48 hour scope of appointment

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.

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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.

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