Amid a competitive health insurance and group benefits market, brokers must seek innovative strategies to enhance their service offerings. One avenue that brokers don’t often explore is Medicare.
One agency leader has said the federal health insurance program, which is primarily for individuals aged 65 and older, offers group benefits brokers an opportunity to expand their market reach and offer comprehensive solutions to a broader demographic.
“If you're not considering Medicare, you're losing clients who are aging into Medicare,” said Elizabeth Gavino (pictured), president and owner of Lewin and Gavino Inc., an independent insurance agency based in California.
As the workforce ages, integrating Medicare into group insurance offerings is an increasingly compelling opportunity for brokers.
Gavino, who has nearly 30 years of experience in employee and group benefits and health insurance, has successfully leveraged Medicare into her business.
She started looking into Medicare after her father, who was then retiring as a tax attorney in New York City, sought her advice on the program.
“My father told me, ‘I know I’m not stupid, but I left Social Security more confused than when I went in,’” she said.
Gavino acknowledged that Medicare is often misunderstood.
“The biggest misconception is that Medicare is free,” she said. This misconception can lead to shock and frustration when new enrollees learn about premiums for Part B and additional surcharges based on income.
“Every time I speak with a business owner turning 65, they say, ‘I paid all these taxes. Why am I paying $500 a month for Part B?’” said Gavino.
She said some brokers shy away from Medicare due to certification requirements and regulatory complexities. Convincing employees turning 65 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 offer valuable compliance assistance to employers, according to Gavino. Despite the hurdles, she finds the Medicare specialty rewarding, both financially and personally.
“It’s been half my business for the last 20 years. Clients often thank me for making Medicare painless and easy because it is a complicated topic,” she said.
Medicare is a robust and evolving program with significant benefits for individuals and employers.
Brokers must understand Medicare's components—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 these can set brokers apart as knowledgeable advisors.
One major benefit of offering Medicare is that it provides a cost-effective solution for employers, especially those in small to mid-sized businesses, to manage healthcare costs while still providing benefits to their employees.
Individuals transitioning from group health plans to Medicare Advantage or Supplement plans could also benefit from brokers’ guidance to ensure continuous and comprehensive coverage.
"It could be more cost effective for the company if employees choose Medicare over the employer’s health plan," Gavino said. “Medicare is complex, but educating clients makes it manageable.”
For Gavino, education is a crucial component of leveraging Medicare. Her commitment to education has extended beyond her clients to financial planners and fellow insurance brokers.
Before moving to California at the start of the pandemic, she regularly conducted training sessions for financial planners through the Financial Planning Association of New York City.
“I did a lot of training to teach financial planners about Medicare so they could better serve their clients,” said Gavino.
“During employee benefits meetings, I explain copays, deductibles, and plan choices to help them understand the financial impact of their decisions.”
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