Using Medicare Open Enrollment to Strengthen Advisor-Client Relationships and Create More Comprehensive Financial Plans

By Christine Simone

We’re in the thick of Medicare open enrollment—the period from Oct. 15 to Dec. 7 when Medicare enrollees can make changes to their coverage. For example, your clients can:

• ‍Change from original Medicare to a Medicare Advantage plan
• Change from a Medicare Advantage plan back to original Medicare
• Switch from one Medicare Advantage plan to another Medicare Advantage plan
• Switch from a Medicare Advantage plan that doesn’t offer drug coverage to a Medicare Advantage plan that offers drug coverage, and vice versa
• Join, switch, or drop a Medicare drug plan (Part D)

Many people don’t take advantage of this opportunity to switch plans. In fact, in 2019, only 29%¹ of Medicare beneficiaries reported comparing their current plan to other Medicare plans that were available during the 2019 open enrollment period for coverage in 2020. Additionally, 95% of seniors with Medicare Part D drug plans overspend on their coverage, likely due to not reanalyzing their coverage each year during open enrollment.

This is a missed opportunity because health needs, drug formularies, premiums, deductibles, and many other factors change every year. Just because a plan worked well last year does not mean it will work for the next year.

Not only are clients missing an opportunity to ensure they get their ideal coverage at a price they can afford, but financial planning professionals are also missing an opportunity to create a stronger financial plan. After all, healthcare costs eat up 15% of one’s assets during retirement—an average of $315,000.² Put another way, healthcare costs are the third-highest³ area of spending in retirement. When this is considered, the question changes from “Why would advisors include healthcare costs in their Medicare-eligible clients’ financial plans?” to “Why wouldn’t advisors plan for Medicare-eligible clients’ healthcare costs?” Doing so will incorporate all facets of clients’ lives (and spending) into their financial plans, thereby creating a more accurate, comprehensive plan.

Using Medicare Open Enrollment to Strengthen Client Relationships

Creating a great financial plan is, of course, the most important part of a financial advisor’s job. But part of being able to create a personalized, comprehensive financial plan is having a good relationship with clients. Clients need to feel they can not only trust you but also that you’re able to offer guidance on many areas of their life. In fact, the top two key areas⁴ that people without financial advisors say they would want guidance on are

• Retirement income planning
• Social Security and Medicare advice

For those who do have a financial advisor, one study found that 25%⁵ of clients would leave their advisor because of a lack of personal connection, and a 2021 Fidelity Investor Insights Study⁶ found that it’s important for advisors to show they care about clients beyond just their financial needs.

Actionable Steps to Help Clients During Medicare Open Enrollment

The bottom line is that you can strengthen your relationship with clients by conducting these annual Medicare reviews. Here are ideas about how to get started on that track.

First, if you’re using the open enrollment period as a trigger for outreach, identify clients who are 65 and over. From there, you can start reaching out to clients to remind them about Medicare open enrollment and let them know that you can help them identify which coverage options are best for them. In a blog post, I outline questions to ask clients⁷ to help them identify their optimal Medicare coverage options. Check that out before moving to the next steps.

Next, try looking at your client’s healthcare needs from last year. Seeing how frequently clients use the healthcare system can make a big difference in the healthcare planning process. If your client is comfortable sharing medication costs and information with you, you can review the medications they took over the last year and their costs, how frequently your client used the healthcare system (and the out-of-pocket costs associated with those visits), and their monthly premiums. If your client suspects their needs will remain the same, review their current plan to see if any coverage will change. For example, a medication that was covered last year under their current plan might not be covered next year under the same plan. Another example is that their medication will still be covered, but the pharmacy they typically get the medication from won’t be considered “in-network” next year under their current plan. Contracts change every year, so never assume that just because a plan covered something last year, the same plan will cover it next year.

When you meet with clients to help them determine which Medicare coverage options will work best for them, a quick tip is to make sure you and your client look at more than just the monthly premium costs. Yes, the monthly costs are important. But they aren’t the only important costs. As a comprehensive financial advisor, it’s up to you to help clients review all the costs associated with Medicare.

For example, drug coverage costs are crucial. Don’t take either of the following approaches for your client who wants to keep their healthcare costs low. In the first case, you help them choose a plan with a low monthly premium without looking at other criteria. The chosen plan ends up not providing comprehensive enough drug coverage for their current prescription list, so your client ultimately pays more on an annual basis.⁸ Or, your client doesn’t take any or very minimal prescription drugs at 65, so they don’t enroll in a drug plan, exposing them to a late enrollment penalty fee when they do enroll later.

Special Wrinkle for Medicare Advantage

There’s an additional open enrollment period specifically for people enrolled in a Medicare Advantage⁹ plan. From Jan. 1 to March 31, Medicare Advantage enrollees can

• Switch to another Medicare Advantage plan with or without drug coverage
• Drop their Medicare Advantage plan and go back to original Medicare
• Join a Medicare drug plan

This open enrollment period is important because it allows Medicare enrollees to change their selection if they didn’t make the optimal choice in their earlier enrollment. For example, let’s say your client picks a Medicare Advantage plan this fall, but then they find out the plan they selected doesn’t cover all their medications. Between Jan. 1 and March 31, they can switch to another Medicare Advantage plan or switch to original Medicare and join a Medicare drug plan. Essentially, Jan. 1 to March 31 is another opportunity to ensure clients pick the optimal coverage for their needs and preferences (as long as they’re enrolled in a Medicare Advantage plan).

Check in Now!

Medicare open enrollment ends on Dec. 7, so now is the time to check in with your Medicare-eligible clients. Embrace this open enrollment season to reach out to clients to assist them with optimizing their Medicare coverage. Doing this will help strengthen their financial plan, as well as their trust in you as an exceptional financial advisor.

 
1. Nancy Ochieng, Juliette Cubanski, Meredith Freed, and Tricia Neuman, “A Relatively Small Share of Medicare Beneficiaries Compared Plans During a Recent Open Enrollment Period,” KFF, Nov. 1, 2022.  
2. “How to plan for rising health care costs,” Fidelity, June 21, 2023. 
3. “Biggest Expenses for Retirees—And How to Minimize Them! (2021 Edition),” Vision Retirement, Jan. 12, 2021.
4. “Everyday Wealth In America 2022 Report,” Edelman Financial Engines, 2022. 
5. “Future of Client-Advisor Relationships,” MIT AgeLab and AIG & Life & Retirement, 2020. 
6. “Drivers of a Successful Advisor-Investor Relationship,” 2021 Fidelity Investor Insights Study, 2021,
7. Christine Simone, “How to Help Clients Pick a Medicare Plan,” Caribou Blog, Oct. 4, 2022. 
8. “From $40K in Annual Drug Costs to $4K: A Caribou Case Study,” Caribou, June 13, 2022. 
9. “When to join a Medicare health or drug plan,” Medicare.gov.

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Christine Simone is the CEO of Caribou, a software solution for the finance industry. She can be reached at contact@getcaribou.com. Although she’s years away from her own retirement, Christine is obsessed with helping people plan for and optimize their healthcare costs.

image credit: istock.com/Nudphon Phuengsuwan