Bill Pellegrini

Building a Successful Medicare Insurance Portfolio

When it comes to planning and building a Medicare sales portfolio, there isn’t a one-size-fits-all approach.  Instead, the most successful agents have a well-rounded portfolio that has a little bit of everything for their clients.

It’s critical to have a wide range of Medicare products to ensure you’re prepared to meet the range of needs from clients.  Having choices for your clients ensures repeat business and referrals – losing sales because your portfolio is missing a plan can be frustrating.

As an Independent agent selling Medicare insurance, you’ll have various product options to choose from including a range of Medicare Advantage products, Medicare Supplement products, Prescription Drug plans and Ancillary products.  Your portfolio choices will boil down to those plans available in your market that is competitive and serves your customers’ preferences and best interests.

We suggest having a well-rounded portfolio including HMO’s, PPO’s, PDP’s, and Medicare Supplements. Contracting with large national carriers will provide all of those products under one contract in many cases.

There are several things to consider when adding Medicare Advantage plans. You may find similar copays amongst plans with the drivers being, network, formulary, MOOP and the extra benefits.

When comparing Medicare supplements, consider 5-year age bands (65,70,75) to determine how competitive a plan may be and then review the several zip codes in both the rural and metro areas. Also review the underwriting questions, some plans may have more liberal underwriting than others.

Below are the types of plans an Independent Medicare agent can carry in their portfolio:

  • Medicare Advantage (MA) plan: MA plans pay instead of Medicare and include Dual Special Needs Plan (D-SNP) Chronic Condition Special Needs Plan (C-SNP), and Medicare Savings Accounts (MSA).  MA/PD plans may have low to no premiums.  They often offer additional services such as hearing aids, wellness discounts, and dental work.  MA/PD plans are marketed and sold during certain times of the year, or in specific situations or election periods. Emergency coverage outside of the US may be included.
  • Medicare Supplement (Med Supp) plan, including Hospital Indemnity (HI) and Ancillary (Dental, Vision and Hearing): Med Supps pay after Medicare and never include prescription drug coverage. They may work well for heavy domestic travelers as there is no network. Some Med Supps may be a good fit for those who are going to require extensive hospitalization or will be visiting providers multiple times a month.  Med Supps can be marketed and sold all year. Emergency coverage outside of the US may be included.
  • Prescription Drug Plan (PDP):  PDP enrollment is required to avoid the Medicare Part D penalty (unless other credible coverage is active). A beneficiary with either Medicare Part A and/or Part B can enroll.
  • Medicare Savings Account (MSA) plan: MSA plans are a unique type of Medicare Advantage plan and work well for people who are healthy and want the flexibility of no network and a low plan premium. The MSA is well suited for those who enjoy provider flexibility. These unique plans offer the ability to pay for qualified Medical expenses from your MSA account, these services include Dental, and Vision services.
  • Short-Term Medical (STM) plan: STM plans are great for people who are under 65, may need to bridge the gap until Medicare or have recently lost a job and need interim coverage.

If you’re a new agent just getting started, you’ll want to offer the top 3 national plans in your local area.  Also consider adding dental, vision, and Hospital indemnity. This will allow you to meet your clients’ requests for standalone options.

If you’re a more experienced agent, you’ll want to expand your portfolio to offer more plan choices, including a Medicare Savings Plan and Short Term Medical.  A more experienced agent will look at how to mix and match plans such as combining a MAPD Dividend plan with a Hospital Indemnity (HI) plan – the Dividend plans provide extra money every month and this money can be used to fund a HI plan and reduce hospital copays.

There are many plans available for a variety of circumstances and as agents learn the ins-and-outs of the Medicare industry, they will build their portfolio accordingly.   We recommend discussing the best portfolio building strategies with your FMO to determine what plans are the most popular in your market, have the biggest opportunity and will allow you to sell all year to a large and diverse audience.

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