Medicare Enrollment Begins With Holistic Education

The volume of Medicare disenrollments and complaints of inappropriate marketing practices are a black mark on a system tasked with supporting a vital population. While yes, there are a litany of bad actors in the marketplace, there is an issue upstream - the beneficiary's an incomplete or incorrect understanding of the Medicare benefit landscape and how it operates. More importantly, an alarming number of beneficiaries do not understand how this complex system applies to them as an individual.

"...about one-quarter of elderly Americans lack sufficient understanding of the health insurance they rely on for coverage."

I feel like a broken record on repeat saying, "every day 11,000 people become Medicare eligible. We simply throw them in the deep end of the pool and wish them luck."

So, what can an enrollee do to not only understand the lay of the land but also feel confident that they're finding the right coverage for their needs?

• There's good ol' Google which is ripe with a gazillion different sources of information. Textbook level content that will meticulously (as compliance demands!) define the different parts of Medicare, the stringent rules around enrollment and eligibility, the different flavors of carriers/plans and the various methods of enrollments available. Crystal clear.
• Ask a friend - while we may trust our friends or family, they are biased towards their own experiences (which are rooted in their own health needs & financial constraints) and are definitely not trained to understand all the nuances of the system. Medicare selection is not a one size fits all.
• Still working? You'd think that your HR rep would be a great source of advice especially if you now have to also decide whether or not (or even if you can!) stay on your employer sponsored plan. It's most likely that they aren't Medicare trained and given the stringent rules employers must live by, they're not going to give you personalized advice even if they're professionally trained/certified.
• The carrier/broker world. Yes, you can get a rep on the phone who will happily take your information and outline a plan they've selected for you before walking you through an enrollment application over the phone. While there are a ton of great licensed agents out there that will take the time to account for all the meds you take, the doctors you need to see, your financial situation.....you're putting a lot of blind trust into someone who is advising you on a decision that can have a catastrophic effect on your physical and financial well-being. Who cares if they're getting you a Silver Sneakers membership if your hospitalization copays are going to double.

So, let's minimize the risk by beginning with bespoke education that increases understanding of the Medicare system and promotes confidence in plan decision making? Drumroll....... enter Artificial Intelligence and behavioral science.

Even at first blush, employing an AI tool is clearly a better vehicle for retained education in the senior population than static content. By providing a personalized and interactive learning experiences, the beneficiary is going to automatically be more confident in their choice which leads to stickier enrollments & increased brand affinity. Everyone wins!

AI technology can analyze and understand the unique needs and preferences of each individual as well as provide them with tailored educational experience that is relevant to their specific situation. Goodbye to Medicare textbook materials fraught with If/Then statements that are difficult to follow.

"(AI) models and algorithms routinely produce remarkable results, informing decisions that are often far better than a person on their own may be able to muster."

Static content is one-size-fits-all and may not address the specific concerns or questions of the individual. The expectation that a beneficiary (or even the adult child trying to help their parent) can decipher eligibility data, variances in out of pocket by plan and formulary differentials for their own needs demands a personalized experience.

By employing AI-driven Medicare education on the front end of the enrollee experience, we optimize the quality and accessibility of healthcare education for the entire Medicare population, leading to better health outcomes and a more efficient healthcare system.