Your goal as an independent insurance agent is to sell as many plans as you can, and you will likely get the best results if you focus on selling MAPD plans.  As a quick refresher, MAPD plans are MA (Medicare Advantage) plans that include the Medicare Part D coverage for prescription drugs. These plans provide more benefits for your clients and help protect them in case of unexpected costs for medications and additional services, such as hearing or vision, to a greater degree than other Medicare plans do.


Why Sell MAPD Plans

Discover just some of the reasons that a MAPD plan is likely to be the best option for your clients.


Comprehensive Coverage

The main benefit of MAPD plans for you as an insurance agent and for your clients is that they offer comprehensive coverage. They build on Medicare Advantage or Medicare Part C plans, which already add extra services to original Medicare (Medicare Parts A and B). MA plans can include extra services such as fitness plans, hospital coverage, medical coverage, hearing aids, vision care, and dental care. In addition to all these benefits, MAPD plans offer prescription drug coverage.

Essentially, MAPD plans give your clients peace of mind as they know that nearly every aspect of their health care will be covered by insurance.


You Cannot Always Add Medicare Part D to MA Plans

It is crucial to keep in mind that depending on the Medicare Advantage plan, it may not be possible to add a PDP (prescription drug plan) as a standalone after the fact. In other words, if your clients do not start with a plan that includes coverage for prescription drugs, they may not be able to get one in the future. This would leave them on the hook for all drug costs out-of-pocket, and they would likely be dissatisfied with your lack of warning about this possibility.

The best way to avoid this? The only way to ensure coverage for prescriptions is to start with a plan that includes it, such as an MAPD. As a bonus, it helps you with client satisfaction, as they get the coverage they need.


Available from All Major Insurance Providers

Because almost everyone over a certain age is on Medicare, most insurance companies go out of their way to offer a selection of MA plans, including MAPD ones. For example, Blue Cross and Blue Shield, United Healthcare, Humana, Cigna, and Aetna all offer MAPD plans.

This helps both you and your clients. Your clients benefit from having more options available, making it easier to find one that fits their needs.

You benefit from the ability to sell insurance from most companies while offering MAPD plans. In other words, you do not need to extend your specialization to include another insurance company since those you sell likely already offer it. You will also have more options to offer your clients, and some of those may come with better commissions than others, despite all meeting your clients’ needs. This way, you can increase your commission while still meeting the best interests of your client.


Multiple MAPD Plan Types Available

Yet another advantage of MAPD plans in terms of the range of offerings is that there are multiple plan types commonly available.

Most of them are Health Maintenance Organization (HMO) plans. These restrict your client to their provider network and require referrals for specialists. Preferred Provider Organization (PPO) plans have slightly higher premiums but are less restrictive. Private Fee-for-Service (PFFS) plans do not require your client to choose a primary health network or primary care physician. SNPs (Special Needs Plans) are for those with certain financial situations or medical conditions, such as patients in nursing homes or people with chronic heart conditions.

Like the range of insurance providers, the selection of plan types makes it easier to find a MAPD plan that fits the needs of your client. They get the plan they want, and you get the sale.


Opportunities for Client Savings

Encouraging your clients to enroll in MAPD plans compared to original Medicare (and some MA plans) can also provide opportunities for them to save money. Just switching to MA plans instead of original Medicare provides savings on medical equipment and laboratory services. These plans also have varying price structures, including some services with no costs or maximum out-of-pocket expenses.

Your clients will be encouraged by these savings opportunities, increasing the chances that you will make a sale.


Enrollment Is Offered at Multiple Points

When you sell MAPD plans, you will not find yourself limited in terms of clients as you can either sell the plans to new Medicare patients or those who are already enrolled. The only caveat is that each type of enrollment occurs at a different time of the year. While this is inconvenient for your clients, it does let you focus on specific types of plans, and that focus may improve your efficiency.

Open enrollment is between Jan. 1 and March 31. During this time, you can switch clients between MAPD plans or from a MA plan to a MAPD plan. From April 1 to June 30, you can switch clients to a MAPD (or another MA) plan from Medicare Part B. From Oct. 15 to Dec. 7, you can change the coverage of clients, including signing them up for a new MAPD plan, whether they were on a different MAPD plan before or had original Medicare.


The Impact of MAPD Plans

Before you begin selling MAPD plans, you should be fully aware of their pros and cons although we already touched on some of the pros.


The most obvious pro of a MAPD plan is that it includes Medicare Part D, which provides prescription drug coverage. This way, your clients do not have to worry about having multiple plans to get prescription coverage or paying for medicines out of pocket.

Additionally, MAPD plans tend to cover a larger list of services compared to original Medicare.

Some people are even eligible for discounts or reduced pricing depending on their income levels. This allows you to find a plan for more clients, regardless of their financial situation.


Depending on the area, there may be limited options for MAPD plans, somewhat restricting the ability to find a suitable plan. Most plans go state by state, so you will have to be familiar with which plans are available to your clients. This contrasts with original Medicare plans, which are available across the country.

In some cases, MAPD plans come with higher drug costs than those associated with separate Medicare Part D plans. MAPD plans can have higher premiums compared to original Medicare. 

For most insurance agents and most people on Medicare, the pros of MAPD plans far outweigh the cons. Even with the potentially limited options, the fact that most major insurers offer MAPD plans and that there are several types should make it easy for you to find one that fits your clients’ needs. Additionally, the higher premiums for MAPD plans over original Medicare make sense and save money in the long run, as the MAPD plans provide a much higher level of coverage.  


The Takeaway

When you sell Medicare Advantage plans, focus on MAPD plans. They add prescription coverage, something that cannot always be added to other MA plans, and there are plans to fit every client’s needs.

Bryan Oram
Bryan Oram AVP of Healthcare Enterprise Sales

Bryan Oram is a Healthcare professional at Podium, the leading messaging platform that connects healthcare businesses with their patients.

Adapt the way you do business. Press send.