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Meet growing needs for innovative insurance solutions while increasing operational health and improving compliance.
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Deliver detailed, personalized Medicare plan pricing comparisons through a simple web, API, or consultative experience.
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.
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.
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.
With no software to deploy or manage, and a subscription-based pricing model, you can provide sophisticated recommendations at low cost.
The system is entirely cloud based, enabling rapid deployment and providing users with a seamless experience. Industry-standard APIs simplify connection with external systems.
Medicare Suggest can provide recommendations for Medicare Advantage and Prescription Drug, Medicare Supplement, and Medicare Prescription Drug Plans.
Built on Microsoft Azure, Medicare Suggest supports high levels of scalability and availability, so it’s always there when people need it.
Research data supporting our matching algorithms is sourced from Milliman databases containing millions of lives and billions of claims records across the country.
Organizations can configure the results and display of Medicare plans available to beneficiaries to meet their business needs.
Brokers and carriers should recognize the value in looking at medical costs when helping members with plan selection.
Improve care quality and cost efficiency with the leading independent Medicare experts.
Build quality MedSupp solutions and succeed in a growing, yet complex market.
Access comprehensive Medicare Advantage services including employer group pricing support, feasibility analysis, payment validation, and more.
Facilitate rate development, ensure feasibility, implement communications strategies, and more with dedicated Part D expertise.
Evaluate relative values of Medicare Advantage program plans using a comprehensive, Excel-based tool.
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