The Annual Election Period (AEP) has arrived! Now is the time you can enroll your client in a Medicare Advantage (MA) or Prescription Drug Plan (PDP) from October 15th to December 7th. If you already checked out our previous articles in our Medicare Advantage series we reviewed the basics and the marketing guidelines for MAPD plans and PDPs (see below for article links!). So now let’s review what you can expect during the AEP.
What The Agent Can Do For The Client During the AEP
- Switch from Original Medicare to a Medicare Advantage plan
- Switch from their Medicare Advantage plan to Original Medicare
- Switch from one Medicare Advantage plan to another Medicare Advantage plan
- Switch from a Medicare Advantage plan that doesn’t include prescription drug coverage to one that does (and vice versa)
- Enroll, switch, or drop a Prescription Drug Plan
While the above seems pretty basic on what you can do for your client during the AEP there are some details that the agent should keep in mind. During your clients’ appointments make sure that you also touch base on the following details to avoid confusion in the future.
- The Scope of Appointment form will need to be signed – Make sure the client knows that this is like a permission slip to review what plans and products they want to discuss and they are not required to enroll in any plan during the appointment. While the previous 48 hour rule has been lifted by CMS, the agent will still need to have the client complete the Scope of Appointment form before discussing any plans or plan details. Download the generic SOA form here.
- The client will still be paying their Part B Premium – Even though the client decides to enroll in a MA plan, make it clear to the client they will be paying the Part B Premium for the following year in addition to any costs of the MA plan.
- Review the service area and network for each MA Plan – The availability of MA plans can vary by state and county so double check the client’s location to make sure they can use their new plan. In addition, make sure to double check the client’s network. Some MA plans are available in the client’s county but the client’s doctor or preferred hospital might not be in the network. This is important especially if the client has a HMO plan and will absolutely need to receive care within the plan’s network.
- There is no penalty to switch plans and the client is guaranteed approval – Many clients do not think they can switch plans once they decide on something. Make it clear to the client that they can switch anytime from October 15th – December 7th and they are guaranteed a policy effective January 1st. The only exception is if the client has End-Stage Renal Disease (ESRD) – They will not be approved for coverage and will need to look for a specific Special Needs Plan (SNP).
- Clients cannot have a Medicare Supplement plan and a MA plan – If the client switches from Original Medicare to a MA plan they will have to cancel their Medicare Supplement plan (if they even have one) effective January 1st, when their new MA policy takes effect. Make sure the client doesn’t cancel their Medicare Supplement insurance right away or else they will be without coverage until the New Year.
- This is the one time of year clients can switch plans – Make sure the client knows that this is the time to join, switch or drop a plan. Whether it’s a MA plan or a PDP, reach out to your clients to make sure they know they have the option to change their current MA or PDP coverage.
- Clients can enroll on their own – The client is free to enroll in a MA plan or PDP on their own. They can do so by calling the carrier direct, contacting 1-800-Medicare (1-800-633-4227), or by utilizing the Plan Finder Tool on www.Medicare.gov to enroll online (read more about the new Plan Finder Tool here). However, let the client know that if they have any issues with their new plan you, as the agent, might have a more difficult time resolving any problems (if you can help out at all!) since you did not complete the original application.
There’s a lot going on during the AEP so if you any questions or feel as if we missed something please feel free to comment below! Hopefully this guide will help you during your Medicare Advantage appointments or give you some more insight into selling Medicare Advantage plans during the AEP.
Check out our previous articles about Medicare Advantage below:
Medicare Advantage Part 1 – The Basics
Medicare Advantage Part 2 – Marketing Medicare Advantage Plans
Medicare Advantage Part 3 – Educational Events Vs Marketing/Sales Events