Agents selling Medicare Advantage and Prescription Drug plans put in the work to pair clients with the plans that are best suited for them. Not only does that effort benefit the agent’s business, but it also helps Medicare beneficiaries access the care they need and save money.
Sometimes plan members are dissatisfied with their Medicare plans and voluntarily disenroll within the first three calendar months after their initial enrollment effective date. When this happens, it’s called a rapid disenrollment. The top reasons for rapid disenrollment include inaccurate provider network information, inaccurate benefit or coverage information, incorrect drug formulary information, unsuitable plan enrollment, and inaccurate plan description.
As an agent, there are some steps you can take to help make sure that your client has found the right plan. Read on for a few tips to reduce rapid disenrollment rates.
How to Reduce Rapid Disenrollment
Check that all of your client’s providers, both from primary care and specialties, are participating in the plan. Make sure you confirm whether they will be in-network or out-of-network and how that status will impact the coverage and costs your client will be charged.
Provide all the plan information regarding benefits and coverages, explaining each aspect thoroughly. It can help if you start with the Summary of Benefits and go through this page by page, making sure to cover coverage limitations and rules, including copayments, coinsurance, the plan’s provider network, and the coverage gap and Part D penalty for prescription drug plans.
For Medicare Advantage Prescription Drug and Part D Prescription Drug plans, verify the medication coverage for your client. Check that your client’s prescriptions will be covered under the plan and make sure your client understands the costs that will be associated with their coverage. If they are dual eligible for Medicaid or have a Low Income Subsidy, let them know that the state will determine their cost sharing amounts. Dual Special Needs Plan clients make up a bigger proportion of rapid disenrollments, so you may need to take extra care with this group.
Choose the plan with the best options for your client, and make sure that this is the plan that coordinates with the enrollment application. At the time of enrollment, review next steps and encourage the client to contact you with questions. You can encourage the client to attend member events to boost their engagement, and you should send clients a Thank You!
Know that even if you follow all of these tips, your client may still experience a difficulty with their new plan and decide to voluntarily disenroll. By supporting your clients as best you can during the enrollment process, you’ve done your part and can be there to help them when they next need to compare plans.
