How the GoHealth CARES Team Forms Lasting Relationships With Medicare Beneficiaries

As a trusted healthcare marketplace, GoHealth is dedicated to remaining customers’ top choice from their initial Medicare Advantage enrollment on through any plan changes they make in the years to come. Building and strengthening those relationships requires an organization-wide commitment to provide every new or current Medicare beneficiary with transparent, pressure-free, and responsive guidance. 

That mission depends on the licensed insurance agents and other professionals who make up GoHealth’s CARES Team. At every stage of the enrollment process, consumers can expect personalized, engaging interactions based on expertise in the Medicare system and genuine empathy. 

“I believe our CARES Team is one of the factors that truly sets us apart from other firms operating in the Medicare space,” said GoHealth Chief Operating Officer Michael Hargis. “They’re deeply knowledgeable about insurance, but more importantly, they treat everyone who calls in with respect and personalized attention.” 

CARES is a massive undertaking that draws on the talents of five smaller teams, each tasked with essential functions. These are the individuals who make the GoHealth customer experience possible: 

Connect

A member of the Connect Team is the initial point of contact for anyone reaching out to GoHealth. This agent is primarily responsible for checking that a prospective customer meets the eligibility requirements for Medicare Advantage, including that they are over 65 and already enrolled in Original Medicare.  

In addition to gathering the essential details to move customers forward, the Connect Team lays the foundation for a lasting relationship with straightforward, thoughtful communication. They treat callers like the unique individuals they are, not numbers on a spreadsheet, addressing their particular situations and concerns.  

Even if it turns out a caller is too young or otherwise not eligible for the current enrollment period, this conversation could be the start of a relationship that eventually leads to them receiving improved health benefits and savings.  

Advocate

The Advocate Team uses GoHealth’s PlanFit technology to run a comprehensive member needs assessment that matches a consumer with the best plan for them. Based on analytics from millions of sales calls, the PlanFit CheckUp process reveals a unified view of benefits, coverage, and savings. 

Signing up for your first Medicare Advantage plan or switching to a new one is a big decision, but it should never be a high-pressure, sales-driven experience. During a PlanFit CheckUp, GoHealth agents are incentivized to serve the interests of Medicare beneficiaries, even if that means saying they’re already on the plan that’s best for them.  

“I’m trying to make customers for life, not just an enrollment for the day,” GoHealth agent James Wester explained. “I need to get to know the customer’s needs and how they use their insurance to be able to truly serve them. When a happy client thanks me for teaching them how insurance works, I am glad to have this job.” 

Carriers add new options and plans undergo changes each year. If there are no better alternatives on GoHealth’s marketplace this year, consumers can always call back for another PlanFit CheckUp during the next Annual Enrollment Period. 

Resolve

The Medicare Advantage enrollment process is complicated, and it’s critical that agents gather full and accurate details about consumers’ doctors, prescriptions, and other needs. 

However, miscommunications are possible in any transaction. That’s why GoHealth has representatives responsible for double-checking that new enrollees fully understand and are happy with their choices before moving forward.  

A representative from the Resolve Team verifies that the customer: 

• Has signed up for a plan with all the benefits that are most important to them. 
• Lives in an area where their chosen plan is available. 
• Will be able to access all of the prescriptions and treatments they rely on. 
• Has their preferred healthcare providers and pharmacy in network. 

The team member finalizes enrollment only after carefully checking for any inconsistencies and making certain that the beneficiary feels confident that their healthcare is in good hands for the coming year. Agents like Susan Millet appreciate knowing that they’ve helped people achieve greater peace of mind. 

“The opportunity to assist members in receiving coverage that will improve their financial situation is awesome,” Susan said. 

Engage

Joining a Medicare plan is just the start of a journey, and GoHealth wants to be there for beneficiaries over the long haul. The Engage Team develops personal relationships that continue well past enrollment by serving as a go-to resource for Medicare questions and concerns.  

Engagement touchpoints can vary based on Medicare carrier requirements, but GoHealth agents commonly reach out for:  

• An onboarding call to ensure customers have received their plan cards and are prepared to start taking advantage of their benefits immediately when the new year starts. 
• A Member Care Assessment to gain a deeper understanding of beneficiaries’ life situations and health needs. 
• A 30-day check-in to manage any other problems or questions that may arise shortly after a customer starts using their new plan. 

Support

To achieve consistently great experiences for customers requires high standards and accountability. That’s where the Support Team comes in, monitoring the rest of the CARES Team’s interactions with callers for quality assurance and performance improvement. 

GoHealth prioritizes clear communications and metrics that lead to meaningful improvements in customers’ experiences. The Support Team collaborates with agents to promote a personalized, detail-oriented approach that demonstrates empathy at every turn.  

“The most important thing for agents and everyone at GoHealth is doing what’s right for the customer,” said Senior Director of Quality Assurance Amber Ro. 

By fostering meaningful connections, advocating for the needs of Medicare beneficiaries, resolving any miscommunications, engaging over the long term, and providing support, CARES team members make a lasting impact in the lives of the people they serve. These highly trained professionals bring their wealth of Medicare knowledge and dedication to helping others into every interaction, from initial contact through plan enrollment and beyond. 

About GoHealth

GoHealth is a leading health insurance marketplace and Medicare-focused digital health company. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science, and deep industry expertise to build trusted relationships with consumers and match them with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare plans and individual and family plans. For more information, visit GoHealth.com.