insurance carriers and Medicare Advantage/Prescription Drug Plan carriers. Check out our Medicare insurance carrier index our partners use to make selling the best Medicare insurance policies easy.
Call us now (540) 400-6275 to learn about our training programs for Medicare and other insurance products.