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Understanding Medicare and the Challenges Faced with Medicare Sales


May 26, 2022

64 million Americans are currently enrolled in Medicare.  Every day, more than 10,000 people in the US turn 65 and face a staggering number of choices between traditional Medicare or Medicare Advantage, which are Medicare plans managed by private insurance companies.  In 2022, there are over 3,834 Medicare Advantage plans available across the country.

Medicare Advantage is growing rapidly as these plans offer additional coverage, such as vision and dental, but may also restrict a patient’s choice of providers.  In 2021, over 26 million seniors enrolled in a Medicare Advantage plan, representing 42% of the Medicare population.

With all of these options, and potential limitations, it’s never been more important for senior citizens to be able to make informed choices about the right plan for them.  That means insurance agents and brokers need access and visibility into plan options to help their clients make the best choices.

A Challenge for Insurance Brokers

The very nature of Medicare Advantage (MA), a public and private partnership in a highly-regulated industry, presents significant challenges in plan management and administration.  The government sets the price points for MA products and private insurance carriers create products to meet the market needs.

Insurance brokers market and sell the plans to seniors, but each application is still processed by the government.  Brokers and agents often lack visibility into the application process and don’t know if and when it is accepted or rejected and why.  Information follow-up and reconciliation is extremely labor-intensive and creates huge inefficiencies in the MA market.  Agents are limited in their ability to help seniors find the right plan and brokers have a difficult time forecasting their business and managing sales commissions. 

Applying Existing Technology Solutions to Medicare Advantage

Fortunately, for MA insurance brokers and agents, there is a solution.  For nearly 20 years, Enrollment 123 (E123) has been empowering insurance agents to better meet the needs of their members from enrollment, policy management, billing, membership management, and more.  Enrollment123 streamlines communication and reduces inefficiency for over 250,000 agents and 1.6 million active members.

With this tremendous track record of success in the insurance industry, E123 is expanding into the Medicare Advantage market.  As Brendan McLoughlin, the President of Enrollment 123 explains, “We’re combining an industry leading software platform in individual health insurance with data conductivity to all the places you need to access Medicare advantage data.  That creates a really unique solution where people can track their applications, communicate with their customers to find the right product fit, and even track commission dollars.”  

e123 also has the ability to ingest and standardize data from many sources, including government, insurance carriers, and third-parties.  The data can then be configured so that each E123 client can view and analyze data to meet their business needs.  According to Brendan, “Medicare Advantage is a universally liked product, but it has all kinds of challenges.  Some things are very difficult for agents to do because of a lack of information.  We have invested in putting that information into our platform, so it’s not only accessible, but it also assists insurance agents in helping customers choose the right product, streamlines the enrollment process, and simplifies commission tracking.”