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How to Enter the Booming Medicare Insurance Market

There’s probably never been anything like it in the past — or ever will be again.

With the Medicare-eligible population expected to exceed 72 million Americans over the next three decades, the Medicare market promises a golden once-in-a-lifetime opportunity for insurance agents and brokers.

As an insurance agent certified to sell these Medicare Advantage and Medigap policies, you'll be helping America’s seniors make one of the most important decisions regarding their health care. You’ll be guiding them through the often-times confusing maze of Medicare options.

1. Examine Your Market

The Medicare market is booming, but it’s not the same everywhere. In fact, 10 states account for nearly half of America’s senior market.

If you want to maximize your investment in the Medicare market, you need to take the time to identify the right market for you — and remember that you’re not limited to your home state.

Technology allows agents who live on a farm in Wyoming or Alaska to serve health insurance shoppers in Florida and Texas. Some people may prefer a local broker. But with most agents unwilling or unable to afford the cost of home visits, Medicare plans are increasingly being purchased online or over the phone.

So choose the right states you want to target, then get licensed in those states.

Hint: it’s now much easier to get licensed in additional states. Just visit the National Insurance Producer Registry website ( to learn how easy it is.

2. Identify the Insurance Carriers You Want to Represent

Even though many long-time Medicare Advantage and Medigap insurance carriers have backed away from offering these policies as a result of the new regulations, there are still insurance carriers operating in the field.

The way they contract work and the commissions they pay can vary, so it's important to do your research before making any decision on the carriers you want to represent. Depending upon the state in which you live, the leading carriers in the Medicare Advantage and Medigap field include such highly regarded companies as Aetna, Blue Cross Blue Shield, Cigna, Coventry Advantage Rx, Humana, Anthem Blue Cross Blue Shield, and Kaiser Permanente.

Check with insurance agent forums and your agents in your local association of health underwriters (AHU) to get feedback and reviews on the best Medicare Advantage and Medigap carriers in your target states.

3. Get Certified to Sell Medicare Advantage Policies

Your basic health insurance license is not enough to Medicare Advantage (Part C) or Medicare Prescription Drug (Part D) plans.

The Centers for Medicare and Medicaid Services (CMS) requires that all licensed sales representatives, agents and brokers also complete a CMS certification program and receive certification — before they can start marketing those two Medicare products.

If you’re not currently certified with CMS, you can still market Medigap (Medicare Supplement) plans as long as you have a valid health insurance license.

One reason that we recommend you investigate Medicare Advantage carriers in your target states is that some insurance carriers will pay the costs of the certification for its agents.

In order to receive certification, an insurance agent must demonstrate an understanding of important Medicare principles and regulations:

  • Group plan-specific programs
  • CMS rules and regulations
  • Benefits information about Medicare premiums, deductibles and standard Part D coverage

A final exam is required, and agents must receive a minimum score of 85 in order to pass and receive their CMS certification. Applicants may take the final exam up to three times to obtain the minimum score. Because there are frequent changes and amendments to CMS rules and regulations, agents must typically undergo recertification every year.

4. Do Your Homework

Of course, once you've successfully completed the certification process, there's still a lot of work ahead of you.

Successfully selling any insurance instrument requires an in-depth understanding of each product. The same principle holds for Medicare-related plans… perhaps, even more so.

Although all Medicare Advantage plans must provide certain required coverage, insurance carriers do have leeway to adjust or increase certain provisions of their Medicare Advantage plan. Because enrollees are typically locked into their policy for at least a year a time, you need to make sure that they understand the specific Medicare plans they’re buying.

The process of providing your clients with the very best coverage to meet each one's unique needs requires patience, compassion and the ability to answer questions clearly and completely. Many factors go into the final decision, including physician preferences, prescription drug coverage, and financial considerations.

Fortunately, the best insurance companies, such as those listed above, offer comprehensive training and support so that their agents are equipped with first-rate knowledge and support. In addition, it is easy to find companies that can provide Internet and e-mail marketing support and sales lead generation to help you reach a wide market.

5. Prepare Your Marketing

Finally, you need to start looking for your Medicare Advantage and Medigap prospects.

Just like traditional insurance marketing, you need to go out there and bring in the business. Fortunately, agents and brokers have powerful tools at their disposal, which will help them connect with seniors (or their family) who are in the market for Medicare-related insurance coverage:

  • Websites. The fastest-growing U.S. segment on the Internet is the senior market, and this will become even more pronounced as Baby Boomers enter the market. Make sure you have a website that can serve and appeal to Medicare Advantage and Medigap shoppers online.
  • Internet leads. Top lead providers can provide quality leads, filtered for age — which is the key factor for Medicare eligibility. These leads give you permission to call and aren’t considered disallowed cold calling.
  • Lead management system. Because of the sheer size of the Medicare market (and the potential for huge traffic), you need to have a proven lead management system to keep your sales pipeline flowing.

For more information about these powerful (and necessary) tools for marketing to Medicare-eligible seniors, contact your Norvax technology representative to learn about the technology already available to help you become the Medicare Advantage and Medigap top producer you deserve to be.

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