You don't need a plan that's better at everything. You need to identify what matters to this client.
Discovery
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Plan History
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Eligibility
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Network
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Doctors
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Copays
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Prescriptions
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Benefits
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Find the Fit
Ask yourself these before you recommend anything
- 01Why are they considering a change?Get the real reason in their words, not your assumption.
- 02What matters most to them?Cost, doctors, drugs, a specific benefit — let them tell you.
- 03What do they like or dislike about their current plan?Dislikes are often the real opening.
- 04Did something change?Health, address, income, household, or coverage status.
- 05Did their Medicaid or LIS status change?This can open or close entire categories of plans.
- 06Did another agent recently enroll them?Check MARx before assuming they're on their original plan.
- 07Are they moving PPO→HMO or HMO→PPO?That's a meaningful structural change worth discussing on its own.
- 08Would they lose a benefit they value?Don't let a good-looking new benefit hide a real loss.
- 09Would they gain something they actually need?Not something that just sounds appealing.
- 10Are their doctors covered?Verify, don't assume, especially across network changes.
- 11Are their prescriptions covered appropriately?Covered on paper isn't the same as covered at a reasonable cost.
- 12Are there meaningful cost differences?Meaningful to them, based on how they actually use care.
Reframe
Stop asking: "Which plan has the most benefits?"
Start asking: "Which differences matter to this client?"
Start asking: "Which differences matter to this client?"