Helping your clients avoid Medicare penalties is an important aspect of guiding and educating them. Below are some tips to help your clients enroll on time to avoid paying more.

Part A Penalties
​Most Medicare eligibles receive Part A for free however, if you have  a client who has to buy Part A, and they don't buy it when they're first eligible for Medicare (age 65), their monthly premium may go up by 10%. 

Your clients won't have to pay for Part A at age 65 if:

• They or their spouse has worked at least 40 quarters
• They already get retirement benefits from Social Security or the Railroad Retirement Board or they're eligible to get either of those benefits but just haven't filed for them yet.
• They or their spouse had Medicare-covered government employment.

​If your client has limited income and resources, their state may help pay for Part A.

Part B Penalties
​If your client doesn't sign up for Part B when they're first eligible, their monthly premium may go up 10% for each 12-month period that they could've had Part B. In most cases, they'll have to pay this penalty each time they pay their premiums, for as long as they have Part B. 

There is typically no late enrollment penalty if your client meets certain conditions that allows them to sign up for Part B during a Special Enrollment Period. As with Part A, if your client has limited income and resources, their state may help pay for Part B. 

If your client has other creditable coverage, they can delay Part B and postpone paying the premium. They can sign up later without a penalty, as long as they do it within eight months after their other coverage ends. There are directions on the back of their Medicare card if they want to refuse Part B.
 ​
​Part D Penalties
In order to avoid any Part D penalties make sure your client enrolls in drug coverage when they're first eligible. Even if they don’t take drugs they should consider joining a Part D Plan or a Medicare Advantage Plan that includes drug coverage. If they don't they may pay a late enrollment penalty if (at any time after their Initial Enrollment Period is over) there's a period of 63 days or more when they don't have Medicare drug coverage - or other creditable prescription drug coverage. 

Additionally, make sure they enroll in drug coverage if they lose other creditable coverage (from an employer, union, TriCare, Dept. of Affairs, etc.) that's expected to pay at least as much as Medicare's standard prescription drug coverage. You'll want to advise your clients to keep records showing when they have other creditable drug coverage in order to avoid possible penalties in the future. If your client disagrees with a penalty, they can request a review by completing a 'reconsideration request form'.

Avoiding Medicare penalties doesn't have to be tricky as long as you advise your clients accordingly. Review their specific situation to determine when they should enroll in the different parts of Medicare to avoid any issues.

​If you'd like to review the different enrollment periods, request our Medicare Enrollment Periods guide which goes over the following: 

• Medicare Annual Enrollment Period (AEP) ​
• Initial Enrollment Period (IEP)
• Medicare Advantage Open Enrollment Period (MAOEP) 
• Special Enrollment Period (SEP)
• Medigap Open Enrollment Period (MOEP)

By Carolyn Portanova

The Medicare Advantage Enrollment Period runs from January 1st - March 31st. ​​

If your client is unhappy with their current Medicare Advantage plan, they can make a switch to another Medicare Advantage Plan (with or without drug coverage). They can also dis-enroll from their Medicare Advantage Plan and return to original Medicare. If they choose to do so, they'll be able to join a Medicare Prescription Drug Plan as well (Part D).

​If they enrolled in a Medicare Advantage Plan during their Initial Enrollment Period, they can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without drug coverage) within the first three months they have Medicare.

If your client switches to a different Medicare Advantage Plan or goes back to original Medicare with or without a drug plan, their new coverage will start the first day of the month after their new plan gets the request for coverage. An important detail to remember though, if your client decides to go back to original Medicare, they may not be able to buy a Medicare Supplement policy.

​The best time for your client to get a Medicare Supplement policy is during their six month Medigap Open Enrollment Period. During that time they can purchase any Medicare Supplement policy sold in their state, even if they have health problems. This period starts the first month they have enrolled in Medicare Part B and they're age 65 or older.

There are many details to consider, before jumping off their current coverage. However, there are options if their current plan is not a good fit.

By Carolyn Portanova

The Annual Enrollment Period which occurs every fall is right around the corner. October 15th kicks off the beginning of that window when your clients can make changes to their Medicare Advantage plans. So now is the time to go through our AEP checklist to ensure you're ready for the busiest time of year. Whether you're selling Medicare Advantage products, Prescription Drug Plans, Medicare Supplement products or any combination of the three, being prepared is your best asset. Below we'll go over our AEP checklist as well as review what your clients can do during the Annual Enrollment Period which ends on December 7th.

​1. Change from Original Medicare to a Medicare Advantage plan (or vice versa)
2. Switch from one Medicare Advantage plan to another Medicare Advantage plan
3. Switch from a Medicare Advantage plan that doesn't have drug coverage to one that does offer drug coverage (or vice versa)
​4. Join a Medicare Prescription Drug Plan (PDP)
5. Switch from one Prescription Drug Plan (PDP) to another PDP
6. Drop Medicare Prescription Drug coverage completely

There are many scenarios that can play out during AEP and it's in your best interest to review your clients' policies with them to ensure they have appropriate coverage for the coming year. Many of your clients may want to review their Medicare Supplement plans during this time as well, and it's the perfect time to do so.

1. Contracting
​​If you need to finish any contracting you may have started, complete it and review any carriers you wish to add.​ Carriers have blackout dates where you can no longer move your contract. You can review our carrier black out dates on our AEP page.
​2. AHIP Training
Be sure to complete your AHIP training. Many carriers offer discounts, but you must access the training through the carriers' agent websites to receive that discount.
3. Product Training
​Login to agent sites and complete all product training. You'll get notified by the carrier when you’re eligible to being selling. Watch your Inbox carefully​.
​4. MedicareCENTER
Login to MedicareCENTER and get familiar with all the new tools available. Upload and update your clients in the CRM and review the training and best practices guides.
​5. Electronic Applications
Familiarize yourself with electronic applications now (before the rush). This will make them much easier to complete. You can download carrier e-App training guides from our Electronics App page.​
​6. Order Supplies & Materials
​Order any supplies you may need from your carriers directly, and be sure to request our complimentary*, branded marketing materials to help you promote yourself.

Make sure you're ready to go and have everything you need to make this your most successful AEP yet. We're here to help you succeed and are always available to assist you with your AEP strategy.

*Must be a contracted producer to qualify for our complimentary marketing materials.

By Carolyn Portanova

Every year between October 15th and December 7th Medicare beneficiaries have the opportunity to make changes to their existing policies and change their benefits with regard to Medicare Supplement plans, Medicare Advantage plans and Prescription Drug plans. It can be an overwhelming time for seniors as they sift through all the literature that has been mailed to them, and all the plans they've been researching online.

​Your clients should have received their 'Annual Notice of Change' from their insurance company. This notice will list any changes in their policy, such as possible increase in costs or coverage. The notice should compare the benefits they currently have and what they will be in 2020. Their prescription drug plans should also be reviewed at this time of year to ensure that their medications will still be covered.

​As their insurance agent, you can assist them with making the best decision regarding their policies for the next year or even longer. We've laid out everything your clients can do during this enrollment period below.

1. They can change from original Medicare to a Medicare Advantage plan, or vice versa. (If they switch to original Medicare they'll likely need a Medicare Supplement plan, and unless they happen to be in their Initial Enrollment period, they'll have to answer health questions. Learn more about the Initial Enrollment period and Guaranteed Issue rights.)
2. They can switch from one Medicare Advantage plan to another Medicare Advantage plan.
3. They can switch from a Medicare Advantage plan that doesn't have drug coverage to one that does offer drug coverage, or vice versa.
4. They can join a Medicare Prescription Drug Plan (PDP).
5. They can switch from one Prescription Drug Plan (PDP) to another PDP.
6. They can drop Medicare Prescription Drug coverage completely.

Source: CMS.gov

​There are so many options for your clients, and it can be a daunting process to assist them with their choices, but utilizing our tools and resources will help make the process smoother. Some of these tools include using our rate and underwriting tool which will allow you to cost compare Medicare Supplement and Medicare Advantage plans for them. If you don't have access to our Resource for Rates tool, you can request access and receive a 30 day trial. Our contracted agents always have full access to this tool. It's also available as an app in the App Store and on Google Play. Use your login credentials for the desktop version to access quotes on the go.

Reviewing our new Medicare & Part D Plan Finder guide will help you if you're not AHIP certified and selling prescription drug plans to your clients. It's a step-by-step guide to the newly launched site on Medicare.gov. The new plan finder has a much simpler, and user-friendly interface; however, it does encourage Medicare beneficiaries to create a My Medicare account and to login with their credentials so they can save their prescriptions. It is not necessary to have them create an account if they do not wish to; you'll still be able to assist them with their drug choices.

In some cases, your clients may already have the best plans, and they won't need to do a thing. However, this is your opportunity to review their policies and determine if they'd be better off with another plan. It also provides the opportunity to open up the discussion about other types of insurance they may need.

By Carolyn Portanova

Annual Enrollment Period (AEP) is right around the corner, and you know what that means.  Your clients who are enrolled in a Medicare Advantage plan now have two options:

·        They can enroll in a new Medicare Advantage plan
OR
·        They can return to their original Medicare and purchase a Medicare Supplement plan

We are here to assist you by helping you make the best decision for your clients’ needs.  Whether they enroll in a new Medicare Advantage plan ore re-enroll with their current carrier (and we have a brand, new carrier here in North Carolina, Gateway Health, that is providing Dual Eligible and Special Needs plans) or their needs are best met with a new Medicare Supplement plan (Mutual of Omaha is a carrier that we hold a top 10 contract with, they have outstanding Plan F and G rates and have been offering Medicare Supplements since 1966), we are here to offer our support.

Our Medicare Supplement carriers (Mutual of Omaha, Cigna, Aetna, Medico – to name a few) all have online applications that allow you to enroll your clients quickly, efficiently and anywhere you have access to an internet connection.  The majority of these e-Apps are completed and turned around within three days.  There is no stamp and a much shorter wait time for approval. 

Our Senior Solutions Marketing Managers can offer you guidance with which plans are best for your clients' geographic location, depending upon which state your clients reside in.  They can help you with quotes using our online rate tool, and give you answers to questions you may have about different carriers and the benefits of the plans that are offered.

October 15th is right around the corner.  Now is the time to get in touch with our Marketers, get contracted with us if need be, and get your questions answered.  AEP (October 15th – December 7th) is a busy time of year, as we all know, and we look forward to making it a very productive time of year for you and your practice.


By Carolyn Portanova