Starting out as an insurance agent in the Medicare industry can seem daunting. There are many ins and outs of selling Medicare and quite a list of things you need to decide and do.
In this article, we touch on the hot topic areas for those new to the business. You’re getting the full scoop from contracting to closing sales and everything in between.
Listen to this article:
Consider Joining a Field Marketing Organization
An FMO can be thought of as an agent’s support system. Most offer their partnered agents back-office support and tools and resources to help make running their business easier. It can be a misconception that only agents just starting in the industry will benefit from an FMO partnership, but actually, both new and seasoned agents can reap rewards from an FMO.
Now, not all FMOs are alike and the services and benefits offered by one, may not be offered by others. So, keep in mind when looking for an FMO what you really want to get out of the partnership. If you want to gain contract assistance, marketing dollars, educational industry info, or sales technology then a new-age, industry leading FMO is for you as opposed to a traditional FMO offering more surface level partnerships. Also know that you want to look for an FMO that invests 75 percent of its resources into providing their agents with sales tools and services and 25 percent into recruiting new agents.
Questions are common when making important business decisions like this and it’s likely other agents are raising the same ones. Doing some research and checking out frequently asked questions about working with an FMO before making any decision is always a good idea!
Complete Medicare Insurance Agent Training
As you know, Medicare is a federal program, which means Medicare Advantage (MA) plans are administered by the government. To keep everything on the up and up, there are rules for selling these plans, resulting in required certifications, such as America’s Health Insurance Plans (AHIP) training.
AHIP Training Overview
Annually, insurance agents need to complete the two AHIP training modules, Medicare and Fraud, Waste & Abuse (FWA), and pass the exam with a 90 percent or higher. Most carriers require AHIP to be completed and passed, along with their own specific certifications, in order to sell their MA plans during the Annual Enrollment Period (AEP). AHIP is normally required by insurers as it ensures that agents selling their plans are compliant with the latest Centers for Medicare & Medicaid Services (CMS) guidelines and regulations.
Details on Completing the AHIP Training
The AHIP certification can be accessed on the AHIP website and unfortunately, it is not free. Typically, the AHIP certification test costs $175. Luckily, many carriers offer a discounted rate of $125 if you take the exam through their agent portals. If you’re partnered with an FMO, they should be able to provide you with details on carriers’ specific AHIP training discounts. Ritter posts information like this close to the AEP season on our carrier pages for our agents to reference.
The first part of the AHIP training, the Medicare section covers the basics of eligibility and benefits, along with the different types of Medicare Advantage and Part D prescription drug plans. Teaching compliance with the marketing guidelines and proper enrollment procedure is an important part of this course.
The FWA section covers industry efforts and tools to detect fraud in the Medicare program. The federal government takes fraud very seriously. This training educates you on the human and financial cost of FWA, as well as the proper reporting techniques.
It is essential to mention that you only get three tries to pass the AHIP exam. If you fail to do so, you must purchase AHIP again and start over. Also, many carriers will not accept a passing score exceeding a third attempt, meaning you’ll be benched for the season with that carrier, unable to sell their MA plans. Because of this, don’t assume because you took the training last year that you can go straight to the exam. The Medicare industry is ever-changing, and we can guarantee there is new plan and regulation information each year.
Although it may seem like another hoop to jump through, the AHIP training is in place to benefit you. It is imperative to understand the do’s and don’ts of selling Medicare and if you don’t, you could find yourself in some serious hot water. So, completing AHIP every year will ensure that you are on top of your game and prepared to service your leads and clients at the very best of your ability.
If you have never completed AHIP training before, being a bit stressed about it is understandable. Rest assured that there are self-study AHIP courses available and resources filled with answers to your questions from agents who have been in your shoes!
Create a Well-Rounded Medicare Portfolio
It’s essential that you offer a wide range of Medicare products to ensure you’re prepared to meet the needs of a variety of clients. One plan does not fit all and losing sales because your portfolio is missing a type of coverage option will hurt your wallet and your business.
Which Medicare Products Should I Choose?
A good idea of what a diverse portfolio can look like, depending on your region, of course, features:
- At least two Medicare Advantage (MA) plans and Medicare Supplements
- A minimum of one stand-alone prescription drug plan (PDP)
- At least one hospital indemnity plan (especially if selling MA plans)
- At least one dental, vision and hearing plan (especially if selling Medicare Supplements)
How Do I Choose the Right Medicare Products?
This is an instance when having a partnership with an FMO can be really beneficial. Your FMO can assist you in your product selection by offering insight and resources to make the feat a little easier for you. At Ritter, our Sales Team is always available to answer product questions and provide insight on what could be a good addition to your selling options.
We also offer state and region-specific Smart Sheets that outline a glimpse of competitive carriers in your area along with details about their selling potential. These Smart Sheets are extremely helpful resources because, as we all know, there are tons of carriers and plans to choose from. We boil it down for you and remove the stress of gathering that info.
Complete Medicare Contracts and Certifications
Once you have decided which types of Medicare plans and products you want in your portfolio, you will need to contract with the carriers that offer them and most likely complete their specific certification training in order to sell their plans. Another advantage of partnering with an FMO is receiving their contracting assistance and access to helpful certification info!
Medicare Contracting with Preferred Carriers
Most FMOs offer contracting assistance to help you through the process and make it a little easier. For example, at Ritter, we use prefilled contracting with links that are sent directly to your email. Our licensing representatives will work with you to ensure your contract paperwork is complete the first time you submit it and void of any missing information. Then, we take care of getting your completed contract to the carrier, so processing is as fast as possible.
In addition to assisting with completing contracts, Ritter also helps agents add appointments, process hierarchy and commission level changes, and we answer all your general contracting questions. You can register with Ritter for free and take advantage of our contracting assistance!
Medicare Product Certification
Once your contract has been completed and approved by a carrier, you’re not ready to start selling their Medicare plans just yet. The next step is to certify to be deemed “ready-to-sell” their Medicare Advantage plans, prescription drug plans, and select Medicare Supplements. Certification must then be completed annually. Carriers release their Medicare Advantage product and compliance certifications for the upcoming plan year late June through September of the current plan year.
To aid you in the process, your FMO may offer a resource with carrier information that includes certification specifics. In Ritter’s Certification Center, for example, you’ll find MA and Part D certification info for all of our 80-plus preferred carriers. We also cover helpful info like if certifying for 2021 will allow you to sell 2020 products and who you can contact at a carrier to confirm that you’re certified.
Secure Medicare Leads and Clients
Once you are “ready-to-sell” some Medicare plans, you need people to sell them to. Finding new leads can be tough but things like following-up and creating a website can do the trick. Also, FMOs can make it a bit easier as they can offer lead and marketing programs, prospecting lists, and other lead opportunities!
FMO Lead and Marketing Programs
Co-op or lead opportunities are incentives some FMOs may offer to agents and Ritter, specifically, offers both!
With Ritter co-op, we split costs up to 50 percent with qualifying agents! This benefit allows you to stay in budget while putting out great marketing materials to generate leads.
Our T65 Lead program (not available in PA or TX) permits the sending of up to 250 generic mailers in a service area of your choice. These are sent out monthly on your behalf and at no cost! All leads acquired are available to you at just $12 a lead.
Follow-up to Keep Medicare Leads
In any business, following up with consumers is a good practice because it shows that you care. In the insurance world, following up is not only a good business practice but also a way to stay on prospects’ radar and hopefully snag some referrals.
Following up after an initial meeting is a good idea because we all know life gets busy and things get pushed aside. Your phone call or email is a friendly reminder that you are available to help them whenever they are ready.
Another great time to follow-up is after the close of a sale. You can make sure the client received all the materials they should have, for example their Medicare plan card or coupon booklet, and also ask if they have any questions regarding their new plan and benefits.
Chances are your prospects and clients have friends and family that are ready to age into Medicare. By following up you’re showing that you’re a dedicated insurance agent. This will make your clients and prospects more inclined to trust you with the needs of their friends and loved ones.
Establish a Website to Create Medicare Leads
Websites can serve multiple functions and enable you to reach a wider range of consumers. With 73 percent of U.S. adults aged 65 and older using the internet in 2019, chances are they’re using the internet to find answers about Medicare. By having an online presence, they could be searching for agents, find you, and become a lead! And if you don’t have a website, they could very well find another agent’s site and you’ll miss out. And the best part is, this can happen at any time because your website is available 24/7. So, your website can do the work for you while you’re getting other things accomplished.
Use Efficient Medicare Sales Tools
Having easy-to-use and reliable sales tools at your disposal is a must. For quoting, enrollment, and client management, you want technology you can trust and use consistently to take Medicare sales from start to finish. FMO partnerships come into play again for this need since many offer their own tools and tech for their agents to use. Of course, Ritter is no exception! Between Medicareful and our Ritter Platform, we’ve got it all covered. These resources are exclusive to our partnered agents and you can gain access to them by completing a free registration with Ritter.
What is Medicareful?
Medicareful is a CMS-approved tool that has many different functions and perks for your business. With Medicareful you’ll be able to easily generate plan comparisons, run prescription quotes for your clients, collect both Scopes of Appointment and applications, and market yourself in unique and powerful ways. Additionally, you’ll have access to a powerful CRM that allows both you and your clients to keep their records up to date. And the best part – Medicareful is completely free.
Remote Medicare Sales Capabilities with Medicareful
You can certainly use Medicareful when you’re sitting next to a client, but sometimes, a face-to-face appointment isn’t possible or recommended. Luckily, Medicareful allows you to obtain permission-to-contact, collect Scope of Appointments, and quote and enroll clients all from the comfort of your own home. Check out our Medicareful Enrollment Process Guide for the exact steps on how to complete an application using Medicareful remotely!
Shared Client Records through Medicareful Accounts
Medicareful has a client account feature. You can send a Medicareful-branded email to a client that invites them to create an account on Medicareful.com. Upon creating an account on Medicareful, clients can begin adding and maintaining their personal info into a consumer record. The info entered into the consumer record is then accessible on the Clients tab of the Ritter Platform – we call this a Shared Client Record. So, not only does the feature create a seamless connection between Medicare and the Platform, it also allows your clients to be more active in their enrollment process.
The info your client can see or add to their shared record includes:
- Previous plan history
- Primary care providers, hospitals, and pharmacies
- Prescription drugs (including dosage and quantity)
- Notes of conditions such as allergies, diseases etc.
- Personal info such as contact information
The Ritter Platform
Our comprehensive agent dashboard aligns the sales process into one fluid operation. With the Platform you can access client records, run tailored quotes and check your daily schedule all in the same location. So, no more jumping to multiple different resources to get your work done.
Since the Ritter Platform is an interface, there are many different components and functions found within it. Below we cover some of the Platforms features and their purposes.
Medicare Quote Engine
This quoting system allows you to quote multiple plans from several carriers simultaneously for faster rate generation. Its easy-to-use platform was developed with three initiatives in mind: efficiency, speed, and intelligence! Most importantly, the data on the quote engine is updated monthly, you can be confident that the information you give your clients is accurate!
The MQE can:
- Quote Medicare Advantage, Medicare Advantage Prescription Drug (MAPD), Medicare Supplement, prescription drug, and final expense plans based on a client’s age, zip code, county, gender, and marital status
- Show the plan’s rating, type, and any costs associated with it, and plan enrollment statistics
- Filter the results based on plan type and carrier
- Compare up to three like products (e.g., MAPD 1, MAPD 2, and MAPD 3) side by side
Drug Cost Estimator
The Drug Cost Estimator is our latest Ritter Platform tool to be integrated with Medicareful. This tool works in conjunction with the Shared Client Records through Medicareful accounts. The information entered into the clients’ Medicareful accounts can be pulled into the Drug Cost Estimator to run tailored estimates for specific clients.
Check out how it works!
The Clients page allows you to maintain your book of business and manage your client relationships. When used together with Tasks and Notes, this lead management tool can help to maximize profit and productivity. Below are some notable features of this tool.
- It allows agents to upload clients’ info, add notes, track products they sold, and create tasks.
- It makes it easy to separate leads from prospects, so agents know who they can reach out to.
- Fields were designed with beneficiaries in mind, so agents can store information they may need for Medicare sales.
Agents can actively add new clients manually, import clients via a spreadsheet, export clients, and merge duplicate client records. From the Clients page, agents will also be able to invite clients to create an account on Medicareful.com, run a quote for a client with a zip code in the record, and more!
Tasks can also work hand-in-hand with Clients to provide a better way to manage your leads. You can create tasks for specific actions to maximize your productivity, to keep you focused, and to increase your profits. For example, you may want to set reminders for specific conversations with leads or set time aside for studying the latest changes to plans.
Agents can add tasks via the Clients page or the Tasks page. You’ll also see a snapshot of open Tasks next to Events on the Overview page of the agent dashboard. From there, you can click View All to go to the Tasks page.
On the Clients page, you can add notes. Simply click on the Sticky Note icon to add a note for a client. Notes can be used to document personal facts or to capture information about interactions. You can make a note for anything you would like to remember for a particular client. A perfect example would be to make a note reminding you of a client’s upcoming enrollment period that you’ll want to take advantage of pursuing.
Understanding Medicare Enrollment Periods
There are various times when a beneficiary can enroll in a Medicare Advantage plan. If you sell health insurance, it’s important you know all the Medicare Advantage enrollment periods and how to help your clients navigate them.
Initial Enrollment Period (IEP)
The Initial Enrollment Period (IEP) isn’t truly a Medicare Advantage enrollment period, but you need to have a good handle on it to understand the Initial Coverage Election Period (which we’ll discuss next). A person enters their IEP the first time they become eligible to enroll in the federal Medicare program, commonly referred to as Original Medicare or Medicare Parts A and B. This period lasts for seven months.
For clients who are aging in to Medicare, the IEP begins three months before the month they turn 65 and ends three months after their birth month. If they miss their IEP, your clients can still get coverage, but they may have to wait. As a result, they may experience coverage gaps for a limited time and/or even have to pay late enrollment penalties.
Example: If your client is aging in to Medicare and their 65th birthday is on April 26, their IEP would begin on January 1 and end on July 31.
If a client is under 65 and has been receiving Social Security or Railroad Retirement Board disability benefits for 24 months, the stipulations differ slightly. Clients who fall into this category will still have an IEP that lasts for a full seven months. It will span three months before the month of their 25th disability check, and three months after the check is received. Your client’s Medicare coverage would start the first day of the month they receive their 25th check.
Example: If your client qualifies for Medicare based on disability and receives their 25th disability check on May 18, their IEP would begin February 1 and end on August 30.
Keep in mind that, while many people are automatically enrolled in Medicare Parts A and B before they turn 65, the IEP is the first time a client can “manually” enroll in it. Clients can also potentially enroll in a stand-alone prescription drug plan and Medicare Supplement plan during this period.
Initial Coverage Election Period (ICEP)
The Initial Coverage Election Period (ICEP) is the first time your client can enroll in a Medicare Advantage (Part C) plan. It’s important to note that, in order for your client to initiate their ICEP, they must have Original Medicare (Medicare Parts A and B). For a client who enrolls in Original Medicare during their IEP, their ICEP can run alongside it. Like an IEP, an ICEP also lasts for seven months.
Your client’s ICEP start date will be delayed if they wait to enroll in Medicare Part B. Since joining an MA plan requires enrollment in Original Medicare, your client’s ICEP will not begin until they are enrolled in Part B. If your client enrolls in Part B at a later date, their ICEP will start three months before the month of their Medicare Part B effective date and end three months after the month their Part B coverage starts.
Example: If your client’s Part B effective date is November 1, their ICEP would begin August 1 and end on February 28 (or February 29 in a leap year).
Annual Enrollment Period (AEP)
Unlike some Medicare enrollment periods that can have different dates depending on your client’s age and needs, the Annual Enrollment Period takes place during the same time every year — from October 15 to December 7. This enrollment period is also known as the Annual Election Period, or just simply AEP.
During the AEP, beneficiaries can enroll in, switch, or disenroll from a Medicare Advantage plan or prescription drug plan. Coverage selected at this time will become effective beginning the following year.
Example: Someone who chooses an MA plan on November 8, 2020, during the AEP would have coverage through this new plan starting on January 1, 2021.
AEP is the most common and popular time of year for clients to enroll in a plan. As a Medicare agent, it’s likely that most of your enrollments will happen during this time, but that doesn’t mean you can’t sell Medicare Advantage plans all year long!
Medicare Advantage Open Enrollment Period (OEP)
In 2019, the Centers for Medicare and Medicaid Services eliminated the Medicare Advantage Disenrollment Period and introduced a brand-new Medicare Advantage OEP. The new Medicare Advantage OEP takes place from January 1 through March 31 annually.
During this period, beneficiaries with a Medicare Advantage plan (including those newly eligible for Medicare Advantage) can switch to a different Medicare Advantage plan or disenroll from their Medicare Advantage plan and return to Original Medicare. They can also pick up a stand-alone Part D plan (if needed) and a Medicare Supplement plan. Please note your clients cannot use the Medicare Advantage Open Enrollment Period to disenroll from a Medical Savings Account plan.
During this period, beneficiaries with a Medicare Advantage plan can switch to a different Medicare Advantage plan or disenroll from their current plan and return to Original Medicare.
Those enrolled in Medicare Advantage plans as of January 1 can participate in Medicare Advantage OEP from January 1 to March 31. New-to-Medicare clients who enrolled in a Medicare Advantage plan during their ICEP can participate in this OEP from the month of their entitlement to Part A and Part B through the last day of the third month of their entitlement.
MSA Plan Enrollment Period
OK, technically, there isn’t an established enrollment period in which clients can enroll in a Medicare Medical Savings Account (MSA) plan. But, we thought it’s still worth discussing your clients’ options for your benefit!
Beneficiaries can join a Medicare MSA plan during their ICEP or the AEP. They cannot enroll in an MSA during any Special Enrollment Period, except if they’d like to join an employer- or union-sponsored MSA during the Employer Group Health Plan Special Enrollment Period. The MSA plan’s effective date of coverage is determined by the period in which an enrollment request is made.
MSA plans provide the same coverage that all Medicare Advantage plans must offer and can provide insurance for some other health needs, such as dental, vision, or long-term care, for an additional cost. You most likely have clients who would find these plans appealing, so it’s a good idea to include them in your portfolio.
Note: Beneficiaries can only disenroll from Medicare MSA plans between November 15 and December 31 or during a Special Enrollment Period if they move, become eligible for Medicaid, or experience a special circumstance.
Special Enrollment Periods (SEPs)
Various qualifying life events can make your clients eligible for a Special Enrollment Period (SEP) during which they can enroll or disenroll in Medicare Advantage plans. Possible qualifying events could include losing their current health coverage, moving, losing income, or becoming institutionalized.
If your client qualifies for an SEP, they must make changes to their coverage within that SEP’s specified time period. Rules about when your client can make changes to their coverage, and the types of changes they can make, are different for each SEP, as SEPs depend on clients’ specific circumstances.
When you’re selling, it’s important to tell your clients about the Medicare Advantage “Trial Period” SEP. Individuals who enroll in a Medicare Advantage plan when they’re first eligible for Medicare Part A at age 65 are entitled to a “trial period” that lasts for 12 months. During this year, beneficiaries have the option to disenroll from their first Medicare Advantage plan and switch to Original Medicare if they so choose. They also have a guaranteed issue right to enroll in a Medicare Supplement plan that lasts 63 days after they disenroll from Medicare Advantage. Beneficiaries who return to Original Medicare during this trial period also get a Part D SEP to enroll in a stand-alone Part D plan if they had a Medicare Advantage Prescription Drug plan.
As a Medicare Advantage sales agent, you’ll likely find clients who also qualify for an SEP in the dual-eligible market, which is comprised of individuals who qualify for both Medicaid and Medicare.
Remember that multiple enrollment periods mean that there are plenty of times throughout the year, outside of AEP, that you can be increasing your sales and helping your clients find a Medicare plan that they can trust!
● ● ●
We hope this resource has made you feel more prepared to embark on the business venture of becoming an insurance agent. Throughout this article, the benefit of partnering with an FMO has certainly been revealed. It is always a good idea to gather as much support as you can, and Ritter is ready to be in your corner. Registering with Ritter is free and easy and comes with a ton of perks to gain!
Editor’s Note: Some of the content in this article was derived from previous Agent Survival Guide pieces, which have been written by various authors.