Amid the competitive health insurance and group benefits market, brokers must look for innovative strategies to enhance their service offerings. One avenue that brokers don’t often explore is medical care.

The federal health insurance program, intended primarily for individuals 65 and older, provides group benefits brokers an opportunity to expand their market reach and offer comprehensive solutions to a broader demographic, an agency leader said.

“If you’re not considering Medicare, you’re losing clients who age out of Medicare,” said Elizabeth Gavino (pictured), president and owner of Lewin and Gavino Inc., an independent insurance agency based in New Jersey.

As the workforce ages, integrating Medicare into group insurance offerings is an increasingly compelling opportunity for brokers.

Medicare – a “misunderstood” program?

Gavino, who has nearly 20 years of experience in employee and group benefits and health insurance, has successfully leveraged Medicare in her business.

She began researching Medicare after her father, who was then retiring as a tax attorney in New York City, asked for her advice about the program.

“My father said to me, ‘I know I’m not stupid, but I left Social Security more confused than when I entered,’” she said.

Gavino acknowledged that medical care is often misunderstood.

“The biggest misconception is that medical care is free,” she said. This misconception can lead to shock and frustration when new enrollees learn about Part B premiums and additional income-based fees.

“Every time I talk to a 65-year-old business owner, they say, ‘I paid all these taxes. Why am I paying $500 a month for Part B?'” Gavino said.

Some brokers shy away from Medicare because of certification requirements and regulatory complexities, she said. Convincing 65-year-old employees to switch to Medicare also involves rigorous cost comparisons and network considerations.

But while navigating Medicare can be daunting, brokers who position themselves as experts can provide valuable compliance assistance to employers, according to Gavino. Despite the obstacles, you find the medical care profession rewarding, both financially and personally.

“It’s been half my business for the last 20 years. Clients often thank me for making medical care painless and easy because it’s such a complex subject,” she said.

Medicare offers opportunities for group insurance brokers

Medicare is a robust and evolving program with significant benefits for individuals and employers.

Brokers must understand the components of Medicare — Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage) — to make informed decisions. Each part offers unique benefits, and the ability to navigate between them can set brokers apart as experienced advisors.

One of the main benefits of Medicare provision is that it provides a cost-effective solution for employers, especially those in small and medium-sized businesses, to manage healthcare costs while still providing benefits to their employees.

Individuals moving from group health plans to Medicare Advantage or Supplements plans can also benefit from broker guidelines to ensure continuous, comprehensive coverage.

“It may be more cost-effective for the company if employees choose Medicare instead of their employer health plan,” Gavino said. “Medical care is complex, but educating clients makes it manageable.”

For Gavino, education is a critical component in accessing medical care. Her commitment to education has extended beyond her clients to include financial planners and fellow insurance brokers.

Before moving to California at the beginning of the pandemic, she regularly conducted training courses for financial planners through the Financial Planning Association in New York City.

“I do a lot of training to teach financial planners about Medicare so they can better serve their clients,” Gavino said.

“During employee benefits meetings, I explain copayments, deductibles, and planning options to help them understand the financial impact of their decisions.”

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