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2024 CMS call recording requirements

Because there are strict regulations for selling Medicare, the 2024 CMS call recording requirements is a very important subject.  Due to some confusion among sales agents, CMS has clarified that agents must record only marketing , sales and enrollment calls in the their entirety,

Additionally, CMS will require agents to record any virtual/video or other telepresence calls for enrollment, marketing, or sales.

If you are calling to schedule an appointment, invite someone to an event or see if they received materials or have questions, you do not need to record the call.

Effective October 1, 2023;  all third party Medicare marketing for calendar year 2024 must contain the following disclaimer:

“We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov,1–800–MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”

2024 CMS call recording requirements – A few more updated rules (not about calls) for anyone who offers Medicare plans:

Click here to view a more details of the Medicare final rule for 2024

There will now be restrictions on appointment planning at educational events

Agents cannot collect SOAs or schedule appointments during an educational event.  You may however, collect permission to contact forms as well as business reply cards (BRCs).  The distribution of business cards is also permitted.

You may not schedule a marketing event in either the same location, building or adjacent buildings within a 12 hour time period of an educational event.

See more rules for health plan marketers 

Time limits for SOAs & BRCs

Any SOA or BRC you collect is now valid for a limited time; 12 months from the date of the beneficiary’s signature.  Once the time limit has expired, you must collect a new scope or  PTC form.

SOAs must be collected 48 hours before a scheduled sales meeting

Yes, the 48-hour SOA (scope of appointment) rule is back in place.  However, there are a couple Exceptions to this rule.

1.  If the beneficiary is 4 days or less from the end of a valid election period.
2. Walk -in (un-scheduled) meetings initiated by the beneficiary

Need help with AHIP – view our test tips on YouTube

Learn about pro-rated Medicare commissions

How does Medicare work with employer coverage?

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What is a pro-rated Medicare commission

Medicare commissions are an integral part of the healthcare insurance industry.  That is why, understanding what is a pro-rated Medicare commission is something that is important for Medicare agents.  Pro-rated Medicare commissions help ensure that both agents and brokers receive fair compensation.  We will explain a little about what pro-rated commissions are, how they work, and why they are important.

What is a Prorated Medicare Commission:

A prorated Medicare commission refers to the proportional payment that an agent or broker receives for enrolling individuals in either a Medicare Advantage or Medicare Part D prescription drug plan.  Once an agent submits an application for a beneficiary, the agent receives commission.  The amount of commission is based on the number of months the enrollee remains active in that specific plan.

How Does Pro-rated Commission Work:

Pro-rated commissions are based on the principle of fairness.  Agents/brokers receive a portion of the total commission for each month an enrollee remains on their plan. This is done instead of receiving the full commission upfront. This payment structure helps agents avoid chargebacks for unearned commissions.  This structure also motivates agents to provide on going support to clients and ensures they retain their book of business.  Once the initial enrollment is completed, if an agent provides continuous assistance, education and support to a client they are more likely to remain with that agent/broker.

To view more details on commission payments, click here

How do you Calculate a Pro-rated Commission:

To calculate a prorated Medicare commission, simply divide the total commission amount for a specific enrollment by the number of months the enrollee stays active in the plan. For example, if the total commission is $600 and the enrollee remains active for 10 months, the agent or broker would receive $60 each month.

Benefits for Beneficiaries:

Pro-rated Medicare commissions indirectly benefit beneficiaries by encouraging agents and brokers to maintain an ongoing relationship. In other words, beneficiaries have access to a reliable resource to guide them through plan changes, answer their questions, and assist with any issues that may arise during the coverage period.

Agent-Beneficiary Relationship:

Pro-rated commissions foster stronger relationships between agents and beneficiaries. Agents have a vested interest in delivering high-quality customer service, ensuring that beneficiaries have a positive experience throughout their Medicare coverage. Beneficiaries can rely on agents for personalized advice, plan comparisons, and assistance in navigating the complex Medicare system.

To sum it up, pro-rated Medicare commissions are a fair and transparent compensation structure for agents/brokers who enroll individuals in Medicare plans. By aligning incentives between agents and beneficiaries, prorated commissions contribute to better long-term relationships, ongoing support, and improved customer experiences. For individuals seeking Medicare coverage, partnering with an agent who receives prorated commissions can be a valuable resource for obtaining guidance and assistance throughout their healthcare journey.

Click here to view a YouTube video on Medicare commission payment details

If you are an agent looking to work with an FMO, click here and see what we can do for you.

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Does Medicare Cover Hospice ?

How to Qualify for Hospice Care:

Your clients qualify for hospice care if they have Medicare Part A and meet the following conditions:

• A hospice doctor (and regular doctor if applicable) certifies that they are terminally ill (defined as a life expectancy of 6 months or less).

• They accept comfort care (palliative care) instead of continuing to try to cure the illness.

• They sign a statement choosing hospice care instead of other Medicare-covered treatments for the terminal illness and related conditions.

Your clients can usually get Medicare-certified hospice care in their home or other live-in facility like a nursing home. They can also get hospice care in an inpatient hospice facility.

What is Hospice Care:

Depending on the terminal illness and related conditions, a hospice team will create a plan of care that can include any/all of these services:

• Doctors’ services.

• Nursing and medical services.

• Equipment for pain relief and symptom management.

• Medical supplies.

• Drugs for pain and symptom management.

• Aide and homemaker services.

• Physical therapy services.

• Occupational therapy services.

• Speech-language pathology services.

• Social services.

• Dietary counseling.

• Spiritual and grief counseling for you and your family.

• Short-term inpatient care for pain and symptom management.

• Inpatient respite care, which is care provided in a Medicare-approved facility (like an inpatient facility, hospital, or nursing home), so that the usual caregiver can rest.

• Any other services Medicare covers as the hospice team recommends.

What it Costs in Medicare:

• Clients pay nothing for hospice care.

• Clients pay a copayment of up to $5 for each prescription for outpatient drugs for pain and symptom management. In the case the hospice benefit doesn’t cover a drug, the client’s hospice provider should contact the Medicare plan to see if Part D covers it.

• The client may have to pay for board if they live in a facility and choose to get hospice care.

• To learn more about what is covered under Hospice Care, visit Hospice Care Coverage.

Find out what Medicare covers

Click  here to learn 5 things Medicare does not cover.

If you would like more information on Medicare enrollment, you can find it at Medicare.gov.

Already a licensed Medicare agent?   Click here to contract with a better FMO.

2023 Medicare Advantage commissions

Any agent who offers MA plans this year, will be interested in the 2023 Medicare Advantage commissions.  We are happy to announce that commission for bot MAPD and PDPs have increased again this year.

The commissions are still divided into 4 areas as follows:

1.  In CA and NJ, the initial MA commission has increased by 4.9%.  Last year, commissions for initial enrollment was $715 per member annually.  This year the commission is $750 per member.  The renewal commission rate has also increased by 4.75% for 2023.  This means,  renewal commissions have increased from $358 per member annually to $375 per member annually.
2. The states of CT & PA as well as DC have had 4.95% an increase in commissions for 2023.  This means in 2022 the initial enrollment MA commission  was $646 annually per member and is now $676 per member.  Renewal commission rates  have increased from $323 per member annually to $339 per member annually.
3. In both Puerto Rica and the U.S. Virgin Islands, an increase of 4.31%  over last year is in place.  Last year the initial MA commission rate was $394 per member and it is now $411 per member.  Renewal commissions in these areas have been raised by 4.75% brining renewal payments from $197 per member to $206.
4. Nationally (all other states not listed above), a 4.89% increase has been implemented for initial MA enrollments.  This brings initial MA commissions up from $573 annually to $601.  Renewal commissions have increased by 4.88%, this means commissions have gone up from $287 per member to $301 annually.

Click here to watch our YouTube on commission payment details

Part D commission increase:

There has been an increase of 5.75% for an initial enrollment in a Part D plan.  This means; commissions have gone from $87 annually per member to $92 per member.

Additionally; renewal commissions will increase by 4.55% annually from $44 per member to $46 per member.

Do you need E&O; click here to get coverage for as low as $301 per year!

Read the official CMS  announcement on the increase.

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