Idea: automatic switching medicare advantage

[Yanster]

Hi all, three years ago I founded a company in the Netherlands where users automatically switched energy suppliers every year. Every year the algorithm scanned the market for the best deals and compared these to your current plan. If there is a possible saving the system would automatically switch the user and notify them about the switch.

I was wondering if a system like this could be useful for medicare insurance agents as well. Every AEP the system would scan the market for the best deals and compare these with the current plan. If a saving is possible, the system would send an automated message to the customer informing them about this. If the current plan is the best option the system would send an automated message to the customer they are still on the best plan.

I think this could improve retention + repeat customers for agents. What do you think?

 

[somarco]

Health care and health insurance is (should be) a more complicated decision making process than picking your utility provider.

Also, CMS frowns on using terms like "best" . . .

 

[Yanster]

Thanks for your reply. I understand health insurance is more complicated than utility. What if we would compare on mutiple variables like for example: premium, out of pocket, doctor / medicine coverage. Would this enable us to automate the yearly plan picking for agents more? For example: medicare plans can change every year. What if someone's current medicine is dropped from the current plan. The system would then recommend a different plan and the savings can be huge.

Would a system like this be helpful to agents and customers?

 

[rmhaire]

I think this could improve retention + repeat customers for agents. What do you think?

Won't work. CMS would have to regulate it and they're already too busy screwing every thing else up.

 

[straightnochaser]

Health Insurance is not like purchasing utilities, terrible idea.

 

[sman]

Thanks for your reply. I understand health insurance is more complicated than utility. What if we would compare on mutiple variables like for example: premium, out of pocket, doctor / medicine coverage. Would this enable us to automate the yearly plan picking for agents more? For example: medicare plans can change every year. What if someone's current medicine is dropped from the current plan. The system would then recommend a different plan and the savings can be huge.

Would a system like this be helpful to agents and customers?

It would still require manual input of medications, pharmacy and doctors (to verify if in network). There are systems in place for this already. The only thing not available to an agent would be an automated process after comparing plans. In addition, many times it still requires a conversation with the client. Very few would likely accept an automated change (even if Medicare would allow it which is highly doubtful if initiated by a third party).

I can't tell you how many times I have to go over in great detail why it makes sense for the client to change plans. All they know is the plan works for the current year and have the belief it will continue that way the following year.

In theory, your idea is great. I just don't see how it would be practical. At least not currently.

 

[Yanster]

It would still require manual input of medications, pharmacy and doctors (to verify if in network). There are systems in place for this already. The only thing not available to an agent would be an automated process after comparing plans. In addition, many times it still requires a conversation with the client. Very few would likely accept an automated change (even if Medicare would allow it which is highly doubtful if initiated by a third party).

I can't tell you how many times I have to go over in great detail why it makes sense for the client to change plans. All they know is the plan works for the current year and have the belief it will continue that way the following year.

In theory, your idea is great. I just don't see how it would be practical. At least not currently.

Thanks for your reply, really appreciated. Good point in mentioning that it often still requires a conversation with the client.

Perhaps the switch does not necessarily has to be fully automated. The system could also serve as a tool for the agent to find out which customers might be able to save. The customers who are still on the best plan will get an automated message like: "we have scanned the market and you are still on the best plan" (this could be valuable for the agent since the customer is more likely to stay on the current plan when he/she has the feeling someone is continuously looking after their interests.) The customers who can save will get an automated message like: "we have scanned the market and you can save xxx by switching to xxx" + a call option for more information.

Would a system like this be helpful?

 

[Yanster]

Won't work. CMS would have to regulate it and they're already too busy screwing every thing else up.

Thanks for your input. I will try to contact them about this.

 

[sman]

Thanks for your reply, really appreciated. Good point in mentioning that it often still requires a conversation with the client.

Perhaps the switch does not necessarily has to be fully automated. The system could also serve as a tool for the agent to find out which customers might be able to save. The customers who are still on the best plan will get an automated message like: "we have scanned the market and you are still on the best plan" (this could be valuable for the agent since the customer is more likely to stay on the current plan when he/she has the feeling someone is continuously looking after their interests.) The customers who can save will get an automated message like: "we have scanned the market and you can save xxx by switching to xxx" + a call option for more information.

Would a system like this be helpful?

As has been mentioned, you are not allowed to use terms like "best plan" when discussing Medicare Advantage and Medicare Prescription plans.

I assume you have never dealt with CMS before. Good luck on getting something like this approved in a timely fashion. If you started today, it wouldn't likely be approved (even if you could get it approved) until the 2025 enrollment year.

 

[somarco]

In the US, utilities are regulated at the state level . . . most of Medicare regulation occurs at the federal level. More corruption and bureaucracy to deal with . . .