Why face-to-face Medicare shopping is a bigger challenge during this year’s AEP

During the 2021 Medicare annual enrollment period, October 15-December 7, U.S. seniors will be asked to choose from over 3,000 Medicare Advantage plans, with the number of plans available ranging from none in certain rural counties to as many as 31 in the most populous areas of the country.

While some of these plans will duplicate their offerings for 2020, others will be making changes in monthly premium, services covered, drug formulary, network of care providers, or other plan characteristics relevant to seniors’ decisions.

“The sheer complexity of this market, coupled with the logistical challenges caused by the COVID-19 pandemic, make Medicare insurance shopping via traditional insurance purchase practices increasingly ineffective,” says Ensurem CEO Dave Rich. “Self-service, online shopping tools—supported, always, by human expertise—offer seniors a much better alternative.”

Dave Rich

Rich, whose company is a growing online multicarrier insurance brokerage, points out that the cost of aging is a matter of growing concern across the country. In all of the focus group discussions in a survey of older women conducted by the Government Accountability Office, for example, women expressed concern about the future of Social Security and Medicare benefits, and the cost of medical care and housing.

According to another recent study, 45% of Americans ages 50 to 64 say they have little or no confidence that they will be able to afford health coverage once they retire. Further, one in 10 say they had thought about going without health insurance altogether; an additional 19% of adults in this age group say they decided to stay in their current jobs rather than change jobs or retire, just to keep their job-related coverage.

A key concern for Americans in all age groups, Rich notes, is the rising cost of prescription drugs. A study released early this year showed that retail prices for 460 prescription drugs would increase by an average of 5.2% in 2020, more than quadruple the current projected rate of inflation for the year. President Trump recently signed a new executive order aimed at reducing prescription drug prices; implementation of the order, however, is expected to be slow and subject to extensive modification. There are also a number of state-level initiatives in the works, but their effect is expected to be limited primarily to Medicaid contracts.

All of which, says Rich, indicates that, at least for Medicare-eligible seniors, the best option for controlling drug expenditures for 2021, as well as out-of-pocket medical expenses, may very well be either a Medicare Part D prescription plan or a Medicare Advantage plan that offers prescription coverage. This is provided, of course, notes Rich, that they have been able to sort through the offerings and find the solution that best fits their needs and circumstances, as well as those of their family.

During the 51-day enrollment period, Medicare beneficiaries can:

  • Switch from Original Medicare to Medicare Advantage (if they are enrolled in both Part A and Part B and live in the Medicare Advantage plan’s service area);
  • Switch from one Medicare Advantage plan to another;
  • Switch from one Medicare Part D prescription plan to another; or
  • Enroll in a Medicare Part D plan if they didn’t enroll when they were first eligible for Medicare.

In addition to these changes, there are certain pending government-mandated changes in Medicare coverage. In May, the Trump administration and the Centers for Medicare and Medicaid Services announced finalized requirements designed to:

  • Increase access to telehealth for services in Medicare Advantage plans;
  • Expand the range of supplemental benefits for beneficiaries with a Medicare Advantage plan who have chronic diseases;
  • Provide support for more Medicare Advantage options for patients living in rural areas; and
  • Expand access to Medicare Advantage for patients with end-stage renal disease.

To help seniors make the most of the choices available to them, Ensurem’s Rich says the Clearwater, Fla.-based company has deployed web-based products that enable online, self-service product shopping and comparison, including the ability to determine whether a customer’s preferred healthcare providers or prescription drugs are covered by a particular plan. Once a customer has made his or her plan/coverage selections, Rich says the company’s brokerage systems are designed to facilitate and simplify as much as possible the process of final policy issuance.

In the meantime, seniors who prefer to have human guidance through what could be a confusing process have the ability to speak with a broker. Due to the what Rich says is an “enormous increase” in volume of calls, over the course of this year the company has doubled its workforce of licensed brokers.

“We believe,” says Rich, “that our business structure—digital products that enable online product shopping and comparison, backed by instantly available staff who can provide any further needed information and efficiently execute the necessary paperwork—is the wave of the future, not just for the Medicare policy market but for the entire insurance industry.”