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What to Do During the Initial Coverage Election Period

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Medicare enrollment and marketing may be divided into several calendar periods throughout the year (open enrollment, annual election, etc.), but there is a tremendous opportunity year-round for licensed life and health agents who are selling or looking to sell Medicare products to first-time enrollees. This period is called the initial coverage election period (ICEP), and it takes place when a senior is first eligible to sign up for Medicare – beginning the three months before and ending the three months after a senior turns 65. Some companies will even allow an agent to take a Medicare supplement application for someone turning 65 as far as six months in advance of their Medicare effective date.

Every day, more than 6,000 people turn 65 in the U.S. – that’s more than 180,000 people every month. These numbers are expected to grow to more than 10,000 a day and 300,000 a month as the baby boomers continue to age over the next few years.

As you are working with seniors who are turning 65, consider implementing a few of the following tips to make this process as simple and beneficial as possible for both you and the client.

Finding clients
Because the ICEP only applies to those who are turning 65 and enrolling in Medicare for the first time, agents need to find a way to track down and target these prospects.

There are different vendors and lead sources that collect age data, and by either working with those vendors directly or brokering through a BGA, you can locate new beneficiaries. Most vendors allow agents to customize the lists based on criteria such as dates and ZIP codes. Many brokerage agencies will compile the lists for free for producers who are working with them, but vendors usually charge $100 to $125 per thousand names.

Once the prospects are found, you have several options for contacting the potential clients. You can use direct mail (the vendors who offer the names will be able to provide addresses, as well), but any material dealing with Medicare Advantage or Medicare Part D must be approved by CMS. Another approach is to hold a seminar. Although this is a more costly method, it can be an excellent opportunity to meet new beneficiaries face-to-face. Again, keep in mind that any marketing material or seminar invitations dealing with Medicare Advantage or Part D must be CMS-approved before dissemination.

“Medicare & You”
Much of the education for those new to Medicare comes from the latest “Medicare & You” guidebook, offered by the federal government at This resource makes the agent’s job easier because it details the many benefits received from the different parts of Medicare, including private Medicare programs. It also serves as an excellent take-home pamphlet for clients to help them understand Medicare basics from a trusted, reliable source.

The guide greatly simplifies the selling process as it leads you and your prospective client into the solution phase of the interview. If you have asked the right questions and thoroughly explained all available Medicare benefits, you will be setting yourself up as an expert in this area. When this is done properly, the solutions phase can be as simple as laying out two or three options, or possibly guiding clients directly to the best plan for their current situation.

Plan options
Targeting clients who are turning 65 allows agents to educate the senior on their newly acquired Medicare benefits and how any gaps in this coverage can be filled or how they can enroll in the correct Medicare Advantage program.

There are many different Medicare Advantage plan types, including:

  1. Medicare Advantage (MA) alone: This is coverage, not including prescription drug costs, that serves as a replacement for original Medicare and is sold by private health insurance companies.
  2. Medicare Advantage plus prescription drug coverage (MAPD)
  3. Private-fee-for-service (PFFS) plans: In PFFS plans, Medicare pays a set amount of money every month to the private insurance company to provide health care coverage to people with Medicare on a fee-for-service arrangement. Also, the insurance company, rather than the Medicare program, decides how much you pay for the services you get.
  4. Health maintenance organizations (HMO)
  5. Preferred provider organization (PPO)
  6. Special needs plans (SNPs)

In addition to these choices, first-time beneficiaries can also choose original Medicare, Medicare supplement, or one of the myriad specialty Medicare plans such as cost plans or programs of all-inclusive care for the elderly (PACE).

At the time of enrollment, it is up to the agent to discuss every option available and help the client choose the best plan type for their needs.

Jason McClellan is the national director of sales for United Insurance Group Inc. He can be reached at 800-878-1058, ext. 1402 or [email protected].


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