America's Benefit Specialist March 2023

MEDICARE MATTERS

“The commonsense proposals in the Advance Notice, cou pled with the proposals in the MA and Part D rule released in December, ensure these important programs continue to meet the healthcare needs of all beneficiaries while im proving the quality and long-term stability of the Medicare

program,” said CMS Deputy Administrator and Director of the Center for Medicare Meena Seshamani, MD, Ph.D. The Medicare Advantage and Part D payment policies for 2024 will be finalized in the CY 2024 Rate Announcement, which will be published no later than April 3, 2023.

THE IMPORTANCE OF THE AGENT’S ROLE IN MEDICARE (AND MEDICARE PLAN) ENROLLMENT

by Margaret Stedt

• If they are on a small-group plan (less than 20 employees), then they should also enroll into Medicare Parts A and B. They may continue on their group plan if the small-group plan continues to offer coverage to those age 65 and above, or they may leave the plan and enroll in a MAPD or Medicare Supplement Plan and a Stand-Alone Part D Plan. Again, you need to address any coverage issues for a dependent spouse or children. Once clients determine that they do indeed want to enroll into Medicare, you then may proceed to discuss the next steps. It is important to note that enrolling in Medicare has

Agents who assist a client to transition into Medicare have a special responsibility to select the plans that best fit their clients’ individual needs. Agents need to understand the client’s financial and medical concerns and communicate the timing, enrollment requirements and potential penalties regarding the Medicare-enrollment process, which begins by setting realistic expectations for the completion and timing of each step. When meeting with the potential client in person, on the phone or via an online meeting such as Zoom, make sure that you have scheduled enough time to discuss and review both Medicare and the plan information. I usually schedule the initial appointment for an hour and half. Always ask if the prospect needs to have any additional support at the meeting such as a spouse, significant other, son, daughter or other key person. If you will be discussing Medicare Advantage (MAPD) or stand-alone prescription drug plans and benefits, be sure to obtain a signed and dat ed scope of appointment. I start the meeting off asking them about what questions and concerns they have so that I can make sure to address them. You need to help clients determine if they indeed should enroll in Medicare or delay to a later date. Ask what type of coverage they are currently on. Their options depend on their current coverage and their situation at age 65. • If they are working for a company with 20 or more employ ees and intend to continue working, they may continue to be covered under the group plan and waive their Initial open-enrollment period. If they wish to leave the group and go onto Medicare coverage and enroll in a plan, you need to address coverage issues for a dependent spouse or children. • If they are on individual coverage (on or off-exchange) or on COBRA coverage, they should enroll into Medicare as these plans are not deemed creditable coverage by Medicare and later Medicare enrollment could be further delayed and may be subject to penalties (A, B and D). Dis cuss dependent coverage concerns as well.

DON’T FORGET THAT IT IS ALWAYS THE BENEFICIARIES’ FINAL DECISION ON WHAT TYPE OF COVERAGE AND PLAN THEY WANT TO ENROLL IN.

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