Rapid disenrollments can be challenging for Medicare agents and clients alike. A rapid disenrollment occurs when a client leaves their Medicare plan shortly after enrolling, typically within the first 90 days. These early exits can signal dissatisfaction, misunderstandings about coverage, or a mismatch between the client's needs and their chosen plan. Preventing rapid disenrollments not only helps maintain clients' coverage but also builds trust and strengthens relationships. Here's a guide to preventing rapid disenrollments.
Help Clients Choose the Right Plan from the Start
Taking the time to understand clients' specific needs is key to helping them select the most appropriate plan. Consider:
Lifestyle and Health Needs: Asking clients questions about their healthcare preferences, current health conditions, preferred providers, and pharmacy needs ensures the plan you recommend aligns with their unique situation.
Financial Considerations: Be clear about out-of-pocket costs, premiums, deductibles, and copayments so clients know what to expect and feel confident they've chosen a plan they can afford.
Future Coverage Needs: Clients may have upcoming health needs that require specific coverage. Addressing these proactively can prevent misunderstandings or disappointments down the line.
Provide Clear and CMS-Compliant Information on Coverage and Costs
CMS compliance requires transparency and accuracy in all Medicare-related communication. Use CMS-compliant materials to explain the plan's benefits and potential limitations. Make sure clients understand:
Coverage Scope: Explain which services are covered and which may require additional out-of-pocket payments.
Provider Networks: Verify that the client's preferred healthcare providers and pharmacies are in-network, as this can be a significant factor in maintaining client satisfaction.
Prescription Coverage: Address specific medication needs and any formulary changes that may impact costs.
This transparency helps set realistic expectations and avoids misunderstandings, which can lead to early disenrollments.
Offer a "Post-Enrollment Check-In"
Once enrollment is complete, follow up with clients to address any remaining questions ad provide support for getting started with their new plan. Post-enrollment check-ins can be as simple as:
Welcome Call or Email: Within the first month of coverage, reach out to ensure clients have received their member materials and help them feel more engaged with their coverage.
Highlight Plan Features: Walk clients through useful plan features, such as telemedicine options, member discounts, or wellness programs, so they can make the most of their benefits.
Encourage Clients to Use Preventive and Wellness Services
Medicare Advantage plans often include preventive care and wellness services that support health and well-being. Make sure clients are aware of these benefits, including:
Annual Wellness Visit: Encourage clients to schedule this free, annual Medicare service, which includes a personalized health plan and helps them feel more engaged with their coverage.
Additional Benefits: Some plans offer wellness programs, fitness memberships, and incentives for health living, which can improve client satisfaction and encourage them to stay with their plan long-term.
Be Available for Questions and Concerns
Clients value agents who provide ongoing support and are available to answer questions after enrollment. Offering support can make clients feel more comfortable reaching out rather than seeking alternative options if they experience concerns. Use CMS-compliant materials to guide any follow-up discussions and answer questions.
Address Satisfaction with Proactive Communication During the Year
Check in periodically, not just at enrollment periods. The proactive touchpoints can include:
Quarterly Email Updates: A brief email summarizing relevant updates, such as new plan benefits or changes to provider networks, can reinforce the value of staying enrolled in the plan.
Survey or Feedback Request: Ask clients about their satisfaction and if they need help understanding benefits. This feedback helps you identify any potential issues early, before they become reasons for disenrollment.
Provide Resources for Navigating Coverage Changes
If clients experience changes that may impact coverage, such as moving to a different are or a change in health needs, offer CMS-compliant resources to guide them through potential plan adjustments. By showing clients if you're there for them during transitions, you can build trust and help them feel confident in their plan.
Keeping clients enrolled and satisfied is about building a strong foundation and supporting clients throughout the year. When clients understand their coverage and feel supported, they're more likely to stay enrolled, making it a win-win for both the client and the agent.