7 Steps to Compliant Sales During AEP

  • Originally published November 7, 2011 , last updated January 12, 2016
  • AEP
7 Steps to Compliant Sales During AEP

You are contracted, licensed, appointed and certified to sell Medicare Advantage and Part D plans. You may have your supplies too. So, how do you sell successfully and cement your sales with clients and avoid complaints? Here are a few suggestions:

1. Carriers offer a table-top or PowerPoint presentation to keep you on track and make sure you don't overlook key disclosures. Order one and use it!

2. Remind your client that a Verification Call will be made within 10 days to make sure the client knows what they bought and what they didn't buy!

3. Remind the client that if purchasing a network-based plan (usually HMO or PPO) there is a provider listing and the lowest copays are available or benefits are payable only when going to these providers.  Check the online provider directory and make sure the client's provider is on the list!

4. If purchasing a Private Fee for Service plan, be sure to describe the deeming provisions and that a provider can accept the terms and conditions of the plan on a visit-by-visit basis.

5. Disclose the pharmacy network and if taking medications, be sure the pharmacy your client visits is on the list. Check the medications being taken and ensure the plan covers your client's drugs too.

6. A client joining a Medicare Advantage plan needs to know that this plan replaces Original Medicare Instead of the 80/20 coinsurance program with Original Medicare, the client has co-pays and an annual Maximum Out-of-Pocket. Use an output from Medicare.gov and show a side-by-side comparison of Original Medicare to the MA plan from the Summary of Benefits to make sure the client understands how the plan works. Comparisons to Medicare Supplement plans can confuse your clients! Medicare Advantage plans replace Original Medicare, not Medicare Supplement.

7. This sounds simple but many agents forget to leave their business card with contact information after taking an enrollment application. This is a CMS requirement!

Top agents follow a simple formula. Use the carrier sales presentation, be thorough in looking up drugs, pharmacies and providers and patiently explain the benefits, using all required disclosures. Follow these steps and you are on your way to success with compliant Medicare Advantage and Part D plans!