Episode Summary
The podcast discusses a program that provides personalized support and retention services for Medicare beneficiaries living with diabetes, available at no cost to insurance agents or their clients.
It begins by highlighting the prevalence of diabetes, stating that 37.3 million Americans are living with diabetes and 96 million have prediabetes. The annual estimated cost of diabetes in the US healthcare system is $327 billion. Given that 1 in 3 Medicare beneficiaries has diabetes, this program can help agents support a significant portion of their book of business.
The host explains that diabetes medications like metformin, insulin, and injectables like Ozempic can indicate which clients have diabetes and may need supplies. Diabetes testing supplies like test strips, lancets, meters, and control solutions are covered under Medicare Part B with a $0 copay through preferred brands like OneTouch and AccuCheck.
New continuous glucose monitoring (CGM) technology like Freestyle Libre and Dexcom is also covered, but under DME rules which may have cost sharing depending on the plan. Still, the program can provide extra help to reduce out-of-pocket costs for items like these.
For those using insulin pumps, Medicare Part B covers the supplies like batteries, cartridges, tubing, and infusion sets needed to operate the pump. The pumps themselves are covered once every 5 years. Omnipod Dash is unique as a disposable pump refilled every 3 days, covered under Part D drug plans.
To get started, agents simply refer eligible clients to the program at the point of sale when enrolling them in a new Medicare plan. The program contacts the client within 48 hours to complete intake and verify benefits. Prescription paperwork is sent to the doctor to ensure medical need and continuity of care.
Once approved, supplies are shipped with tracking information. Reorders happen automatically every 90 days. This prevents gaps in care when transitioning plans.
In addition to diabetes supplies, ancillary items like pen needles and alcohol pads are offered with the extra help program to cover copays for those who qualify based on income.
The host emphasizes that the program provides national coverage, marketing materials, and dedicated account support so agents can better retain and serve clients while getting them needed supplies at a low cost.
With diabetes impacting so many Medicare beneficiaries, being able to maximize their benefits and reduce out-of-pocket costs for needed supplies allows agents to improve health outcomes and finances. This program is an invaluable but often overlooked resource.
Timestamps
(0:00:00) - 37.3 million Americans are living with diabetes
(0:00:46) - One out of three Medicare beneficiaries has diabetes
(0:10:26) - We ask agents to refer at the point of sale for diabetic clients
(0:11:31) - Getting your clients to answer the phone is probably the biggest delay
(0:16:02) - How do you get started with the Brokerage, Inc.?
