Ways to Avoid Medicare Disenrollment

Peter Orth
Peter Orth
Published on January 28, 2021

Medicare options for senior citizens

Medicare insurance plans can be confusing. The experts at American Senior Benefits work hard to find the right Medicare plan for our customers. If the customer is not satisfied with the plan selected, the customer has 90 days to disenroll from the plan. This Medicare disenrollment disrupts an agent’s book of business. Here are some tips for avoiding Medicare disenrollment.

Find the Right Fit

According to Medicare’s website, people cite several reasons for disenrolling from their Medicare Advantage plan. The more common reasons include:

⦁ Problems with the care provided in the plan
⦁ Problems with coverage at doctors and hospitals
⦁ Financial reasons
⦁ Problems with prescription drug coverage
⦁ Problems getting help from the plan

These common reasons can be avoided with additional care in selecting the right plan for your client. When a customer disenrolls from Medicare, the underwriting company will seek to recover all the commission paid out on that policy.

If you have too many disenrollments, you may encounter compliance concerns from The Center for Medicare and Medicaid Services (CMS). Taking the extra time to go over all the Medicare Advantage plan details will help prevent disenrollment.

Review the Coverage

Sit down with your client and explain what will and will not be covered under the Medicare Advantage plan he or she has selected. This coverage should include participating providers and facilities and the procedures covered. Be sure to review any prescription plan coverages as well.

If your customer is willing to disclose the information, work together to determine if his or her existing providers will accept the Medicare plan chosen. If your client discloses their current prescriptions, take the extra step to verify if his or her drugs are covered. If your client has needs that will not be met by the Medicare plan, work with your client to find solutions for these needs. Reviewing this coverage with your client will ensure that they are comfortable with the plan and make sure that the plan meets their needs.

Review the Costs

Many Medicare recipients live on fixed budgets. Disability or retirement funds are carefully managed. Keep this in mind when helping your client chooses their Medicare Plan to ensure that the price is manageable. The costs may include the premium, deductible, copay, or coinsurance, and it is essential to disclose all the financial details to your client. The Medicare plan must meet both the medical and the financial needs of your client.

Follow up

The client has 90 days to disenroll from the chose Medicare plan. This means that the sale is not final when your client leaves your office. Schedule a time a week or two after your meeting to check in with your client and make sure all their needs were met.

Often, people will think of questions or concerns after a meeting. A follow-up call is a welcome opportunity to address these additional questions and assure your client of the coverage choices. Take the time to develop a relationship with your client.

Final Thoughts

To learn more about reviewing senior life insurance policies, contact the experts at American Senior Benefits. Our licensed experts will be happy to answer any questions you have.

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