Why Health Agencies are Pivoting to Medicare

Over the past four years, the insurance industry has undergone major shifts from the Affordable Care Act (ACA). Insurance carriers—like Aetna and UnitedHealth Group—are opting out of the ACA marketplace in a number of states, citing financial losses. Younger demographics—who typically use less healthcare services than older patients—are choosing to risk paying out-of-pocket expenses versus paying for health insurance.

To offset the loss of these revenue streams, agencies are turning toward Medicare to help them meet their financial goals. Here are our insights as to why this shift makes sense:

Commission Stability

In the Obamacare era, major medical insurance plans cost companies millions more dollars than previous years. Expenses came from a natural rise in the cost of medical care, healthy people not participating in the ACA, and new legal mandates for insurers to provide more coverage to more people (e.g., children staying on parents plans longer, people with pre-existing conditions, mandated mental health and maternity benefits, etc.). These factors resulted in compressed commissions for agents.

However, commissions held steady on the Medicare side. New regulations within the ACA had only a minor impact on what was covered under Medicare plans. Medicare compensation is structured so that commissions are more constant, allowing agencies’ revenue to stabilize.

Affordability

One of Obamacare’s major impacts is increased regulation concerning coverage minimums. The rising costs of insurance policies have outpaced many consumers’ ability to pay. As they retire, the over 65 market typically has more disposable income than the younger generations, and therefore are able to purchase plans with monthly premiums. Since the pricing of Medicare is not based on income, almost everyone over age 65 is going to buy health insurance through a Medicare Advantage or supplement plan.

Medicare presents an opportunity for agencies to provide plans to a market that can afford to have the plan and are actively seeking health coverage. To the over 65 generation, the low premiums and obvious need for healthcare make Medicare an attractive product to purchase.

Growth in the Market

Each day, 10,000 people in the United States turn 65. Reports show this steady growth continuing through 2030.1 This means 3.65 million people per year are entering the Medicare market. These projections show a huge opportunity to enter the Medicare market for overall agency development. As agencies move into selling Medicare products, they are engaging a customer for life, opening up opportunities for both new and existing customers. Wealthy, engaged consumers sustain business development over time, helping an agency’s longevity.

Looking Ahead

While the healthcare landscape is ever-changing, current trends show that Medicare is positioned to counterbalance shifts in other types of coverage. For agencies to survive these complex times, selling Medicare is vital to sustain profitability year over year.

Contact us today for a demo on our Medicare support solutions!