5 Ground Rules for Turning Enrollment into Retention
For most Americans turning 65, choosing a Medicare plan marks the beginning of a high-stakes learning curve for both enrollees and payers. When beneficiaries or people aging into the program don’t know how their plans work, they can end up paying more than necessary for healthcare or miss out on benefits available to them.
And if customers aren’t satisfied with their experience, they can enroll elsewhere during their next annual enrollment period (AEP), thereby raising the stakes for insurers. With customer acquisition cost heading upward of $2,000 across the country, it makes sense for companies to keep retention top-of-mind even before AEP, when conversations with beneficiaries rethinking their current plans present a singular opportunity to personalize product offerings and foster long-term loyalty.
Here are five ground rules that can help boost member retention when applied to enrollment.
1. Assume that most Medicare shoppers are confused about coverage and costs.
In 2024, the average Medicare beneficiary will have access to 43 Medicare Advantage plans out of 3,959 plans available nationwide, and be exposed to a deluge of advertising: In fact, there were more than 9,500 Medicare-related airings per day during the AEP period for 2023. This firehose of information can culminate in cognitive overload that contributes to hasty or wrong choices, particularly when making complex purchases like health insurance. For example, in a recent survey of 351 beneficiaries of Medicare Advantage plans only 44% said they fully understood their plan. One in eight misinterpreted aspects of their plan after enrolling. Fifty-one percent said their confusion led to unexpected bills for uncovered services, and 46% said they had higher than expected out-of-pocket costs. Another survey found that only 9% of consumers understood terms such as premiums, deductibles, and maximum out-of-pocket costs. The lesson? Bridging knowledge gaps and narrowing choices at the outset of enrollment can reduce the cognitive work needed to process information and, ultimately, support decisions that withstand the test of time.
2. Know your customer.
Communication that drives growth and retention depends on instilling confidence in agreed-upon trade-offs, taking into account such factors as affordability; network breadth and continuity; supplemental benefits like dental care, vision care, or gym memberships; and coverage of prescription drugs. Broadly speaking, customers prioritize affordability and the ability to keep their existing doctors. That said, however, choosing insurance is a personal experience. Some people might prefer a less expensive plan even if it means they can’t see their usual doctors; others will readily pay more if their preferred providers are in-network. People who travel frequently or who have second homes may look for expanded geographic coverage options. And those with low levels of social support and poor social determinants might benefit from features such as transportation reimbursements, in-home care, or companionship. Put simply, establishing ease of interaction at the time of enrollment, as well as insights for shaping the contours of personalized service, will go far in winning members’ trust and renewal every year.
3. Ask the right questions.
Enrollment conversations set the stage for member engagement and subsequent retention. Here are some questions agents should consider:
- Does the customer prefer traditional phone calls or mailings over digital engagement channels such as text messaging or using a member portal?
- What is their level of knowledge about Medicare and Medicare Advantage?
- Are they price conscious?
- What medications do they take regularly?
- Is dental and vision care important to them?
- Do they prefer to see their current doctors or are they willing to switch if needed?
- Are they looking for a policy with lots of supplemental benefits or just the basics?
- Could language barriers lead to misunderstandings?
- Do they plan to travel outside the United States?
Remember, too, that active listening and asking open-ended questions transmit empathy. Comments such as “I can certainly understand how you feel” or “What are your biggest concerns about health insurance?” not only communicate authenticity, but also establish pathways for personalized guidance.
4. Simplify the message.
One of the best ways to put customers at ease is to use plain language whenever possible. It is important to keep in mind that only 12% of Americans have proficient health literacy and more than half have low health insurance literacy. So be prepared to break down the often intricate and complex nature of insurance policies into simple, understandable terms. This not only enables customers to comprehend the most impactful aspects of their coverage, but also prevents misinterpretations that could lead to confusion, mistrust, and ultimately disenrollment. In a similar vein, proactively addressing common concerns—e.g., receiving unexpected medical bills, having claims denied, or experiencing delays in treatment due to prior authorizations — in a manner that signals clear, transparent communication demonstrates a culture of honesty and sincere support.
5. Do your homework.
Because changing consumer behavior requires payers to win members’ trust and renewal every year, customized experience is becoming ever more valuable. Leveraging insights based on demographic, behavioral, and attitudinal data can shed light on customers’ motivations and how best to deliver on their unique needs. In the enrollment stage, for example, it’s helpful to know what type of coverage potential members are coming from and why they are considering a change. Are they aging in, coming from fee-for-service, or another plan? Understanding their prior experiences and expectations will make it easier to explain why certain plans should work better for them than others. Additionally, staying ahead of the curve on regulatory changes, new insurance products, and industry trends allows for a more a consultative approach to enrollment that sets the tone for long-range planning.
Conclusion
Despite the growing popularity of digitalization for routine servicing, payers can’t afford to sacrifice the human touch when it comes to enrollment. The spirit of partnership activated by the ground rules above can turn prospects into customers who feel equipped to take control of their healthcare, now and in the future. The result? Stronger retention rates, better health outcomes, and improved quality scores that, together, add up to a win-win for payers and members alike.
