Individuals can only enroll in Medicare in one state — the state of their principal residence (i.e., where they vote, file taxes, and have a driver’s license).
For health insurance agents, this makes finding the right Medicare plan for retirees who like to travel a complicated matter.
Whether you’re trying to figure out which Medicare plans are best for snowbirds, sunbirds, or travel enthusiasts, here’s what you need to do to ensure you lead clients in the right direction.
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Get to Know Your Clients’ Habits
When you work with individuals who indicate they travel, it’s imperative you learn more about their nomadic lifestyle. How often do they travel and where to? How long are their trips?
Additionally, as with all clients, it’s also important you find out about their health care and insurance preferences and needs. Do they prefer to go to certain hospitals or doctors? Visit their providers frequently? Take prescription drugs?
Getting as much background information on your clients as you can will help you determine the type of benefits they need, and ultimately, the plans that are the best fit.
Weigh Their Options
Upon discovering everything you need to know about your on-the-move clients, consider which product(s) are appropriate for them.
An increasingly popular choice among the Medicare-eligible, Medicare Advantage (MA) plans can offer low copays, $0-premiums, value-added benefits, and prescription drug coverage. The drawback is some can also operate within service areas as small as a zip code and have limited provider networks. While PPOs and HMOs generally offer little to no coverage for out-of-network services, some do offer features allowing members to receive limited in-network coverage in a different state.
Original Medicare ± Medicare Supplements
Original Medicare has benefits more basic than those of MA plans (e.g., it doesn’t offer much dental, vision, or hearing coverage or any prescription drug coverage). Nevertheless, you can sell beneficiaries a Medicare Supplement (Med Supp) policy to help fill in the coverage gaps. Those enrolled in Original Medicare and a Med Supp can go to any Medicare provider in the country. Additionally, some Med Supps even offer coverage for health care services or supplies obtained outside of the country.
Medicare Cost Plans
Though they’re more uncommon, Medicare Cost plans are viable options. Individuals who enroll in Medicare Cost plans keep their Medicare Part A and B coverage. While these plans have networks, members can pay their Part A and/or B coinsurance and deductible to visit out-of-network providers. What’s more, members can also get prescription drug coverage through these plans (if it’s offered) or opt for a stand-alone prescription drug plan (PDP).
Prescription Drug Plans
Depending on the type of Medicare plan your clients choose, they may need to purchase a PDP. These plans vary in the drugs they cover, their costs, and their in-network, preferred, and mail-order pharmacy services. For instance, some PDPs offer a regional pharmacy network and some offer a national pharmacy network.
Advocate & Advise
Finally, after you’ve weighed all their options, research plans and prepare to make recommendations for your wanderlust-driven clients.
Clients who like to take week-long trips a few times throughout the year should be fine enrolling in an MAPD plan. They probably won’t need to see their doctor or fill any prescriptions while they’re away, unless an emergency arises. To stay on the safe side, recommend a PPO or an HMO that offers emergency out-of-network coverage and a PDP with a regional or national network.
Snowbirds & Sunbirds
Those who spend months at a time living at a secondary residence would benefit from the combination of Original Medicare and a Med Supp. Your best bet would be to recommend that, or a Medicare Cost plan, to your migratory clients. For those who are passionate about getting an MA plan, suggest one with a regional or national network or one with a feature, such as a guest membership, that will enable them to receive in-network coverage near their second home. As for prescription drug coverage, the MAPD plan or PDP should feature a regional or national network that will fit their needs.
Recommending Original Medicare, a Med Supp, and a national PDP is the best route you can take when assisting those who travel from state-to-state or adventure abroad. If you have clients who enjoy traveling outside the U.S., suggest Med Supp Plan(s) C, D, F, G, M, or N, which offer foreign travel emergency health care coverage. (Keep in mind the Med Supp changes on the horizon when recommending a plan.)
In a 2009 study, Pew Research Center found 52 percent of people aged 65 or older reported enjoying more time to travel as a benefit of aging. By identifying the proper plans for your roving senior clients, you can help them enjoy their golden years knowing that, if they need health care while they’re away, their Medicare coverage will help to pay.
Need assistance with narrowing down the right plan for a particular client? Ask an expert.