It's January 2nd. Your client, Ms. Smith, is waiting in line at the pharmacy. There's just one problem.
Since she switched plans during Medicare's Open Enrollment Period (or Annual Election Period if you're an old-schooler), her new plan identification card hasn't arrived just yet.
Did it get lost in the mail? Slowed down by letters to Santa? Maybe it's under a fruitcake somewhere...
This kind of situation happens more frequently than both carriers and the postal service would probably like to admit. It can create serious frustration for the consumer. And, they'll likely blame, or at least vent their frustrations at you, the health insurance agent who enrolled them in the plan.
But, there are two simple ways to help your clients access benefits in the short term.
First, if your client is willing and able, they can show a virtual ID card. This is available through their plan's mobile app if the carrier offers it.
But if they're not willing and able, your member can bring these items to the pharmacy or provider's office:
With those three or four items ready, the pharmacy or provider can check enrollment and submit the claim as usual.
If the provider can't verify enrollment, you can help the member submit the claim and request reimbursement directly from the carrier.
You're not out of the woods yet. Even though your client may get the care they need today, you'll want to do everything you can to make sure that the ID card finds its way to your member's inbox.
Here's what to try next:
In this situation, your client could also self-service via a member portal or hotline. But you're already in a hole. Don't keep digging by making this their problem.
Taking these steps will help put an ID card in your client's pocket. They'll be on the way to a better experience with their plan, and by association, you.
There's an opportunity cost that comes with spending time in carrier portals, or in their phone queues. You could be spending that time marketing to new clients, deepening relationships with existing ones, or plotting your next big move (or vacation. We won't judge).
Any Medicare field marketing organization worth its salt will have an agent servicing team ready to help with simple issues like this. The best FMOs, though, will be able to help with complex issues like recovering $18,000 in premium for the estate of a deceased member, navigating carrier hurdles to get oxygen tanks delivered, and scrubbing your applications to help ensure their approval. Go ahead and reach out to any member of our individual team. They'd love to tell you how they're helping agents take care of the people who matter most -- their clients.
If you could use that kind of support in your corner, get appointed today.