The Sales Presentation for Medicare Advantage Plans

CB0009-15

May 5, 2015

Are you providing full, compliant sales presentations?

Before you begin your presentation:

  • Have you met all of the carrier’s certification requirements?
  • Do you have a thorough knowledge of the plans’ benefits and limitations, including the formulary and contracted providers?
  • Are you aware the ONLY health question you may ask is regarding End Stage Renal Disease (ESRD)?

Your presentation:

  • Have you completed a thorough needs analysis?
  • Present the carrier’s CMS-approved sales presenation and the Summary of Benefits, in their entirety, and leave it with the beneficiary.
  • Help the consumer enroll into the most appropriate plan based on their needs.
  • Ensure the consumer understands and agrees with the plan’s effective date, premium (when applicable) and benefits.
  • Confirm the consumer understands how to access a provider, explaining any network or provider limitations including referrals and/or higher copays, as applicable.
  • Review the enrollment application in its entirety for completion and the client’s complete understanding.
  • Review the plan’s cancellation and/or disenrollment process.

Before you leave the home:

  • Show the prospective member where they can find the plan’s Customer Service phone number.
  • Leave a copy of the Summary of Benefits; tell the new member that this document is a good referral document in case they can’t remember their benefits.
  • Leave at least 3 of your business cards; one for their user and two to hand out to friends (referrals).
  • Remind the prospective member to call you with any questions.

Thanks for being compliant!

As always, we thank you for your support and cooperation. For questions or comments, please email us at Compliance@YourMedicare.com or you may call the toll-free number listed below.

FOR AGENT USE ONLY. NOT FOR USE WITH CONSUMERS.

Compliance Updates | 2650 McCormick Drive | Clearwater, FL 33759 | 844.206.2927