Medicare Sales Success in 2024: The Health Insurance Agent's Playbook

Medicare vs. Medicare Advantage

Medicare

Original Medicare is a federal health insurance program that is accessible to those who are 65 years of age or older and Social Security Disability recipients. At certain times of the year, those seeking health insurance can sign up for Medicare and choose the coverage they want.

With Original Medicare, recipients meet their deductible, and then Medicare pays the allowable amount, leaving recipients with a coinsurance payment.

Original Medicare includes:

Part A (hospital insurance): Typically costs $0 for those who are eligible and have paid their Medicare taxes while working for at least 10 years. Those who don’t qualify for “freemiums” ($0 premiums) may pay $278 to $505 each month, depending on the amount of Medicare taxes the client or their spouses paid while working.

Part B (medical insurance): Depending on income, costs $174.70 or more each month. The cost may change year after year and clients will be required to pay the premium monthly regardless if they’ve used or not used services covered by Part B.

Parts A, B, C, and D Explained

• Part A (hospital insurance) – For inpatient-type services such as in hospitals and skilled nursing care, hospice, home health services
• Part B (medical insurance) – Medical insurance for outpatient services covers “medically necessary” and preventative healthcare
• Note: Clients must sign up for Part B to enroll in Part A
• Part C (private insurance approved by Medicare, such as Medicare Advantage) – Part C of Medicare is the option for private insurance coverage, offering valuable benefits to enrollees, such as dental, vision, hearing, and prescription plans; some also include wellness benefits.
• Part D – Prescription drug coverage
  
  

Medigap

Additionally, there is Medigap, which, as its name implies, is designed to offer supplemental coverage that fills the gaps in Medicare coverage.

Medigap helps offset deductibles and coinsurance costs. Recipients must qualify for both Part A and Part B to be eligible for C, D, or Medigap.

Medicare Advantage

Medicare Advantage is a private healthcare alternative to the traditional, government-run program. Privately-owned businesses can offer Medicare Advantage (Part C) if they’re in contract with Medicare and other plans, including Part A, Part B, and often Part D.

Medicare Enrollment

While there is an “initial enrollment period” where some people get Medicare automatically, others have to sign up, depending on if they receive retirement or disability benefits from Social Security before age 65.

Otherwise, Medicare has two enrollment periods that are both important to understand:

• January 1 - Mar 31 – During this window, Medicare Advantage participants can update their coverage
• October 15 - December 7 – Medicare beneficiaries can make changes to their plan

AEP vs. OEP: What’s the Difference?

Often, in health insurance, Annual Enrollment Period (AEP) and Open Enrollment Period (OEP) are used interchangeably, but they are not the same, and both have important differences to understand:

• During Medicare AEP (October 15-December 7), Medicare coverage changes are permitted
• During Medicare OEP (January 1 to March 31), Medicare Advantage coverage changes are permitted

There were a lot of new trends insurance agents and brokers had to adapt to in 2023, but 2024 presents even more trends that will impact health insurance.

3 Market Trends Affecting Medicare Sales

1. Growth of Medicare Advantage

Medicare Advantage has continued to grow over the years and enrollments don’t seem to be slowing down anytime soon. In 2023, more than 50% of Medicare beneficiaries with both Part A and Part B have opted for a Medicare Advantage plan.

With this large demographic enrolled in Medicare Advantage, agents must consider selling it as a way to boost sales and provide the plan possible for their clients. Doing so will increase your bottom line, as you will have the opportunity to present more plans for clients and prospects that may not have been considered before.

2. Changes to Annual Prices

In 2024, prices for several Medicare plans will be increased and may continue to increase for years after. In fact, the Centers for Medicare & Medicaid Services (CMS) has announced that Medicare Part A deductible has increased by $32 and is now $1,632 per inpatient hospital stay. Medicare Part B premium has also increased almost $10 per month to $174.70; In addition, individuals with incomes greater than $103,000 will pay $244.60 per month for Part B.

With these changes now in place, your role as an agent selling Medicare plans includes updating your clients and prospects on the updates to their plans as well as providing different plans that may better fit their financial circumstances. Building this trust with your clients will help you cultivate strong relationships, retain and attract more clients, and bolster your position as a trusted advisor for those seeking health insurance.

3. Lack of Understanding of Medicare

As an agent or broker, understanding the ins and outs of Medicare might come naturally. As for clients and prospects, however, they can feel overwhelmed with the frequent changes to insurance plans.

Boosting your sales is not just about finding the right plans for your customers and seeking new opportunities to leverage, but also helping your clients understand the intricacies of health insurance, including what’s going to be best for them and why. Consider taking the time to walk through each aspect of Medicare that pertains to your clients and ensure they feel comfortable with the plans and coverage provided for them.

Top 2024 Medicare Changes

Prescription Drug Coverage

It’s estimated that roughly 300,000 people with Medicare are enrolled in the Part D Extra Help expansion. 

After reaching the catastrophic cap of $8,000 in 2024, beneficiaries will not have to pay any deductible for medications under Medicare Part D, premiums for Part D plans, or low copays for certain prescription drugs.

Due to the Extra Help expansion, the income threshold has increased to 150% of the federal poverty level and $21,870 per individual. Furthermore, in 2025, a $2,000 cap on out-of-pocket expenses per year will be enforced for those who receive medications under Part D or Medicare Advantage plan. 

Behavioral Health Will Be More Accessible

The CMS has announced some crucial Medicare changes for behavioral health in 2024, specifically for mental health practitioners:

“Effective January 1, 2024, married and family therapists and mental health counselors can bill Medicare independently for their services furnished for the diagnosis and treatment of mental illnesses. Medicare Part B pays MFTs and MHCs for these services at 75% of what a clinical psychologist is paid under the Medicare Physician Fee Schedule.”

Given the changes that have already occurred in 2024, insurance salespeople can expect to earn higher commissions on Medicare Advantage plans and Prescription Drug Plans, according to the CMS. In fact, the maximum commission for a Medicare Advantage sale in 2024 for certain states will be $762, which is nearly a 5% increase from last year.

With the right approach, your business can make a lot of money by creating and improving your Medicare sales strategies. If you are trying to figure out how to increase Medicare sales, you’ve come to the right place.

Your goal is to maximize your Medicare sales while selling as many Medicare Advantage plans, Medicare Supplement plans (Medigap), and Medicare Prescription Drug Plans as you can along the way.

Let’s take a look at some best practices to help you achieve that goal. 

1. Become a Medicare Expert

For many Americans, Medicare can be quite a puzzle; it’s a complex health insurance instrument confusing both clients and insurance agents alike. This is especially true for those who have just aged into Medicare and are entering a completely new type of insurance than they may be accustomed to.

As an insurance agent, your job is to make Medicare and all of its adjacent insurance products as easy to understand as you possibly can. In other words, you need to be a Medicare expert so you have sufficient knowledge to answer any and all questions and eliminate uncertainty and doubt.

As a Medicare expert, your clients will be more comfortable buying Medicare to begin with and be more likely to add additional coverage, such as Medicare Advantage. 

Your knowledge should start with the basics, extend to a thorough understanding of Medicare Parts A, B, C, and D, and continue to grow with annual product changes.

At the same time, you need to ensure that you stay in compliance with the Medicare marketing guidelines. The last thing you want is to find out the hard way that you’ve run afoul of the guidelines and wind up incurring fines or other penalties. The bottom line? The more knowledge you have about the intricacies of Medicare and the better you’re able to understand the various options, the more policies you’re likely to sell. 

The best way to stay in the loop and deepen your knowledge is by relying on the governing body for Medicare – CMS – and the consumer-facing Medicare.gov website. These resources are current and accurate, which is not always the case for websites that are not official.

In the case of CMS, you can even subscribe to your choice of dozens of topics, such as updated Medicare fact sheets, tools, information, regulations guidance, and much more.

What You Can Do (Action Items)

1. Bookmark the CMS website and sign up for free CMS email updates. 
2. Bookmark Medicare.gov.
   
   

2. Leverage Technology Designed for Insurance Sales

Gone are the days of requiring you to manually perform all of your operations.

It comes as no surprise that the leading insurance agencies are increasingly investing in modern tools designed to drive operational efficiencies and increase productivity. Customer relationship management (CRM) platforms are used to organize client-specific information. With a robust CRM in place, Medicare insurance agents can easily keep tabs on all of their clients, organizing details such as birthdays, family member names, pet names, where clients went on their last vacation, and more in one place. 

Once that information is stored in the CRM, automation tools can streamline and personalize processes for tasks such as sending happy birthday and holiday messages, notifying clients when they’re aging into Medicare, or letting them know when they can make changes to Medicare. This includes adding Medicare Advantage, Prescription Drug Coverage, Medicare Supplements, or Medigap coverage.

With the right solution, you can also streamline the quoting and enrollment process with a client-driven shopping cart add-on for your website, providing 24/7 access to health plan comparisons and enrollment. 

These kinds of digital tools are not only time-savers, but they also allow agents and brokers to spend more time focusing on the tasks that matter – getting to know clients and helping them find at a price they can afford. 

What You Can Do (Action Items)

1. Perform a technology gap audit to determine daily tasks that you have been manually performing and if inefficient technology is the culprit.
2. Prioritize tasks to determine what specific technology solutions will improve your operations the most.

3. Become a Trusted Advisor

As a broker or agent, you always want to position yourself as a trusted advisor instead of being a salesperson. You don’t become a trusted advisor by saying you are one but by proving it to your prospects and clients.

This is even more true when it comes to selling Medicare. Helping clients and prospects navigate the confusing world of Medicare truly lets you shine if you prepare yourself ahead of time.

Because of the many blind spots in Medicare coverage, you’ll need to be proactive – discovering your client’s pain points, anticipating their needs, and responding to their questions and objections. The ultimate goal is to build a strong relationship, which is the foundation of being a trusted advisor. 

For example, a new Medicare beneficiary might not know that dental insurance isn’t typically included in Medicare. By making sure that each client knows what’s covered by Medicare and what isn’t, you may be able to sell a Medicare Advantage policy or ancillary insurance product, such as routine dental coverage or vision care, which isn’t covered by Medicare in most cases, either. 

What You Can Do (Action Items)

1. Become a Medicare expert so you have the knowledge your clients need.
2. Implement a modern solution that collects, stores, and gives you data about your existing clients, so you have access to deep insights and can effectively advise clients.

4. Gain More Medicare Leads

In addition to nurturing your existing clients, you need to fill your sales pipeline. You can’t sell Medicare to people who don’t even know you exist in the first place.

On the flip side, the more people you have in your network and the more leads you have in your pipeline, the more potential sales opportunities you’ll be able to pursue.

One way to drive more Medicare sales is by getting involved in the community and networking with as many people as you can.

You may also want to reach out to facilities in your community – including local senior centers and libraries – to see whether they’d be interested in having you host a free educational session on Medicare (likely delivered via a platform such as Zoom these days). Seniors who attend these sessions may very well decide to buy insurance from you right then and there after they hear what you have to say.

Utilizing Digital Channels

Take advantage of the rise of social networks such as LinkedIn, Facebook, and X to give you another channel to reach prospects. Doing so can lead to benefits such as:

• Improved brand awareness and recognition
• Stronger client relationships
• Boosted lead generation
• Increased traffic you can then funnel to your website for more conversions
• And more

Another digital avenue to consider is purchasing leads. While this can be a bit of a risk, the trick is to choose a trusted source, such as Quotit. Qualified, vetted leads are available for purchase to Quotit customers and delivered directly to your CRM through Quotit's Lead Marketplace. 

What You Can Do (Action Items)

1. Identify a new opportunity to be involved in your community, and then follow through by signing up, attending meetings, and networking.
2. Take your networking efforts online; invest in social media marketing and other digital avenues.
3. Learn more about how to get Medicare leads, including where you can buy them and best practices.

To sell Medicare and associated products, you have a responsibility to adhere to CMS compliance requirements, which means you need to understand them. These regulations are extensive and include policy and technical changes. 

Meeting and Maintaining Medicare Compliance

Preparing Your Business for Medicare Compliance

The first step you should take is to review the most current CMS guidelines for Medicare compliance. The CMS has a tool that can help you learn the entire compliance details, which you can find here.

Consider outlining all of the compliance requirements that pertain to your business and ensuring your entire organization is familiar with your compliance requirements.

Maintaining Compliance

Perform regular compliance reviews and implement any new changes to Medicare compliance to remain compliant each year.

You should conduct regular check-ins and audits to ensure your organization is following all necessary policies and procedures and that compliance risks are avoided. Have a plan for dealing with any compliance issues and a designated place, such as an online form, for your organization to express any compliance concerns.

Marketing is marketing, and many of your marketing strategies can be used for Medicare marketing. 

1. Follow Medicare Marketing Guidelines

Before selling Medicare plans, you must be compliant with Medicare Communications and Marketing Guidelines (MCMG). This includes guidelines such as text message marketing.

For instance, one guideline states that text message marketing is only permissible if you’ve received consent from the enrollee you’re messaging. Additionally, an opt-out process must be included for each message you send to the enrollee.

Ensure your entire business is up-to-date with current Medicare marketing guidelines to avoid legalities.

Related: Maximizing Opportunities: A Guide for Insurance Agents During the Medicare Advantage OEP

2. Nurture Existing Medicare Clients To Become Brand Advocates

Personalized marketing is becoming the standard for marketing, including selling health insurance. By personalizing your outreach to your prospects, such as providing relevant supplemental coverage, addressing their specific needs and concerns, and tailoring your marketing to each client/prospect specifically, you can increase the chances that they grow into loyal clients and refer new clients to you.

Related: Insurance Referral Program: 6 Ways To Create Brand Advocates 

3. Leverage Tools To Manage Existing Clients As They Age Into Medicare

With insurance software designed for Medicare insurance agents, it becomes easier to manage clients who are both over and under 65, track each client and interactions with them, quote and enroll quotes, create plan proposals, store medical information, track relevant policies and coverage, and – ultimately – sell more insurance products.

Related: Manage Clients Who Age Into Medicare Coverage with Medicare Software 

4. Remember To Include Conversations About Medicare Supplements

Medicare supplements, such as Medigap, are additional insurance policies that cover things that Medicare doesn’t, such as copayments, coinsurance, and deductibles. Medicare supplements can boost traditional Medicare coverage and create a more tailored, robust coverage for each client and prospect.

Related: The Essential Guide to Selling Medicare Supplements After AEP 

5. Use Technology-Based Marketing Tools To Streamline Your Marketing Plan

With automated email marketing tools, you can automate many mundane operations. This includes automating follow-up messages with prospects at established intervals, sending holiday greetings, and sending policy renewal reminders. You can also leverage insurance marketing technology to easily tailor each email message to meet the needs of each individual client or prospect.

Related: 11 Insurance Marketing Tools You Need

At any time, you can access Medicare enrollment statistics. The CMS produces monthly enrollment data and presents it in a tool that lets you review statistics going back to 2013. However, you can use the filters in the tool to access data specific to recent months, the state you live in, and other states you sell in.

Any state is a good one to sell Medicare coverage. Most importantly, the best state to sell Medicare in is the state where you live, along with other states where you are currently licensed.

You may also identify other states as a relevant market and get started by getting your license there.

Medicare quoting – with the associated compliance needs – can be challenging and time-consuming. Fortunately, the right Medicare quoting tool can transform your processes, improve your productivity, personalize the client experience, and ultimately increase enrollments.

The best insurance software allows for:

• Multi-carrier quoting
• Compare and contrast
• Professional plan proposals
• A shopping cart that enables clients to add selections and receive recommendations for other products
• Simplified online enrollment
  
  

How To Jumpstart Your Medicare Sales

Selling Medicare insurance requires a depth of knowledge, efficient strategies, and technological support to streamline your processes. Furthermore, you need tools specifically designed for selling insurance to boost your sales, not limit them.

Quotit is a leading software provider that specializes in helping Medicare insurance agents and brokers sell insurance and improve internal operations. Not only does Quotit provide every capability on the list mentioned above, but our software also provides an advanced, end-to-end CRM, side-by-side plan comparisons for both clients and agents, 24/7 automated insurance sales, accelerated enrollment, and much more.

Learn how Quotit can be your partner by requesting a demo with us today.