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Medicare turning 65 leads

If you are in the Medicare sales field, you know how difficult it is to find good Medicare turning 65 leads.  Medicare leads play a pivotal role in connecting agents with individuals who are looking for advice on the best coverage options available to them.

Understanding T-65 Leads

T-65 Medicare leads refer to individuals who are nearing the age of 65 and are therefore eligible to enroll in Medicare.  T-65 leads are very valuable to Medicare agents because they represent a target audience that is actively seeking information and guidance regarding their Medicare options.

Learn about our lead program

Join the team at Crowe – click here for online contract

The Importance of T-65 Leads

T-65 leads provide an opportunity for agents to establish important relationships with potential clients. Once an individual approaches 65, they often have questions and concerns about their healthcare coverage options. By reaching out to T-65 leads, agents can offer valuable assistance navigating the complexities of Medicare enrollment. This is an opportunity to earn the trust of a beneficiary and add a lifelong client to your book of business.

Learn the details of how commissions pay out – watch a quick YouTube video

Unfortunately, most leads sources such as online leads, inbound call leads and pre-set leads are not going to have many turning 65 prospects. These lead sources usually provide contact information for people who are already on Medicare.

One way to ensure you get a good number of T-65 leads is with the use of our T-65 Seminar selling program.  This turn-key program is one of the only ways to guarantee you get true T-65 leads.  It is easy to use.  Agents get their own portal that keeps client contact information so the agent can follow up and be sure the client knows you are there to help them once it is time to sign up for Medicare. Crowe reimburses our agents for 1/2 the cost of their first seminar.  Get all the details of the seminar program.

Watch a video on our T-65 educational seminar program

Be sure you follow all CMS guidelines for hosting an educational or sales event.

Crowe agents have access to a preset lead program that provides leads at a very good close ratio.  To learn more about this program, click the link below:

Watch a YouTube video on our preset lead program

Tips for effectively leveraging T-65 leads

1. Targeted Marketing: Use targeted marketing strategies to reach individuals who are approaching the age of 65. Think about doing this up to 1 year ahead.  This may include digital advertising, direct mail campaigns, and partnerships with local community organizations.
2. Personalized Communication: Tailor your communication to the specific needs and preferences of T-65 leads. Listen to their concerns and provide customized solutions that address their unique circumstances.  Many agent use a Medicare fact finder to collect important client information.
3. Educational Workshops: Host educational workshops or seminars to provide T-65 leads with valuable information about Medicare enrollment, coverage options, and important deadlines. This helps establish your credibility as a knowledgeable resource in the Medicare field.
4. Follow-Up and Support: Stay in touch with T-65 leads throughout the enrollment process and beyond. Offer ongoing support and guidance to ensure that they make informed decisions about their healthcare coverage.  This helps build a good long term broker/client relationship.  It is important to remember renewals are a large part of your income and this also leads to referrals.

Find out how to get Medicare referrals

T-65 Medicare leads represent a valuable opportunity

This is an opportunity for insurance agents to connect with individuals who are nearing eligibility for Medicare benefits. By understanding the unique needs of T-65 leads and employing strategic approaches to lead generation and engagement, agents can effectively serve this demographic and grow their business in the process. By providing personalized guidance and building lasting relationships, agents can become invaluable allies.

Here are some marketing ideas

the best way to get almost exclusively t-65 prospects is through our T-65 seminar program.  T-65 mailers are a good way to target new to Medicare but you have a very low response rate and mailers are a ton of work and follow up.

Before you contact potential clients – you must understand how the permission to contact works

Click here to see Medicare Advantage commissions 2024

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Resources for new Medicare agents

 Consider joining an experienced upline/FMO

Agents who contract with an experienced upline/FMO have a much easier time getting up and running.  A good FMO provides invaluable resources for new Medicare agents such as contracting, training, tools and guidance they need to be successful in the Medicare field.

Click here to watch a YouTube video on what Crowe has to offer.

Training

One of the most important tools a good FMO provides is training.  Agents not only need to learn the ins and outs of Medicare and how each plan works but they also need to understand the rules and guidelines put in place by CMS and the insurance carriers.  On top of that, they need to know where to get leads and how to make a sale once they have the leads.  As you can see there is a lot of things an agent needs to know before they have a successful Medicare sales business.

Crowe provides our agents multiple ways to get the knowledge they need to succeed including webinars, zoom meetings, in-person training events, one-on-one phone calls with our sales directors, back-office staff or Ed Crowe.  If this is something you would like, we can partner new agents with an experienced agent who can provide guidance.

Learn more about Medicare agent training opportunities.

Visit our events and information page and stay up to date on our upcoming webinars and zoom meetings.

E&O Insurance

Before you contract with the carriers or make a sale, you need to have E& O insurance in place.  E&O protects you in the event you make a mistake in the sale of an insurance product that costs your client a lot of money.  Click here to learn about our discounted E& O Coverage options.

Build an Online Presence

These days everyone is online, that is why it is important to create an online presence.  Once you do, clients can find you easily and see what you have to offer.  An online presence also helps build brand recognition which lends itself to credibility.  There are several ways to do online marketing including, building a website.  Because Crowe and Associates is part of Pinnacle Financial services, our agents have access to their design team who provide free website design help, logo creation, digital marketing or help creating mailers.

there are other ways to create a solid online presence including through a Facebook page, LinkedIn or YouTube just to name a few.

Click here to learn how to create a Facebook business page.

As we mentioned above, the best way to build an online presence is through a website.  Adding a blog to your website is a great way to present helpful tips and information.

Click here to learn how to create a blog.

Quoting and Enrollment

Once you have a good idea of all the rules, regulations and plan details, you will need a quoting and enrollment site you can use to enter each client’s information and show them comparisons of the top plans that fit their needs and budget.  Crowe and Associates provides our agents with free quoting and enrollment tools.

Make sure you fill the application out correctly

We provide the technology that makes quick and accurate comparisons easy. Our quote engines, Sunfire & Connecture provide agents with a built in CRM to store the client’s information including name, address, birthdate, Medicare ID, Medications. pharmacies and doctors.  The CRM makes running a quote quick and easy once you ensure the client’s information is up to date.  Our quote engines also provide agents a PURL (quoting and enrollment link) you can add to your website so clients can run their own quotes and even enroll if they want.

Watch a YouTube video – how to use Sunfire

See how to use Connecture to quote and enroll

Call Recording Rules

All agents need to be aware when CMS’ implements a rule.  You need to be aware of the CMS call recording rule. This rule requires agents to record all sales, marketing, and phone enrollment calls.

Learn the rules for collecting a scope of appointment

Find out about the Medicare sales event guidelines

Both Connecture and Sunfire have call recording capabilities that keep our agents compliant.

Take a look at the 2024 Medicare advantage commissions.

If you are already contracted with Crowe and want to add a carrier, click here

How to find leads

Watch a quick video on ways to generate Medicare leads

Now that you are contracted and ready to sell, you might need some leads so you can start selling.  You can use some of the online lead sources we mentioned in previous paragraphs, but there are many more ways to get Medicare leads.

Click here to learn how to get Medicare referrals

There are numerous companies that offer all different types of leads such as live transfers or mailers.  Whatever lead sources you choose make sure the leads are CMS compliant.

More information for Medicare agents

Visit our events and information page and stay up to date on our upcoming webinars and zoom meetings

Medicare supplement comparison

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48 hour scope of appointment

Agents who plan to offer Medicare Advantage or Medicare Part D coverage to beneficiaries, need to understand the CMS 48 hour scope of appointment rule.

Watch a quick YouTube video on the 48 hour rule

A SOA (Scope of Appointment) is an agreement that both the agent and client must sign before a scheduled in-person, phone or online appointment.  The SOA shows exactly which products the client and agent plan to discuss at their meeting.  This gives the agent as well as the client time to prepare for the discussion and helps to avoid high pressure sales tactics. This document is mandatory if there is a discussion about either Medicare Advantage and/or Part D prescription drug plans.

A scope of appointment may list several types of products the client wants to discuss, or it can be a basic form that lists only Medicare Advantage plans, Part D (PDP) plans, Ancillary products and Medicare supplements.  The products the beneficiary checks off are the products the agent has permission to discuss.

Agents who want to join our team; click here for online contract

How far ahead of time can you get the SOA

A signed SOA is good for up to 12 months before you meet with the client.  Some agents collect a new SOA at the end of an appointment to be prepared for the next meeting ahead of time.  It is important to remember the scope is only good for 12 months, once that time has passed, the client will need to sign a new scope.

Exceptions to the rule

1. One exception to the rule is the last four days of a valid election period. during the last four days of a valid election period.  At this time, agents can collect a same day Scope.
2. Another exception applies when the beneficiary walks into the agent’s office without an appointment. This is a beneficiary-initiated meeting, also referred to as a “walk in”.
3. The final exception is when the beneficiary calls the agent without a scheduled appointment.  This is a beneficiary-initiated call, therefore the 48 rule does not apply.

The CMS call recording requirements; learn more.

Ways to collect a SOA

Although the 48m hour rule was put in place as a way to protect beneficiaries, some may not like the inconvenience of having to meet twice to discuss their plan options. It is important to discuss the reason this rule is in place and let clients know you believe it is important to abide by the rules to maintain your integrity.

Please note; there is more than one way to comply with the 48 hour SOA rule.  Many carriers provide tools that allow agent to collect a voice scope.  Some Medicare FMOs also provide tools that not only provide voice scope tools but also call recording tools for voice enrollments.

Learn more about call recording requirements.

Of course, you can collect a paper scope if your client is willing to meet and sign at least 48 hours before your discussion.  You can also email the scope ahead and have the client send it back to you.  There are also tools such as Sunfire and Connecture that allow agents to send a link for clients to complete an online Scope before the meeting.

Watch our free Medicare training videos

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Medicare financial assistance

Aetna fitness reimbursement

Aetna has expanded their commitment to wellness by adding the Aetna fitness reimbursement benefit to some of their MAPD plans.  This benefit provides members of participating plans an allowance for activities or equipment for things such as; golf, pickleball, swimming, running, or even entrance fees for state and national parks.  Members can also use the benefit for fitness equipment such as athletic shoes, exercise mats, weights, wearable fitness trackers or any other equipment that helps them stay healthy.

Please note; this benefit does not cover expenses for fitness attire other than shoes.

Watch a quick video on Medicare advantage plans vs Medicare supplements

More about this benefit

Once the calendar year ends, you cannot roll over any portion of this benefit allowance.  This is a (DMR) direct member reimbursement, this means the member pays for the qualified item or activity up front and then submits the paid receipt to Aetna for reimbursement. Please make sure all fields are completed and receipts included before you send in the request to avoid delays in payment receipt.
If you are unsure if your plan offers this benefit,  either check the Evidence of Coverage for your specific plan or contact your broker to confirm this benefit as well as any other plan questions you have.

Learn the pros and cons of Advantage plans

Please note:  Members do not use the Fitness Reimbursement Form for reimbursement of benefits other than; fitness activity fees, or fitness supplies or wearable items.  Reimbursements  of any other expenses require a specific form for that purpose.

To determine if you should send in an item for reimbursement, make sure you can answer yes to the following 3 questions:

1.  Did you purchase this item or service this year to use this year?
2.  Is the item or service for your benefit/use only?
3. Do you have an itemized receipt for the items or services you are requesting the reimbursement for.  Please make sure the receipt includes the date of purchase, name of retailer, location of retailer and a description of the item as well as the amount paid.

How this benefit works

1.  The member pays up front for the qualified fitness-related services, activity fees or supplies from licensed provider or retail store.  They collect a detailed receipt that contains costs, date of purchase and payment method.
2. Plan member makes the request for reimbursement.  This can be done online at AetnaMedicare.com/Reimburse, once you are on the site, just follow the prompts and fill out the required form and upload a copy of your paid receipt.  If you do not want to fill it out online, you can either print out a copy from the website or request a form from the member services number on the back of your plan ID card. Please see below for more ways to submit your reimbursement.
3. Wait for your reimbursement to arrive.  Aetna will send members a check to reimburse them for qualified purchases.  Please allow up to 45 days to receive your payment.  Aetna must receive both the form and receipt within 365 days of the original purchase.  Allowance amounts do not roll over to the next calendar quarter or plan year.

To download a copy of the Fitness Reimbursement Form, click here

How to request the reimbursement

1. Members can go to AetnaMedicare.com/Reimburse or scan the QR code in this flyer.
2. You can either complete the form online or download, print and complete the reimbursement form and mail it to the claims address found on the back of your member ID card.  If you are requesting the reimbursement by mail, you should make a copy of your original documents; Aetna will not return them to you.

Please note:  any item you purchase from private, non-retail seller will not be accepted for reimbursement.  Plan members should always check their EOC for a full description of plan benefits, exclusions and limitations.

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Part D late enrollment penalty appeal

Medicare beneficiaries who don’t sign up for Medicare Part D coverage during their initial enrollment period and go for a period of 63 or more continuous days without creditable prescription coverage may incur a late enrollment penalty.  If the beneficiary receives an LEP and they believe it is in error, they can initiate a Part D late enrollment penalty appeal.

Once a beneficiary enrolls in a Part D plan, the plan notifies them in writing if it is determined that the enrollee has incurred an LEP.  If plan administrators believe the enrollee has had a lapse in creditable prescription coverage for a continuous period of 63 days or more. The enrollee receives an LEP Reconsideration Notice and LEP Reconsideration Request Form with the written notification.

Learn more about enrollment in Part D

Either the enrollee or their representative can ask for a review, or reconsideration, of the LEP.  The LEP reconsideration request form provides enrollees a list of circumstances when they can request a review.

LEP Reconsideration Notice

The Part D LEP reconsideration notice gives enrollees an explanation of their right to request a reconsideration of their LEP.  Sponsors of Part D plans must complete the notice and send it to the enrollee with the letter notifying them of the imposition of a Late Enrollment Penalty.

To download a copy of the Sample late enrollment penalty reconsideration notice – click here.

Reconsideration Request Form

Part D plan enrollees should use the form, “Part D LEP Reconsideration Request Form C2C” to request an appeal of the LEP decision. The enrollee completes the form, signs it and then send it to One of the options below:

If you are sending via standard mail; C2C Innovative Solutions, Inc., Part D LEP Reconsiderations, P.O. Box 44165, Jacksonville, FL 32231-4165

Sending by courier or tracked mail; C2C Innovative Solutions ,Inc., Part D LEP Reconsiderations, 301 W. Bay St., Suite 600, Jacksonville, FL 32202

You can also send either by fax to; 833-946-1912 or upload the form to the website https://www.c2cinc.com//Appellant-Signup.  Once you are on the website, you will need to create an account and follow the prompts from there.
If you have a friend, family member or doctor send the request, that person must be your representative. They can complete the last form in the reconsideration request form.   The form is fillable online or you can print it out and fill it from there.

Click here to download the LEP Reconsideration Request Form

LEP appeal process

The LEP appeal process is conducted by an IRE (independent review entity) that has a contract with Medicare. The IRE notifies the enrollee of the final LEP decision within 90 days of receiving the request.  This includes the dismissal of the request.

Please note:  If you receive Extra Help, you do not have to pay a Late Enrollment Penalty.  Click here to learn more about Extra Help programs.

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Medicare Part D 2024

In this post, we will discuss some important information about Medicare Part D 2024.

Medicare Part D plans cover the cost of prescription drugs for Medicare enrollees.  Private insurance companies offer these plans to beneficiaries.   In order to remain complaint, all plan providers must follow CMS’ rules.

Prescription plan costs

There are a few costs associated with Medicare prescription plan coverage.  One of those costs include the monthly plan premium, this amount can range greatly depending on the plan and carrier.  Beneficiaries can opt to have the premium deducted from their monthly Social Security payment.  If the beneficiary has a greater than average income, they may be subject to an IRMAA, an adjusted premium amount based on income.  The premium may also be adjusted for those who have a lower-than-average income and qualify for Extra Help.

Other costs associated with Part D prescription are co-pays and coinsurance amounts paid at the pharmacy.  Many plans also include an annual deductible.  In 2024, the maximum annual deductible has increased from $505 in 2023 to $545 for 2024.

For those who neglect to sign up for a Medicare Part D plan on time, a late enrollment penalty is added to the monthly cost.  The penalty applies to anyone who goes without creditable Part D coverage for a period of 63 or more days.  CMS applies the penalty for as long as the beneficiary has Part D coverage.

Changes for Medicare Part D for 2024 

Because of the Inflation Reduction Act that was signed into law in 2022, there will be changes to the Medicare Part D program.   One important change has to do with the cost Medicare beneficiaries pay for prescription drugs.

 Click here to learn about prescription drug caps

Here are some of the changes in place for 2024:

In 2024, Medicare PDP members who reach the catastrophic phase ($8,000 in 2024) will not pay any additional out-of-pocket costs for the remainder of the year.  This means they are no longer subject to a 5% copay.

PDP plans are no longer able to raise their premiums over 6% per year starting in 2024.

Beneficiaries who use insulin will pay no more than $35 for a 1-month supply for covered insulin brands.  It is important to check your plan’s formulary to confirm which brands they include.  This pricing is in effect until the end of 2025.

Medicare covers many adult vaccines at no cost to Medicare beneficiaries.  this includes the Shingles vaccine as well as TDAP (tetanus vaccine), Covid, flu vaccine, Hepatitis A and many others.

More Medicare beneficiaries will qualify for Extra Help to pay for their health care needs in 2024. This is because beneficiaries with an income of up to 150% of the federal poverty level (up from 135% in 2023) may be qualified for the Part D Extra Help.  This program pays the Part D annual deductible, monthly premium and ensures beneficiaries pay a lower cost for generic and brand name drugs.

A few changes to prescription drug plans in 2025 and 2026

In 2025, one of the changes to the Part D program is a $2,000 out-of-pocket maximum in place for PDP beneficiaries.  CMS is also starting a prescription payment plan program.  The program is referred to as “smoothing” and begins Jan 1, 2025.  This program gives beneficiaries an opportunity the spread out the cost of prescription medications out over the year by using a payment plan.

Click here to learn more about the prescription payment program

In 2026 price negotiations will begin for expensive drugs that have no generic alternatives.

Learn the details of the price negotiation program

To view a comprehensive guide to all the ins and outs of Medicare for 2024, click this link and  download a copy of CMS Medicare and You handbook for 2024.    Information on Medicare Part D starts around page 79.

Watch a quick YouTube video on the drug cap proposed for 2025

Take a look at some of the other compliance updates CMS has in place or has proposed for agents :

Watch a quick YouTube video on the CMS proposed rule CMS 4205-P an how this could effect our business

Find out more about the 2024 CMS call recording requirements

Make sure you are up-to-date with the SOA rules – click here and learn more

Take a look at our video on TPMO rules for 2024

If you are unsure of the differences between an educational event and a sales event, click here.  You may also want to read our blog on “Things you can’t say when selling Medicare“.

If you already have a contract with Crowe and want to add a carrier, click here

Agents who want to join the team at Crowe, click here for online contracting

Please note: agents who offer Medicare Part D plans need to complete annual carrier certifications as well as AHIP before they can offer the plans.  AHIP is an annual certification that CMS requires.  It includes marketing and compliance guidelines as well as FWA laws.

If you don’t follow the Medicare marketing rules, you risk losing commissions, termination of your contracts, losing your license and receiving fines.

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How to get a replacement Medicare card

If you find yourself in need of a replacement Medicare card due to loss, damage, or a name change, the process is straightforward. We will go over the process to get a replacement Medicare card, ensuring you have access to your necessary healthcare information when you need it.

Find out about Medicare premiums.

The importance of a Medicare card

Before we dive into the replacement process, it’s essential to recognize the significance of your Medicare card. This card contains valuable information, such a as your Medicare number as well as the effective dates of your Part A and Part B coverage. Beneficiaries need to have access to it as proof of Medicare coverage when they require necessary medical services. Whether you’ve lost your card, or it’s been damaged, it is important to obtain a replacement card quickly.  This will help enrollees maintain their access to healthcare.

Ensure eligibility

If you are eligible for Medicare but have not enrolled yet, you need to complete the initial enrollment process before you request a replacement card. Once you complete your initial enrollment, you will receive your card within a few weeks.

Click here to learn about Medicare enrollment periods.

Ways to obtain a new Medicare card

There are a couple different ways to obtain a replacement Medicare card.  Because of this, beneficiaries can choose the method that they are most comfortable with. The two ways to get the new card are:

Online:

Beneficiaries can log into their personal account on the official Medicare website www.medicare.gov.  Once they are logged in, it is easy to follow the prompts and request the replacement card. This method is convenient and typically provides a quicker turnaround. Beneficiaries can print an official copy of their card from their online account to retrieve an immediate copy.

Over the phone:

To request a replacement card over the phone, contact Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778). Beneficiaries need to have their Medicare number as well as other pertinent information to verify your identity.

Provide necessary information

No matter what method you opt for, you need to provide personal information to verify your identity and facilitate the replacement of your card. It is imperative that you use only official channels to request the new card.  Medicare will need details such as your full name, Social Security number, date of birth, and even your Medicare number to verify your identity before they can process the request.

Confirm Your Address

Because Medicare will send the replacement card to the address on record, it is important to make sure you update your current address in the Medicare system if you move.  Keeping your records up to date will ensure you receive your new card a quickly as possible.

Learn the difference between Medicare Advantage and Medicare Supplement plans – watch a quick YouTube video

Be Patient

Once you submit your request your replacement card, it will take time for the request to be processed and sent out to you. The time required to process the request will vary depending on how busy the Medicare office is, so you need to be patient while you wait for the Medicare card to arrive.

Obtaining a replacement Medicare card is a straightforward process.  Following these steps and keeping your information current, will ensure the process is smooth should you need a replacement card.

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Wellcare prescription plans

Because the ability to access affordable prescription medications is crucial to maintaining good health, beneficiaries must be aware of all their options.  In order to help individuals make an informed decision, we will discuss some benefits of the WellCare prescription drug plans.

Important; CMS has guidelines in place to regulate the types of medications that prescription drug plan providers must cover.  This includes a minimum standard of benefits for providers to follow. The formulary for each plan Each plan meets the requirements as required by law. Because each plan differs, the cost and drugs included in the formulary can vary.

Find out about the Medicare drug price negotiations

Although Wellcare offers three different plan choices, it is important to review each plan formulary and make sure it provides coverage to fit the prescription needs for anyone considering enrollment.

The three Wellcare PDP plans for 2024

Some features of the Wellcare prescription plans

Wellcare has no or low premium plans available to provide coverage for individuals who qualify for Extra Help.  These plans are available in all states and offer low or no copays when enrollees purchase prescriptions from preferred pharmacies.

Some Wellcare plans include no deductible, so plans cover prescriptions on day one.

Wellcare has a nationwide network of preferred pharmacies that includes thousands of national, regional and local pharmacy chains. It also includes grocers and independent pharmacies as well.  These relationships help plan members save money on prescription drugs.

Use this link to the Wellcare preferred pharmacy tool and find a local in-network pharmacy.

Find a preferred pharmacy tool to find a local pharmacy.

The member service representatives are available either online at wellcare.com/PDP or by phone at 866-822-1339 (TTY – 711) during the hours of 8am – 8pm EST Monday – Friday. They can provide answers to members coverage or medication questions.

If you want to view the plan formulary (complete list of drugs each plan covers), visit Wellcare’s website or contact their member services department.