The Itty Bitty Medicare Book: How I Used My Experience to Write a Guide to Medicare Enrollment

Editor’s note: In this edition of What’s Working Now, an AdvisorRADIO feature in which Horsesmouth members tell us about recent success they have had running and growing their businesses, we hear from Joyce Khoury, who has written an easy-to-understand book on Medicare enrollement.

The following article includes edited excerpts of Joyce’s comments, or you can listen to the full interview below.

I started pursuing Medicare as a career in 2010 because I was getting older myself and have always worked in sales, and I thought, “What can I do?” When I looked around, I knew that insurance has always been a tough thing for people to understand, and it was time for me to understand it.

I started to pursue knowledge of Medicare. What I found out was that this knowledge is sorely needed by the general public. Nobody really knows the ins and outs, even though we are all required to have it. So, I got my credits in life and health insurance, and off I went. I found out about lots of rules and regulations, but also lots and lots of good information.

I would recommend that anybody who wants to sell Medicare seriously consider being a broker instead of a captive agent to one company, because the companies are very competitive. One year they work with a certain hospital and the next year they don’t. If you are a captive agent, you may have the business this year but not next year. I’m a broker and I carry eight different health plans, which are the pertinent ones in my area. Every part of the country is different.

Open enrollment is busy season

After we record this, I have my very first open enrollment meeting of the year at the YMCA in Santa Monica. This seven-week period is the busiest, most productive period for any agent. It’s where you gather the majority of clients year after year.

If you have meetings in strategic places near hospitals, where people really want to know about health insurance, if you are lucky, you will get 20 or 30 attendees, and probably 70% of them will do business with you. Many of the attendees go to several meetings before they make a decision about which agent to work with. But these kind of meetings have become much more prevalent, every single organization is giving a meeting, so attendance may be only two to five people. It’s really unpredictable.

Ninety percent of my business during open enrollment period is from people who are already on Medicare but need to change their coverage for some reason. People turn 65 through the year, obviously, not just during that seven-week period. But this is the time people do their shopping. They want to know if they are on the best plan for them. Is anything new, is their plan not covering something that someone else just got covered? It’s a place to gather information.

You want to retain the clients you have. So, it’s really important for you to have your contact list, and around July or August, start sending notices and reminders to your current people saying, “Are you happy with your plan? Did your medications change? Can I help you? We have a new program coming with so-and-so. I know you go to such and such doctor at so-and-so hospital, maybe we can improve your plan.” It’s really important for retention to communicate with people you’re already working with.

Brokers cannot approach people about Medicare

This enrollment period is especially important for getting new clients because the Center for Medicare and Medicaid Services (CMS) has very strict guidelines. We cannot openly approach a person and say to them, “I know you’re turning 65. I’d like to talk to you about Medicare.” We’re not allowed to do that because of compliance. If you see people passing out flyers in a parking lot, that’s not allowed. We cannot go knocking on doors and we cannot make cold phone calls.

There are many rules, like the fact that when a broker or agent has a meeting, we are not allowed to serve a meal. We can’t even have an educational meeting with a meal. Only snacks, coffee, and pie are allowed!

So agents have to build strategic partnerships. One of the reasons I like being with Horsesmouth is that financial advisors are very good strategic partners for me. Another key piece for me is networking groups. For me, because I’m a woman, women networking groups give me a lot of visibility, and I make friends with people my own age. [Joyce is 68.] Today, for example, after my meeting at 10, I have another talk at 11:30 at a networking group. You have to be active; you have to be in the community talking so that people can recognize you, because you’re not supposed to go up to them.

The magic of branding

I had done cold calling in sales all my life. When I first became a Medicare agent I said, “Wow, what do I do now?” I had to build up a clientele who knew me and trusted me, and yet I was told we cannot actively approach people. It has to be kind of passive and people have to ask you.

I racked my brain and asked, “How in the world are they even going to know who I am?” Gradually I came up with the idea of branding, and asked myself very seriously, “What do I do?” What I really do is coach people. I help them understand their next step, what they can do within the Medicare world and what they cannot do, and what their expectations should realistically be.

So I came up with the notion that I could present myself as a coach. I went a little crazy and even bought a baseball cap that says Medicare Coach 101, but it did make me stand out. People connected with me because they needed the information and knew they needed to be coached.

They next thing was, could I get into a recognizable group so they could know that I do this? That’s what brought me to networking in a more serious way, because networks are small community groups within communities.

So I have my hat, and I had photographs taken of myself, and created a website with myself billed as the Medicare Coach. I was walking in Costco one day, totally crowded with probably a thousand people, and lo and behold, some guy walked right up to me and said, “You do Medicare? Can I talk to you?” And I thought, “OK, this works.”

The Itty Bitty Medicare Book

A couple of years ago I was in a networking group with Suzy Prudden, a woman who was quite famous in the 1980s as a sports coach on T.V. with Oprah Winfrey. She had the idea that each woman in the group should think about who they are and how they want to present themselves. Then she could help us publish a book. She is the publisher of the “Itty Bitty” series. It’s like “For Dummies,” but she calls it “Itty Bitty.”

I thought, “That’s interesting.” Most of my networking groups are comprised of relatively older ladies, maybe 50 and up. There’s not a lot of younger women, I think because they’re just too busy raising children. But the older women are serious about creating something that works for them. So Suzy helped us publish books.

We discussed the fact that people who are getting older don’t like volumes of information to read. I don’t think that’s a bad thing; in fact it’s a great thing. They like succinct things that make sense and give them a sense of direction. So her whole purpose in the Itty Bitty series are books that have important and relevant facts that share your expertise.

I thought that was a great idea, because everything you receive from CMS is volumes of small print, and nobody knows what it means. That’s why we developed Your Amazing Itty Bitty Medicare Book: 15 Key Steps to Successfully Navigate Medicare.

Practical details of publishing

I started by hunkering down and thinking, “What do I think are the steps that somebody needs to know?” One of the advantages is that I had just turned 65, and I was experiencing all the mountains of mail that everyone gets—and all the T.V. commercials.

I was looking and thinking, “If I wasn’t in this business, I would be so overwhelmed. I wouldn’t know which way to turn, because I wouldn’t know what any of this means.” So to write the book, I just sat down and said, “OK, step one, this is what went through my mind. Step two, this is what went through my mind.”

I also included some of the history of Medicare, since I think how it came about is interesting and important, along with the changes that have taken place since then. Medicare was instituted in 1965 when President Lyndon B. Johnson signed it into law. He wanted to establish insurance for people who retired at age 65 and were no longer going to be insured by their employer. That’s how the whole thing started.

But today, people work way past 65 years old. Sometimes they’re insured by their employer, and sometimes they’re not. And there are so many ways of working, as we all know—you can work online, be self-employed, or work overseas. There is a plethora of choices as to how we work today compared to 30 years ago.

And that opens up so many complicated questions. Should I stay with my employer’s insurance? What about my children? My child is just turning 27, what do I do with that? It brings up so many questions that weren’t an issue 30 years ago. I realized how important it is to know the answers.

How I use the book to market myself

I paid about $5,000 dollars to publish the book, which was mostly for design and set up. I printed 500 copies and so far have only done one printing. I’ve had it for about two years. I bring it to all of my meetings and give it away. I think it’s a nice piece to be able to give away.

I just embellished and improved my website and it has a page that links to Amazon, where you can buy the book. The paperback is $6.99 and the Kindle version is $2.99. Mostly I have them for sale just so I can keep it going. If I’m meeting someone, I give it away. I don’t charge.

Even though I’ve only had one print of the book, people now know that I’m the coach—they call me “the coach.” I think that’s the first, biggest step.

I’m going to start giving the book to more workshop attendees, I think. This is an excellent way of not “pro-selling.” I’m not approaching anybody and saying, “Hey, do you want my book?”

If somebody is talking about the subject—and it comes up a lot in my circles—I just hand them a book and say, “why don’t you take this?” It’s a very good tool, I think.

The last two years have been kind of a renewal for me. When I first started in the Medicare business, I was really confused for a couple of years. I was trying to learn the whole thing myself. Then, about two-and-a-half years ago, lots of new things were happening. I turned 65 and renewed, so to speak, my way of working. That’s also when I joined Horsesmouth. Everything is really at the starting line, to be honest. But it seemingly works really well so far, and I’m very happy with what’s going on.

Medicare and retirement planning go hand in hand

If somebody wants to write a book about Medicare or go into selling Medicare plans, I think they should already be involved with the retirement community, so they understand the greater circle of what people at that age are facing. It’s not just going to Target or Ross and buy Medicare like a box of noodles. It really is something that’s customized to the person, and if they don’t understand what they’re getting into, they’re not going to be very happy or satisfied with their plan.

You need to know what Medicare pays for and what it doesn’t pay for. One of the most important things to understand is that Medicare does not cover long-term care. And unfortunately, by the time you get around to thinking about Medicare (and realize it doesn’t give you long-term care) you’re probably a little older than the insurance company would like, and you probably have a couple of conditions they don’t like.

Copays—Medicare doesn’t cover everything!

Another issue that a lot of people just don’t understand is the copay structure. I think it’s very important to dwell on the copay structure. Many employers pay 100% of the insurance bill on a monthly basis, and people never had to pay at the doctor’s office. All of that means that you as an employee don’t really think much about your health plan.

The difference is, when you’re on Medicare, you’re on your own with the copays. You may have to come up with the money to pay the co-insurance, and that’s exactly the part many people struggle to understand, because they never had to think about it before. They think that somebody lied to them because they assumed Medicare was going to cover everything.

Talk to your agent

The other thing is, we have all kinds of new treatments these days, from radiation to medication, that have just come to the market. They might be approved by the FDA, but not by Medicare as far as payment goes. It’s a gradual process where Medicare will eventually pay for very effective treatments. But when a doctor prescribes something that has just come on the market, even two or three years ago, because it’s the greatest thing since sliced bread, that doesn’t mean it’s covered.

This is extremely confusing, and I think the best advice I can give to consumers is, honestly, just keep in touch with your agent. Your agent can do all the research. Please tell your agent, “My doctor just diagnosed me with such and such and gave me X medicine. How is that going to work with my Medicare plan? Is it covered?”

These are very important questions. We’re getting older and we need the medication. We’re also in a great new age where the medication is fantastic, but it’s not necessarily ready to be covered by Medicare. That’s a very important reason to be with a financial planner.