The honest case — both sides. A client should be moving toward Medicare Advantage because it solves something real for them, not because it was the plan on the top of the call script.
What it solves
- Caps total annual cost through the MOOP — Original Medicare alone has no such cap
- Many plans carry a $0 monthly premium
- Bundles medical, drug, and often extra benefits into one card, one plan
- Extra benefits can cover real gaps Original Medicare leaves open
- Some plans coordinate care more actively across a client's providers
What it trades away
- Provider access is limited to the plan's network
- Some plans require referrals or prior authorization for specialist care
- Benefits and costs can change year to year — it needs an annual review, not a "set it and forget it" decision
- Plan availability varies by county
- Can't be paired with a Medigap supplement
Where extra benefits actually matter
These are only worth mentioning if they solve something the client actually told you about in Discovery. A benefit list read out loud without context is a script; the same list connected to something the client said is a soft close.
Dental
Vision
Hearing
OTC allowance
Transportation
Fitness / gym
$0-premium plans
Care coordination
Connects to Discovery
This is the module that gives Discovery its purpose. When you uncover that a client is paying out of pocket for dental work, or skipping rides to appointments, you're not just building rapport — you're identifying exactly which of these a real plan recommendation should lead with. And if the client also turns out to be dual-eligible or managing a qualifying chronic condition, the case gets even stronger — that's Module 06.
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