It’s no secret that Medicare Advantage (MA) plans are the fastest growing segment of the Medicare market. MA enrollment increased by 10% since last year – continuing a 14-year growth trend – to reach an estimated 22 million people.
From just 13% of new enrollees in 2004, MA’s market share has grown to more than 34% today and is projected to reach 42% by 2028. As more senior clients vote with their checkbooks – in favor of MA plans – many of the top senior-focused agents are taking steps to add MA plans to the product portfolio.
What are Medicare Advantage plans?
The Center for Medicare and Medicaid Services (CMS) describes MA as an “all-in-one alternative to Original Medicare,” bundling Medicare Part A, Part B, and usually Part D in a single plan.
“Some plans may have lower out-of-pocket costs than Original Medicare,” CMS says, and “some plans offer extra benefits that Original Medicare doesn’t cover - like vision, hearing, or dental.”
Medicare Supplement and Original Medicare:
Only MA Plans:
All the signs are positive for the MA market:
The path to becoming an MA agent is straightforward.
Here are the simple steps for you, the agent, to follow:
To get appointed you will need to have good credit, no late or outstanding bills due. No DUI’s to get appointed with United Health Care or at least 5 years old. Have a clean background, no felony or criminal background.
Start your certification process now. Realistically, agents need to have their contracting and certification for MA plans locked down several weeks in advance of AEP – ideally by mid-August. As always, AEP runs from Oct. 15 through Dec. 7.
Reach out to JSA or GA Marketing Mentor, such as your contact at Shop N Health Insurance Agency who will help you identify which carriers are competitive in your market. Your marketing Mentor will work with you to determine what your portfolio of carriers and products should look like.
Next, obtain a contract. They then send an email to each agent’s inbox that contains a link to where agents can register. Once registered, the agent goes to the producer-contracting section to begin the contracting process. The first contract is slightly more time-intensive than subsequent ones, but even the first one will take only 10-15 minutes to complete.
The first contract process requests several pieces of information (such as addresses, banking information, void checks, etc.) that, once entered, become part of the agent’s profile, and can be used in all subsequent carrier contracts. The agent completes each of the contracts electronically, digitally signs them and submits. Allow seven-10 business days to process your contract. (The timeframe may vary, depending on the carrier.) During this time, the carrier conducts background checks and makes sure all their criteria are satisfied before accepting your submissions.
Assuming all looks good, the carrier then assigns you an agent number and provides instructions on how you can log into the carrier’s site.
Take the AHIP Certification, this is a difficult test. Cost $125.00 Federal exam must pass with a 90%. You only get three chances please call Tamie if you fail the first time.
But before you Begin AHIP testing, spend time re-familiarizing yourself with Medicare overall, as well as with the specifics of MA plans. Ask about our Agent Sales book.
This will take you through the ABCD’s of Medicare, the differences between Med Supp and MA, PDP features, and processes for appeals, grievances, and penalties; it has all the information you need to obtain a basic understanding of Medicare.
Sign up for the AHIP test. Start with United Health Care contracting this will give you a $50 discount for AHIP. The test has five modules on topics including ethics, compliance, fraud, and abuse.
Each module ends with a quiz. After completing the five modules, agents take a 50-question test. All totaled, it approximately 5-6 hours to complete the modules and the test. You’ll need a 90% score to pass, and you’ll need to pass in no more than three attempts. Please if you don’t pass the first-time call Tamie for assistance.
Once you’ve completed and passed the AHIP tests, go to the site of your individual carrier to take its specific training. You’ll need to complete both AHIP and individual Carrier specific certification before you’ll be ready to sell MA plans.
Each major carrier requires agents to take certification tests on their sites – these involve carrier-specific content such as plan information, carrier marketing rules, and instructions on how to submit business and how to market (such as the use of company logos).
California NEW to Medicare MA and MAPD commission is $750 in 2023 and expected to increase commission 6% per year. For policy change $375 in 2022. Medicare Supplement is 20% commission first year and we have Dental PPO at 12%-18%-30% commission.
After initial payment the next year residuals are $31.25 per person per month for MAPD 100 clients =$3125 in residual income per month plus new sales and builds every year.
Other State commissions for MA and MAPD NEW to Medicare $600.00 and policy change $300.
Now, it’s time to compare rates and submit business. Once you’ve contracted with a carrier and passed your tests to become certified, it all becomes real - and it’s time to get out there and sell.
This includes tools such as those available on the My Health Plan on www.arc.jsaonline.com/myhealthplan including:
Is MA Worth the Effort? Absolutely!
Increasingly, clients and prospects are going to want to work with agents who provide complete Medicare solutions, and that means being equipped to offer access to MA plans. Top agents are finding that it is well worth the extra effort to jump into this large and rapidly growing market.
If you are interested in pursuing the Medicare Advantage market, please reach out to one of our GA Marketing Mentors and they will gladly assist with everything you need. We appreciate your time and the opportunity to assist in growing your Medicare business.
Phone: (951) 795-1943