Conducting the sales appointment for Medicare plans comes with a few regulations. Following a set of procedures for pre-enrollment activities and for the client meeting will help your agency to remain compliant and in good standing.
What Compliant Sales Look Like
Before you meet for the appointment, you speak with the client and agree on which products to discuss during the appointment. To document these decisions, you and the client will fill out and sign a Scope of Appointment form, agreeing to stick to only those products during the appointment. When you meet for the appointment, the client can decide that they want to talk about more products, but you would need to fill out an additional Scope of Appointment form before discussing those new items.
For a compliant appointment, hold the meeting in an ADA-compliant meeting space. Communicate to non-English speakers in a way they will understand. Announce that you don’t work for Medicare and you could be compensated for this sale.
Quote accurate plan costs and advise the client how to use the plan formulary. Use materials that meet CMS requirements. Give the client the pre-enrollment checklist and make sure they understand all components of the plan. Let them complete the enrollment form and only assist with the form if the client is unable to complete the form themself.
What Not to Do for a Compliant Sale
Pre-enrollment, agents must be mindful of regulations. You must not discriminate in any way and cannot engage in high-pressure sales tactics. Do not collect financial information from potential clients during pre-enrollment activities and do not ask to see a list of prescription medications unless they ask for help.
Do not say that you or the plan is endorsed by Medicare or recommended by the federal government. Keep this in mind with all of your marketing and advertising materials, including your personal business cards. Refrain from using “Medicare” in your title.
Do not imply that Medicare is only available to seniors. Yes, a large portion of Medicare beneficiaries are age 65 and older, but around 15% of Medicare beneficiaries qualify for Medicare because of a disability. For this reason, you should avoid using the term “senior” in your communication or marketing materials to prevent discrimination against any of your potential client base.
Do not offer monetary or promotional gifts to induce enrollment or as a thank you: gifts must come with no obligation to enroll and gifts in return for using services are not allowed. Refer back to CMS guidelines for nominal gifts if you have any questions about these off-limits rewards.
