Work smarter, not harder: How agents can inform all Medicare clients of plan changes

By now, everyone in the Medicare industry knows that times are changing. Skyrocketing Medical Loss Ratios and reduced reimbursement from CMS are squeezing Medicare Advantage plans and Medicare Supplements alike. The Part D redesign, which goes into effect next year, forces carriers to share a larger burden of prescription drug costs.

With more obligations to spend, and less cash coming in, carriers have been forced to change their plan designs.

You’ve seen that as more and more plan information becomes available: many Medicare Advantage plans will have a medical deductible. MOOPs are climbing. Drug deductibles are increasing and/or being applied to more tiers. And inpatient hospital copays? Make sure you’re sitting down before you take a peek.

When will my clients see what’s happening?

Hopefully, you’ve been in touch with your clients since April’s final rule came down. You’ve taken a look at the Part D redesign, and prepared them for benefit changes But, all will be spelled out when they receive their Medicare Annual Notice of Change (ANOC).

ANOCs are due to your clients’ mailboxes no later than September 30 each year. Encourage your clients to dive in – there is surely a lot to digest. Invite their questions, too. Just be careful – you can only answer questions about their ANOC before Oct. 1. You cannot allude to the fact that there may be other products or solutions that would help address concerns until the pre-AEP period begins.

Educating many clients at once

You’re going to get a lot of questions. And, you’re going to need to answer them if you want to retain your clients. But, time is money at this point in the year. Here’s how you can maximize it:

• Identify your plans with significant enrollment. To maximize your time, pinpoint where most of your business lies. Get as many of each plan’s enrollees in a room as possible and help them understand the changes ahead – while exploring their options.
  
  
• For each plan, identify an appropriate meeting time and location. Be mindful of time and place restrictions from the Medicare Marketing Guidelines – you can’t have a meeting in a medical treatment space, for example. Consider local libraries, hotel conference rooms, or other meeting facilities.
  
  
• Invite each enrollee, and secure a Scope of Appointment. Because you’ll be talking only to existing clients, you don’t need to register a marketing event. And, there’s no rule saying that appointments have to be on a one-to-one basis --- otherwise, you could never have a spouse join a meeting. But, be mindful of the 48-hour rule. You’ll need to have a Scope in hand from each attendee well before your scheduled meeting time.
  
  
• Break down the ANOC. Some carriers put together off-the-shelf presentations to help you discuss the changes in an individual plan. Others leave you to your own devices. But, because this is not a formal event, you’re free to use the same materials you would compliantly use in any other appointment.
  
  
• If you’re meeting after October 1, discuss possible alternatives. As a reminder, before October 1, you aren’t allowed to discuss any 2025 plan information. But after October 1? It’s all fair game. Recognizing the significant benefit changes, some carriers have pre-packaged recommendations to help clients find the right-fitting plan. That’s helpful if your client is loyal to that carrier. If your client is open to change, other carriers are an option too. Either way, lean on your account managers at Action Benefits to help you find the right fit.
  
  
• If you’re meeting after October 15, collect applications (and SOAs). You are not permitted to collect an application prior to October 15. But, because this is an appointment like any other (just, maybe with a few more attendees), you are allowed to collect applications between October 15 and December 7. And, do yourself a favor by collecting a valid SOA with that application, too. Since SOAs are valid for 12 months, or until they’re used, you won’t need that 48-hour cooling-off period should your client want to chat again soon.
  
  
• If your clients aren’t ready to make a choice, collect SOAs. It’s important to collect an SOA at the end of this meeting for a few reasons. First, this meeting will have used up the SOA you gathered beforehand. Second, having a signed SOA in hand will ensure your clients don’t have to wait 48 hours to talk when they are ready to enroll.
  
  
• Rinse and repeat for your other high-enrollment plans. There’s no way around it: some clients will demand one-on-one time, and you should give it to them. You may have onesy-twosies in other plans, where a meeting like this doesn’t make sense. But if you can even get a few of your clients to show up to one meeting? That’s time saved, and many customers served – freeing you up to drum up new business.

Words of warning

An ANOC meeting is not a marketing event. While it doesn’t need to be reported to carriers and CMS, you also cannot advertise these events. You can’t open them to the public – they’re for your current clients’ eyes only. And, you’re beholden to all the rules you normally would be during an appointment – like stating disclaimers, avoiding superlatives, observing app submission deadlines, and the rest.

Make hay while the sun shines

You’ve only got so much time to meet with existing clients during AEP. And time spent on retention is time you’re not spending on marketing to and enrolling new beneficiaries. ANOC meetings can be a valuable tool in your belt this year, and for every year to come.