Medicare Plan Selection Solution

Medicare Suggest

Deliver detailed, personalized Medicare plan pricing comparisons through a simple web, API, or consultative experience.

Section 1

The challenge

Finding the right Medicare plan match

Medicare beneficiaries often have difficulty matching their needs to the right health insurance products—leading many to overpay for plans relative to the value they receive. Organizations trying to help them—whether commercial carriers, employers, call centers, or brokers—find it challenging to provide beneficiaries with the information they need to make the right decisions.

Section 2

The solution

Fast, accurate Medicare plan guidance

Medicare Suggest uses an individual’s medical history to suggest the least expensive Medicare Advantage, Prescription Drug Plan, and Medicare Supplement insurance products based on their demographic factors, medical claims, and pharmacy claims. Using this data and a robust set of machine learning algorithms based on millions of lives, Medicare Suggest provides highly customized and accurate estimates for Medicare beneficiaries, including those transitioning from ACO, commercial, or employer-provided health insurance.

Section 3

BENEFITS

Medicare Suggest benefits

Accurate

By securely retrieving a beneficiary’s actual claims and provider history, users receive a highly personalized list of plans ranked by total out-of-pocket costs based on their projected personal utilization patterns.

Cost-effective

With no software to deploy or manage, and a subscription-based pricing model, you can provide sophisticated recommendations at low cost.

Comprehensive

Medicare Suggest can provide recommendations for Medicare Advantage and Prescription Drug, Medicare Supplement, and Medicare Prescription Drug Plans.

Versatile

Whether transitioning individuals from an ACO program, commercial insurance, or employer health insurance, organizations can move beyond generic literature to provide next-generation insight into their likely out of pocket costs across multiple Medicare insurance products.

Section 4

FEATURES

Medicare Suggest features

Resilient

Built on Microsoft Azure, Medicare Suggest supports high levels of scalability and availability, so it’s always there when people need it.

Robust

Research data supporting our matching algorithms is sourced from Milliman databases representing millions of lives and billions of claims records across the country.

Flexible

Organizations can configure the results and display of Medicare plans available to beneficiaries to meet their business needs.

Manageable

The system is entirely cloud based, enabling rapid deployment and providing users with a seamless experience. Industry-standard APIs simplify connection with external systems.

Section 5

INSIGHT

Related insight

Article

Medicare plan selection: Pharmacy costs alone are not enough

Brokers and carriers should recognize the value in looking at medical costs when helping members with plan selection.

Read the article

Section 6

SERVICES

Services related to Medicare Suggest

Medicare consulting services

Medicare Supplement insurance

Medicare Advantage (Part C)

Medicare Part D

Products