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CMS has strick regulations in place for anyone offering Medicare plans over the phone. Agents who do not adhere to the rules could face strict penalties. Penalties can include; loss of contracts, monetary fines and damage to your professional reputation. To ensure compliance and build trust with potential enrollees, here are some tips for conducting compliant Medicare phone sales.

Obtain permission to contact

CMS rules strictly regulate how and when agents can contact potential enrollees. If you are calling about Medicare Advantage or PDP plans, to remain compliant; be sure to have documented permission to contact before making outbound calls. Do not cold call or use leads that did not provide consent for the call. Follow all CMS guidelines regarding unsolicited communications, this includes text messages and voicemails.

Comply with Do-Not-Call (DNC) regulations

Agents must respect consumer preferences regarding contact. To comply; make sure you use phone leads that are cross checked with the National Do-Not-Call Registry. Even when you do this, keep in mind the FTC updates the list constantly and you face a fine if you contact someone who is on that list.

Use approved scripts and disclosures

When discussing Medicare plans, agents must adhere to CMS-approved scripts and include required disclaimers.

Agents must clearly state that they do not represent or work for Medicare, but rather the specific carriers and plans they are contracted with. There are standard disclaimers that must be read to prospects. This includes: “We do not offer every plan avialable in your area”. It is always important to provide acurate plan information and do not mislead or pressure the consumer.

Watch a quick YouTube video on updates to the one-to-one consent rule

Avoid prohibited sales tactics

Medicare has strict guidelines against high-pressure sales tactics. Agents should not mislead beneficiaries into thinking they must enroll in a plan immediately (high pressure sales). They must not make unsupported claims about plan benefits or when comparing plans. Always allow the prospect to ask any questions they have and be sure they understand what is said.

Follow call recording and documentation rules

CMS requires that all Medicare Advantage and Part D sales calls be recorded in their entirety. In order to be complaint; calls must start with a disclosure that the conversation is being recorded, the prospect must give permission for this.

Agents must keep call recordings for a period of no less than 10 years as required by CMS and the carrier. It is important to document all client sales interactions; this protects both the agent and the client. A SOA is an important part of this process.

The SOA (Scope of Appointment)

When conducting a Medicare sales call, agents must adhere to the agreed-upon topics. Do not discuss additional products that are not included in the SOA. If the client wants to talk about other products, you must collect a new SOA that covers them. In order to be compliant, agents should keep the SOA for a period of 10 years.

Learn more about SOAs

Provide clear and accurate information

Misinformation or omitting critical details can lead to compliance violations. Make sure you know what the beneficiary is looking for. Discuss current coverage, doctors, medications and their needs and budget.

To maintain integrity, explain benefits, costs and network limitations clearly. Ensure enrollees understand the differences between the plan types (Medicare Advantage, Supplements & PDPs).

Ensure post-enrollment compliance

Your responsibility does not end after enrollment. To ensure your client is happy with their choice, make followup calls and discuss any questions or concerns they have. Make sure they understand their new plan benfits and how to use them. This helps keep clients happy and also helps avoid rapid disnerollments and chargebacks.

If you are ready to join the team at Crowe; click here for online contracting

Staying compliant in Medicare phone sales is crucial to protecting consumers and maintaining your credibility as an agent. By following CMS regulations, using approved scripts, and respecting consumer rights, agents can foster trust and ensure ethical sales practices. Always refer to the latest CMS guidelines or seek guidance from a your upline.

Selling Medicare Advantage over the phone

Selling Medicare Advantage over the phone is becoming the most common approach with agents.  While there certainly are many agents selling face to face, phone sales has grown in popularity.  The business was trending this way but has been accelerated by COVID.

Read below to learn how to start making sales without face to face meetings.

Looking to get contracted with Medicare carriers?  Use our online contracting link to get started

General concepts and things to know when getting started

There are some basics people need to understand when selling Medicare Advantage over the phone.  For those that have already been selling Medicare on a face to face basis, phone sales can be a big adjustment.  In part, this is due to the difference in closing ratio between face to face and phone.  To a degree, it can be easier to get started with phone sales for those that have not sold face to face in the past.  The challenge for the new agent, not familiar with Medicare is learning the benefits and rules. (of which there are many)

Selling Medicare Advantage over the phone:  The positives and negatives

Selling by phone has some major advantages.  A phone sales agent is able to solicit and work more leads than a face to face agent.  They are not spending time on the road or engaging in long conversations in the office.  As a result, they can talk to many more people in a given day. The drawback is the closing ratio will be much lower by phone than it will be face to face.  An agent selling face to face may close 80% or higher.  The best case scenario for a phone sales agent is 20% but even that would be on the highest end of the scale. In other words, a phone agent must be able to accept failure much more often.  The benefit is they can speak to far more people in a day.

Types of leads for phone sales

Leads are essential with phone sales.  Without lead volume, the agent is going to be sitting around a lot and not making money. There are certain types of leads that work best when selling Medicare advantage over the phone.  The lead types most commonly used with phone sales are:

• Inbound call leads
• Warm transfer leads
• Call back recorded leads
• Online or data leads

We have leads available through LeadStar:  Click to learn more

Other lead types such as mailers can be used for phone sales but are not as efficient. Make note, there are subtle differences between the call leads but the process to work them is the same.  Online leads of any type are a different set up and approach given the nature of them.

Importance of tracking leads to determine a CPA

When working any of type of leads for phone sales, it is critical to track results.  Many agents focus on the cost per lead (CPL) vs. the cost per acquisition (CPA).  Some agents may shy away from certain leads due to the price.  At the end of the day, what really matters is how many of them you close for the cost.  If I am getting call back leads at $12 each but I only close 1 out of 20 vs. a $40 lead and you close 5 out of 20, the CPA comes out better on the $40 lead.    Tracking all results is the only way you can determine which lead type is giving you the best CPA.

Selling Medicare Advantage over the phone:  Set up to sell

The set up is different for phone vs. online lead sales.  We will focus on the phone set up and what agents need to do in order to start taking in leads and working them effectively.  The basic steps are listed below:

Access to Medicare plan quoting comparison and enrollment platform

Agents need to be able to quickly quote and compare plans when talking with prospects.  They need to be able to see all available plans in a given area side by side and be able to see the benefits of each.  It is important to see benefits amounts for things like dental, vision, OTC, grocery and Flex cards.  Sunfire, MyMedicarebot or Connecture are the 3 most common platforms agents work with.  CSG also offers the ability to quote and compare but the system does not have the ability to check medications, save profiles or enroll prospects.  Many agents still us the Medicare.gov plan finder.  The system works but profiles can only be saved if the client creates one.  More importantly, if the member self enrolls the agent does not get listed as the AOR on the case.

Enrollment platform

Being able to enroll the members is obviously important.  Medicare enrollments can be completed by voice signature or sending an enrollment link by text or email.   Luckily, the quoting and comparison platforms also have an enrollment function

The 3 most commonly used systems to address this are Sunfire, Connecture and MyMedicarebot.   Crowe and Associates gives agents access to all 3 platforms at no cost to the agent.

CLICK HERE TO LEARN MORE ABOUT ENROLLMENT PLATFORMS

Selling Medicare Advantage over the phone:  Call script

It is common for someone to focus on the idea of a set call script.  In reality, there is not one script for calling all lead types.  The script will vary slightly depending on the type of lead being called. (call back, warm transfer, live transfer, online)  The overall concept is the same for all of them however.  There are some basic skills that any good call agent will have.  Watch the video below and and access the blog for more details on the script.

CLICK FOR CALL SCRIPT MEDICARE

Do you need a CRM?

This question comes up very often.  A CRM is needed to track progress, call back prospects and also help automate other functions such as emails and social media posts.  The 3 enrollment systems in Connect4Medicare all have basic CRM functions that will save client data and allow to schedule call backs.    Many agents run successful practices using the basic functions of the built in CRM’s.  For those looking for a CRM with more functionality, there are a number of systems out there but they will come at a cost.   We have experience with a number of them.   Most notably they are Blitz, Radius Bob, Less annoying CRM and Go High Level. There certainly are many more however.

Read a review of most commonly used insurance CRM systems

Selling Medicare Advantage over the phone:  $500 a month toward lead costs

We give agents $500 a month toward lead and marketing costs.  Click the link to learn more

$500 a month lead and marketing plan for agents

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How to sell Medicare plans over the phone

It is not difficult to learn how to sell Medicare plans over the phone.  We will provide the blueprint in the article below.   If you do not have experience in Medicare sales, there are some steps to take prior to starting.

You will need a health insurance license to sell Medicare plans

Click here to see the steps to get a health insurance license

Starters guide for Medicare Contracting

After you have an insurance license, there are steps to take for contracting and certifications.  Use the link for step by step instructions.   Medicare contracting and certifications guide

How to sell Medicare plans over the phone- The set up

There are a number of ways to sell Medicare plans over the phone.   The most obvious option is to get set up as a call center/telesales agency.  While this set up can ultimately work very well, there are some obstacles to doing it which are time and cost.  Call scripts will need approval by the carriers. All calls will need to be recorded as well. The other negative is the cost to start the call center.  Those with funding and time to invest should call us to discuss the call center option further at 203-796-5403 or email Edward@croweandassociates.com.    For most people we will suggest a different approach.

Selling by phone in conjunction with online enrollment

A quicker and less expensive way to start is selling over the phone and processing enrollment online. The online enrollment function is available at no cost through our online enrollment portal Connect4Medicare  (C4M)  C4M provides agents with their own approved enrollment website and consumer facing URL.  Agents and prospects can quote and compare plans, run drug comparisons, search doctors and enroll prospects online without a face to face meeting.  The agent can enroll the prospect or the prospect can self enroll through the link sent to them by the agent. You can text or email the enrollment links.  CLICK HERE TO LEARN MORE ABOUT CONNECT4MEDICARE   Under this set up, agents can talk to prospects over the phone and then email or text them the link to complete the enrollment.

How to sell Medicare plans over the phone: Generating lead volume

You will need to generate prospects to try to close so figuring out the method to use is important.  There are a number of ways to do this but we will focus on two of them here.

Telemarket leads:  There are companies that will generate leads by phone at a set price per lead.  The calls are recorded and the information is sent to the agent to close the sale.  We have worked with a vendor to offer one of the best prices for teleleads.  With call back leads at $10.00 and live transfers at $16.00 a large amount of volume can be generated at a low cost.  CLICK HERE TO LEARN MORE

Online leads:  Online leads are also a good way to generate prospect volume at a low cost.  You can get online leads for $8 to $15 each depending on the lead aggregator/lead company.  Shared and exclusive leads are available but we suggest using shared leads due to the high price point of exclusive leads.

CLICK HERE TO LEARN MORE ABOUT USING ONLINE LEADS

We offer a free lead program to help off set your lead costs- Learn more about the Crowe and Associates Free Medicare Lead Program

How to sell Medicare plans over the phone: Other important things to know

Having the correct set up for phone sales is important but organization is also key. As a result, it will be important to have a good CRM. Connect4Medicare is a basic CRM but we suggest having your own in order to stay organized.  It will be important to keep all prospects in your database, schedule return calls and keep notes on each call.   In addition, you need to have a scheduled routine every day.  How many leads will you work? What time will you be contacting new prospects vs. calling existing prospects you are working with?   Other things to consider are: How much money will you have in your daily lead budget?  Do you have access to all competitive plans in the area/states you are working?   Thought and preparation is needed in order to be successful when starting any type of phone sales.

WORK WITH ONE OF THE NATION’S TOP FMOs.  CLICK HERE TO GET STARTED.

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