How to Help Clients Navigate the 2020 Benefits Tide



Hint: Let your customer be your guide

By Holly Ackman

Now is the time to educate your Medicare clients about the much-anticipated new benefit plans for 2020. News about this is beginning to buzz. Seniors may have seen ads on TV, received some (or a lot of) direct mail, or gotten their Annual Notice of Change from their current health plans. No matter the delivery method, the point is there’s a glut of information during the annual enrollment period (AEP), and seniors are hearing about the array of “new benefits!” made possible by recent Medicare flexibility. This will be exciting news for some of your clients, but may be just as overwhelming for others.

As you know, there are many Medicare Advantage options in California with seemingly similar plan designs. So how can you best prepare to help your new clients find the right plan for their specific healthcare needs? How do you know when your current clients might need to evaluate their existing coverage? Our ultimate goal is for Medicare beneficiaries to find a plan that will provide real value to their health and quality of life. That’s what, ultimately, leads to member satisfaction and retention for both the plan and the broker.

{subhead bold] Know what floats your client’s boat

Most Medicare Advantage members are satisfied with their current health plans, and we know that low out-of-pocket costs, preventive care and prescription drugs are top priorities, but there’s also interest in additional perks—such as gym memberships and allowances to spend on eyeglasses or over-the-counter items.

With the ability to now offer certain non-medical benefits, SCAN and other Medicare Advantage plans are debuting a variety of extras in 2020 that include everything from home-delivered meals to massage therapy to Fitbits. As a result, you will be able to serve your clients on a more personal level than ever before, with plans that provide products and services targeted to your clients’ unique health needs and lifestyle.

{subhead bold] Know what they’ve already got

To help your Medicare clients navigate their options, you’ll first need a clear picture of what they’re looking for. A good way to do this is to ask them how their coverage fits into their life. When a new client comes to your office or you’re making your annual follow-up calls, ask, “What do you like about the plan you have now? Is there anything you wish would be different?” Understanding what matters most to your clients will make it easier to find and recommend the plans that best match their specific needs.

First, though, don’t assume your client knows everything their current plan includes. In SCAN’s service areas, for example, we’ve found something surprising about Medicare Advantage members: Although a majority of seniors belong to plans that offer a variety of supplemental benefits, most of those members don’t know they have them! But perhaps we shouldn’t be that surprised. We don’t typically “market” new benefits to existing members the way we do to prospects. Existing members receive their Annual Notice of Change, with format and content dictated by Medicare. It’s far from an exhaustive benefit list and doesn’t always highlight what’s new and notable for the coming year.

That’s where you can help. Your client may find that something they were hoping to get with a new plan is already being offered in their existing coverage.

[subhead bold] Consider today and tomorrow

As you help clients weigh the value of new benefits each year, there are a few important things to consider.

What health changes has your client experienced this year? In a perfect world, seniors would review their available health plan options regularly and adjust as needed if their health status changes. The reality is, many seniors stay with their existing plan merely because it’s easier than trying to compare options or find out how to change coverage. A recent poll by WellCare Health Plans shows just how much seniors dread reviewing their Medicare plan: Nearly a quarter of seniors surveyed said the task is just as unpleasant as getting a colonoscopy or going to the dentist!

Despite their hesitation, even your most anxious clients stand to benefit from a plan evaluation if they’ve experienced a change in their health—perhaps not to change plans, but to at least fully understand what their current plan offers that can address any new health challenges. For example, SCAN was already offering Special Needs Programs (SNPs) for members with certain chronic conditions, but is now able to offer even more services to help members manage their conditions.

Just because it’s new or different doesn’t necessarily mean it’s better. A plan that offers something exciting like a free Fitbit might catch your client’s eye, but is getting a non-medical item that they might be able to buy themselves (or put on their holiday wish list) worth leaving a plan they’re otherwise happy with? Probably not. On the other hand, this could be a nice value-add for someone aging into Medicare. Help your clients keep things in perspective.

A plan is worth more than the length of its benefits list. It can be tempting to judge a health plan solely by how many extra benefits it offers. After all, more is better, right? While options are great and choice is important, what is most critical is delivering on what we’re here to do: provide trustworthy health insurance. People depend on us to cover the care they need with no surprise costs. When you have seniors depending on you, this charge takes on extra meaning (at least, it does for me and my colleagues at SCAN).

So, one of the most important questions to ask this year is: how can you best evaluate new benefits? Your personal experience and that of your clients counts for a lot. Ask yourself, is the plan responsive? Do its representatives resolve issues and follow up in a timely manner? These are important factors to consider. More objectively, also take into account a plan’s 5-Star quality ratings, the stability of its provider network, whether a client’s prescription drugs are included in the plan formulary, and if a client’s doctors are in-network. These things may not be as alluring as a free fitness wearable or regular massages, but recommending a plan that cares for your customer’s needs will bring more value to your client—and your reputation as a trusted advisor.


has almost 30 years of experience in the Medicare Advantage industry. She is currently the vice president of sales operations for SCAN Health Plan, one of the nation’s largest not-for-profit Medicare Advantage plans with more than 200,000 members in Cali­fornia. In addition to Medicare Advantage, SCAN Health Plan also offers special needs plans for those with chronic conditions or who are dually eligible for Medicare and Medi-Cal. For more information visit or, or follow us on twitter @scanhealthplan.