Why Your Clients Really Buy Medicare Advantage

  • Originally published August 3, 2010 , last updated December 30, 2015
Why Your Clients Really Buy Medicare Advantage

Regardless of which side of the political fence you're on about whether Medicare Advantage costs our government too much, it’s time to get off the fence about the value it offers to consumers.

Just look at the most recent enrollment numbers—10.7 million total members enrolled, a 23-percent share of the total Medicare market—and you’ll see that consumers have made up their minds about MA. Furthermore, Deft Research recently released a study showing that if Medicare Advantage members were to switch plans, 61 percent would choose another MA plan compared to just 18 percent who would choose Original Medicare.

So it's clear that consumers have embraced Medicare Advantage—probably to a greater degree than many anticipated. But why? What is the key advantage of MA that you should be talking about with your clients and prospects? Is it ancillary benefits, such as vision, dental or gym memberships? Low or $0 premiums? Maximum out of pocket (MOOP) limits? Part D prescription drug coverage?

This is an important issue to consider right now as Medicare Advantage has come under scrutiny from our new President, some in Congress and many in the media. I recently encountered a consumer advocate at a conference in Washington D.C. who was railing against Medicare Advantage. Most of her attack focused on the ancillary benefits, which she claimed carriers and their agents are using to entice seniors to sign up. So I asked a simple question, "The benefits are nice, but isn't the real benefit of Medicare Advantage the maximum out of pocket limit?"

She grudgingly agreed with me and all but ended her own argument. Vision and dental are good benefits to have, but these should not be the reason that people buy an MA plan. The real value of Medicare Advantage is the ability to put a cap on the beneficiary’s out of pocket medical expenses. Original Medicare does not do this. If the consumer can get a cap on his or her medical expenses for a $0 premium, that’s incredible!

A lot of carrier marketing materials over-emphasize value-added benefits and under-emphasize the value of MOOP limit, so it is your responsibility during the appointment to keep the client focused on the true benefits of Medicare Advantage. Doing otherwise would be tantamount to selling someone a hybrid car and spending most of your time talking about the cup holders.

Staying on message in your Medicare Advantage sales will become even more important in light of the reduced reimbursements to MA plans that are part of the health care reform bill. Consumers will likely feel the effects of these cuts through increased co-pays and premiums and possible reductions in benefits. As an agent who understands the product and talks to clients every day who benefit from it, you will be called upon to make the case for MA more clearly and have solid answers to the questions: Why do we sell this product? Why do seniors want this product?

We like to say at SMS that change is the one constant in Medicare. That has been especially true of Medicare Advantage. That’s why you need to partner with the experts at Senior Market Sales. We’ll keep you current on all the regulatory changes in the market to keep you focused on a selling smart and staying compliant.