What Seniors Value Most in an MA Plan

It doesn’t matter if you’re selling kitchenware, travel packages, or health insurance. If you don’t know what your market values the most in the products you’re selling, you’re missing out on sales.

Right now, nearly a third of the Medicare-eligible population has a Medicare Advantage plan. By 2026, MA enrollees could make up 41 percent of that same group, according to projections from the Congressional Budget Office.

In the coming years, a big chunk of MA business will be up for grabs. Understanding what seniors value the most in these private plans will be the key to securing your share of it.

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Monthly Premiums vs. Provider Networks

When shopping for an MA plan, seniors often look for a low-cost plan that includes their preferred health care providers. But what if they can’t find such a plan? How do they compromise?

In 2014, The Henry J. Kaiser Family Foundation (KFF) held small focus groups of seniors in four cities to better understand how seniors choose and change their MA plans. They found that some seniors would enroll in a cheaper plan, even if it meant they couldn’t see their usual doctors, while others would rather have a plan allowing them access to certain hospitals or treatment facilities.

Seniors’ feelings about the matter appeared to vary based on their relationships with their doctors. People who have been going to the same providers for years most likely feel assured their providers will respect their privacy and successfully put them back on the road to recovery if needed. When push comes to shove, some seniors will readily pay more for a plan just so they can see their preferred providers and have the peace of mind that comes with knowing their life is in good hands.

Some seniors will readily pay more for a plan just so they can see their preferred providers.

Star Ratings vs. Brand Names

CMS implemented the Star Rating system in 2008 to help beneficiaries assess the quality of Medicare plans and make plan selection easier. However, it seems that Star Ratings may not influence seniors’ decisions as much as one would think.

KFF’s focus groups found that participating seniors didn’t understand the system and that Star Ratings didn’t majorly impact their decision to purchase a plan. Instead, those studied seemed to care more about the plan having a “recognizable name.”

Surprised? Consider this: According to a 2013 study conducted by Nielsen, 60 percent of shoppers around the world with internet access favor purchasing new products from a familiar brand instead of a new brand.

Star Ratings may not majorly impact a senior’s decision to purchase a plan.

Just as they trust their providers, people trust brand names. They may also give more weight to their own experiences than others’ experiences, especially others whom they don’t know. So, if seniors had a good experience with a certain carrier before turning 65, there’s a good chance they’ll be interested in sticking with that insurer after they’ve turned 65, even if the government doesn’t rate its Medicare plan 5 out of 5 stars.

Convenience vs. Practicality

You likely recommend MA plans that meet your clients’ budget, medical needs, travel habits, and preferences. Your clients, on the other hand, may believe certain plans are the best for them based on other reasons. For instance, some seniors in KFF’s focus groups stated they enrolled in a plan to have the same coverage as their spouse.

Would you believe that several seniors involved in the study also reported that they don’t review or switch plans during the Annual Enrollment Period? It’s true. Many would rather get by in their current plan, even if it means switching to different prescription medications.

Convenience plays a large role in Americans’ lives, especially today where one can communicate with others instantaneously, take pictures, and control home appliances with a mere cell phone. Above all else, people value their time. If there’s an easier way to do something, they’ll frequently take it. The same runs true for determining their health insurance plan.

Many seniors would rather get by in their current plan, even if it means switching prescription meds.

Numerous Medicare eligibles report choosing and changing health plans to be a confusing, overwhelming, and frustrating task. Consequently, some seniors will enroll or stay in a plan simply because it’s easier than trying to compare their options and figuring out how to change their coverage.

What This Means for You

As a senior market health insurance agent, it’s vital to look out for your clients’ best interests and take a holistic approach in narrowing down their plan options.

You may encounter clients focused on a brand name carrier or wanting to enroll in a plan because a family member is in it, but you should do your research and weigh all the factors for them. It’s also important you make sure your clients understand the Star Rating system and explain to them why certain plans work better for them than others.

Look out for clients’ best interests and take a holistic approach in narrowing down their plan options.

Everybody has different preferences and needs. Some clients you meet will want access to their usual providers, a free gym membership, and dental, vision, and hearing benefits; others will only want a $0-premium plan without the bells and whistles. By asking your prospects what matters most to them when it comes to their health plan up-front, you can streamline sales. And by making follow-up calls to your clients, you can ensure they’re in the best plan if their needs or preferences have changed.

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Trust is a powerful driving force in the decision-making process. If you find ways of cultivating prospects and clients’ faith in your business, there’s no limit to how much it will grow.

A modified version of this article was previously published in the April 2017 issue of California Broker Magazine.

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