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Medicare agent sales training

As the demand for Medicare coverage continues to grow, the role of Medicare agents becomes increasingly important. For that reason, Medicare agent sales training is crucial. Agents need to be prepared to provide guidance for beneficiaries to ensure they receive the health care coverage that fits their needs and budget.

There are various training programs available to equip agents with the necessary knowledge and skills. Agents need to take in a lot of information including; rules, contracting, benefits, quoting, certs and much more.  We will discuss some of those things below.

Initial Training Programs

Newer Medicare agents require comprehensive initial training programs.  These programs should provide a solid foundation of the Medicare system including eligibility, coverage options and enrollment periods as well as how they work together.  We provide a weekly zoom training for all our newer agents that need the extra time to get up and running.

Product-Specific Training

Because there are so many coverage options for Medicare beneficiaries,  including Original Medicare, Medicare Advantage (Part C), and Medicare Prescription Drug Plans (Part D), agents need product-specific training. This training ensures that agents are well-versed in the details of each plan, allowing them to match individuals with the most suitable coverage.  Each carrier provides it’s agents with product training opportunities.  We also offer training when a new product that shows potential is introduced into an area or if agents show an interest in learning more about a specific product.  Agents can either join one of our weekly zoom meetings or webinars or find information on our website or YouTube channel.  You can find links to this information on our website, just click on the link below.

Click here to view our updated Events and information post

Annual Training and Updates

Given the dynamic nature of  Medicare coverage options, agents must undergo annual training and updates. This ensures that agents stay current with any changes to Medicare regulations, coverage options, and compliance standards.  Agents can get helpful tips on the annual AHIP training on our YouTube channel as well as updated CMS regulations for Medicare sales.

Technology Training

Because technology is always advancing,  agents need updated tools and technology to remain competitive.  That is why we provide both Sunfire and Connecture for quoting and enrollment to our agents at no cost.  We offer one-on-one training and video instruction to agents who want it. These tools offer a built in CRM as well as the opportunity for agents to record their sales calls and remain compliant. Our technological resources enhance the agent’s ability to serve clients effectively.

Visit our YouTube channel and watch some free training videos on any of the above subjects you have questions about

Ethical and Compliance Training

Ethics and compliance are a big concern in the insurance industry. Agents undergo annual training on ethical sales practices and conduct, as well as updated regulatory requirements. This training ensures that agents operate with integrity and in accordance with industry standards.  Our zoom meetings and webinars often focus on updated CMS regulations to ensure our agents maintain their compliance.  All our informational webinars are recorded and put up on our YouTube channel.

If you want to join our team, click here for online contracting

Sales Skills Training

Many agents appreciate training programs that help focus on honing sales skills.  This training teaches agents how to educate clients, address concerns, and facilitate informed decision-making.  Some training programs we offer focus on different types of approaches and opportunities agents can use to generate sales.  Because each agent is an individual, we offer calls or meetings to discuss different approaches agents can use to generate sales.

Networking and Business Development Training

Agents require training programs that go beyond the technical aspects of Medicare.  They need guidance to building a successful business. This includes strategies for networking, lead generation, and business development to help agents establish and grow their client base.  We provide agents with information and guidance on lead programs as well as how to host sales events and much more.

Learn how to generate Medicare referrals

The landscape of Medicare agent training is diverse, this reflects the multifaceted nature of the Medicare business. Whether it’s mastering the benefits of Medicare plans, staying compliant with regulations, or developing essential sales skills, ongoing training is a must for Medicare agents.  This helps ensure they provide high-quality service to their clients.

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How to get more Medicare referrals

Agents who generate a steady stream of referrals not only build their client base but also establishes their credibility in the industry.  We will go over how to get more Medicare referrals with a few ways agents can build their referral network and achieve sustainable growth.

Build good relationships with your existing clients

Agents who put in the effort to ensure their clients are happy with their coverage choices can easily earn referrals.  In order to ensure clients are happy, agents must be in contact with their clients and go over new plan options each year during the AEP.  Agents should use a good CRM to keep client information up to date.  This includes a list of their current doctors and medications so you can quickly update it each year when you run a plan comparison for AEP.

Watch a YouTube video on Sunfire and Connecture our quoting and enrollment tools

Collecting your clients email and phone number can be a good idea.  This way agents can send out a mass email that contains any pertinent information for your clients.  The phone numbers are useful not only to contact your clients in general but can be used as a tool if they want to opt in and receive text messages from you.

They also need to be available when a client calls with a coverage question.  If a client has confidence in the service they receive, they are more than happy to tell friends, neighbors or anyone else who asks.  This a very valuable source of new business.  It is also ok to ask clients for referrals, just find a way that is comfortable for both you and the client.

Click here to watch a quick YouTube video on AEP marketing rules

Establish relationships with local healthcare professionals

It is a great idea to introduce yourself to healthcare professionals, doctors and clinics in your area.  Once they know you and are aware of the service you offer, you can create a partnership. Establishing a good relationship with healthcare providers can open doors to a continuous stream of leads. Volunteer to attend healthcare events, workshops, and seminars to connect with providers who may refer individuals seeking Medicare coverage. Position yourself as a reliable and knowledgeable resource for their patients’ needs.

Build a strong social media and online presence

In today’s digital age, a strong online presence is essential. Agents should consider creating business profiles on social media platforms.  Once the profile is created, it is important to maintain the the platform with any pertinent information potential clients may find valuable.  Information about Medicare options and answers to common questions are a couple things to post on your platform to engage your audience. An online presence not only helps you reach a broader audience but also positions you as an expert in the Medicare field.

See how we can help you build an insurance website

Host free educational workshops

Host workshops or webinars to educate the community about Medicare coverage options and changes. If you provide valuable insights into the complexities of Medicare, you will gain status as a valuable resource.  Anyone who attends may be more inclined to refer friends and family to you when they are looking for guidance on their Medicare choices.

Want to learn the best practices for educational seminars, click here

Offer Referral Incentives

Create a referral program that rewards clients and other individuals for referring new clients to you. Incentives for clients can include a gift card or anything appropriate with a value of $15 or less. It is important to be complaint when offering referral gifts. By acknowledging and appreciating referrals, you encourage your existing network to actively promote your services.

Referral gifts for another agent or business professional (ACA agents, P&C agents, Medicare agents not licensed in a particular area) can be a cash payment of up to $100 per sale.  It is important to remember to pay them this so they will be more likely to refer other clients to you in the future.  Please note:  in most cases, financial planners cannot accept the referral gift.

Collaborate with Local Businesses

Explore partnerships with local businesses that cater to the senior population. Establishing connections with senior centers, fitness clubs, or retirement communities can be mutually beneficial. These businesses may refer clients to you, and in return, you can refer clients to them for services.

Find a FMO that will help you reach your full potential

Stay Informed

Because Medicare plans change each year, it is important to stay informed on any updates and adjust your strategy accordingly. Be sure you are up to date on compliance rules and attend product training sessions, workshops and conferences regularly.  This is a good way to build relation ships with broker managers and other agents in the industry who may send you a referral if they have a beneficiary who needs an advisor.  An informed and well known agent is more likely to attract referrals from clients and other professionals.

Click here for AHIP test tips

As a Medicare sales agent, building a large referral network is essential if you want to achieve long-term success. By focusing on client satisfaction, and following the other suggestions noted above, you can build a successful referral-based business that continually brings in new clients and opportunities.

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Humana Vantage login

Medicare agents who contract to offer Humana Medicare plans should make sure they have a Humana Vantage login. Vantage provides access to several helpful tools that will make it easy to find answers to both agent and client questions.

How to access Vantage

You need to be contracted to sell Humana and have your writing ID before you can access Vantage.  Once you are ready to go, visit the Humana website.  Once you are on the site, click sign in on the top right corner of the screen and enter your username and password.  If you forgot your username or password, click the links below the sign in button and reset either one.

Contract with Crowe to offer Humana Medicare plans, click here

Are you a new to the Humana Vantage site

If this is your first time on the site, just click activate online profile to follow the prompts to get set up.

There are several sections on the Vantage home screen.

Licensing, Certification and Contracts

Licensing, Certification and Contracts lets agents know what their current status is for all Humana licensing and certifications.

Education

Agents can find a link to the Humana MarketPoint University (aka HMU) in the Education section.  In MarketPoint University, agents can complete certifications and courses as well as find training webinars and job aids.

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Medicare prescription payment plan

The Medicare prescription payment plan is also referred to as “smoothing“. This is a way to help Medicare beneficiaries pay for the high cost of prescription medications.  The Medicare prescription payment plan is one small part of the inflation reduction act of 2022.

Watch a quick YouTube video on potential changes to commissions in 2025

When will the program start

In 2025, Medicare Part D (PDP) plan enrollees have a chance to opt for a prescription payment program.  The plan will help beneficiaries pay out-of-pocket costs for prescriptions.  Everyone in a PDP plan has a chance to enroll in the payment program, it is not based on income.  Enrollees have the option to enroll before the plan year starts or during any month of the year.   Please note, the payment plan does not include plan premium payments.

Here are some of the details

Participation in the Medicare prescription payment plan is optional.  PDP plan enrollees must choose to be part of the program.  Once an enrollee joins the program, and has out-of-pocket prescription costs, they receive a monthly bill to cover those costs.  Any out-of-pocket costs for prescriptions are included even during the deductible phase of PDP coverage.  There is no minimum out-of-pocket amount required before anyone can join.  Participants receive a monthly bill as long as they remain part of the program.

How is the monthly payment amount decided

There will be an annual cap of $2,000 on out-of-pocket costs in 2025.  The amount each beneficiary pays for their monthly plan depends on a few different factors.  It is not as easy as dividing $2,000 over the course of 12 months.

Learn more about the Part D drug cap

1. The Medicare prescription payment plan will deduct the out-of-pocket amount beneficiaries have already paid before enrollment in the program.
2. Any remaining costs are then divided by the number of months left in the year.

CMS will create a payment calculator so Part D beneficiaries can decide if enrolling in the payment plan is a good idea or not.

CMS is still working out the details of this program

We do not know exactly how the prescription payment program will work yet because the details have not been finalized by CMS yet.  We will post additional details as they are available to the public.

Please note:  This program is set to start in 2025, the same year the annual drug cap will be set at $2,000.  In other words, no Part D enrollee will pay more than $2,000 out-of-pocket for their prescriptions.

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Medicare scope of appointment rules

The Medicare scope of appointment rules are put in place by CMS.  The SOA (scope of appointment) is a form that clients or potential clients as well as their agent must complete before meeting to discuss Medicare plan options. The scope is mandatory if you are discussing either a Medicare Advantage or Part D prescription drug plan. Although, it is a good idea to collect a SOA before any client meeting to protect both the agent and the client.  The SOA form should be kept no less than 10 years and may be collected either physically, verbally or electronically.

Watch a quick video on the scope of appointment rules for 2024

Verbal scope of appointment

When the pandemic began, it was not advisable to host in-person meetings to discuss coverage options.  Because of this, many appointments took place over the phone.  That lead to the use of verbal scope of appointments which are recorded and saved.  Many carriers offer this option as well as quoting/enrollment tools such as Sunfire and Connecture.

Click here to watch a Sunfire enrollment demonstration on YouTube 

General information about a verbal SOA

• If the client calls the agent (inbound call), the 48-hour rule does not apply.
• The scope is good for 12 months from the date it is signed.  You must complete the appointment within that time or obtain a new scope. The scope is still good if the call drops and the same agent calls the client back.
• If additional benefits are added to the discussion, a new scope is necessary.

How long is a SOA good for

As we mentioned above, a scope of appointment is good for 12 months from the date it is signed. It is important that you discuss only products that were agreed to and included in the scope.  If additional products are added, the beneficiary needs to sign a new scope.

If the client asks about Medicare Advantage plans during the 48-hour waiting period and they had not included them on the original scope, you will need to have them sign a new scope before your discussion.  This will restart the 48-hour waiting period and may move your meeting date out further.  This rule applies to any product regulated by CMS.

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CMS guidelines

In order to be complaint with CMS, agents need to have their clients complete a Medicare Scope of Appointment form. The 2024 CMS final rule went into effect September 30. 2023 and has added some changes to how agents obtain the SOA.

The SOA rules apply to agents and brokers who discuss Medicare coverage options and plans.  The 48-hour rule was put in place so beneficiaries could avoid the high-pressure sales tactics some agents use.  The 48-hour period provides beneficiaries time to consult friends, relatives or anyone they like to research their options. This time also provides agents time to prepare for the discussion.

Agents are able to contact the beneficiary once the SOA is completed for up to 12 months. It is essentially permission to contact until the meeting takes place.  The beneficiary has the option to opt out annually.

Please note, if the beneficiary does not select a coverage option on the SOA, Medicare requires the agent to avoid discussing that option without a new SOA where the option is clearly selected.

Find out about the proposed CMS rule 4205-P, see how it could affect agents!

Exceptions to the 48-hour rule

If the beneficiary is in the last four days of a valid election period, agents may collect a same-day SOA.

When the beneficiary walks into your office and initiates a conversation about coverage options, agents can take a same-day SOA.  This same rule applies to inbound call initiated by the beneficiary to the agent requesting advice.

How long do you need to keep a SOA

Agents must be able to access the SOA form for ten years. Clients have the right to request a copy anytime within that time frame without any issues.  The SOA can provide help in the event that an issue or dispute occurs.  The Scope is in place to protect the consumer, but it can also protect the agent.

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What’s the Medicare GEP

Please note:

Those who did not enroll in Medicare Part B because they had insurance coverage through theirs or a spouse’s employment, do not pay an LEP.  There is also no penalty for beneficiaries who qualify for an MSP (Medicare Savings Program).

Before 2023, no matter what date beneficiaries enrolled in Medicare during the GEP, their coverage would start July 1.  Since the CMS rule change that began is 2023, there are no longer delays in Medicare effective dates for beneficiaries who enroll during the GEP.  In other words, coverage begins the first day of the month following the enrollment.

Our YouTube channel has many important guidelines and updated rules for Medicare sales – subscribe to our channel and take a look.

Common Medicare terminology

If you are getting started in Medicare sales, there are plenty of terms that can be confusing. This list of common Medicare terminology can help you moving forward with your Medicare sales career.

Ancillary products 

These are plans are offered by private insurance companies outside of Original Medicare or Medicare Advantage.   Some examples of Ancillary plans include life insurance, LTC policies, stand-alone dental or vision as well as many other stand-alone insurance products.

Annual Enrollment Period (AEP)  

During this time from October 15 through December 7 each year eligible beneficiaries can either enroll in or change their current Medicare coverage.

ANOC (Annual Notice of Change) 

Each year beneficiaries receive a letter from the plan they are enrolled in.  This letter explains any changes that the plan will have in January when the plan year begins. It lets beneficiaries know about cost and benefit changes. This letter arrives each fall so beneficiaries can decide if they want to change plans during the Annual Enrollment Period that starts in October.

Coinsurance 

This is the amount, usually a fixed percentage, the insured must pay toward a covered claim after the deductible is satisfied.

Co-payment 

The set fee a plan charges the insured at the time of each doctors visit or when you purchase prescription medication or other medical service.

CSNP (Chronic Condition Special Needs Plan)  

A type of Medicare Advantage plan for beneficiaries with specific chronic conditions such as end stage renal disease (ESRD).

Deductible 

The pre-determined amount you have to pay before your insurance coverage begins to pay for covered services.

Donut Hole aka the coverage gap 

This refers to a gap in your Medicare Part D prescription drug benefit.  This occurs when your prescription drug expenses exceed the initial coverage limit of your plan but have not yet reached the catastrophic coverage level.

Dual eligible Special Needs Plan (DSNP)

DSNPs are specialized Medicare Advantage plans that provide healthcare benefits to beneficiaries who have both Medicare and Medicaid.

Durable Medical Equipment (DME)  

DME refers to medically necessary, prescription healthcare devices that Medicare Part B usually covers. This includes things like wheelchairs, infusion pumps and blood sugar monitors, to name a few.

Extra Help (LIS, Low-Income Subsidies) 

These terms refer to a program that helps eligible Medicare beneficiaries with limited income pay for prescription drug coverage.

Formulary 

The list of drugs that each Medicare plan covers.  Each plan separates the drugs on the formulary by tier the tier corresponds to the price the plan member pays.

General Enrollment Period (GEP) 

Eligible beneficiaries who miss their Initial Enrollment Period, can use this time to sign up for Medicate.  The GEP runs from January 1 through March 31 and is only available to first-time Medicare enrollees.

HMO (Health Maintenance Organization) 

A type of Medicare Advantage plan that requires the selection of a primary care physician.  Your PCP will coordinate your care and needs to provide a referral if you need to see a specialist.

Hospice  

This is a type of healthcare for terminally ill patients that provides pain management, counseling, hospital care, and more. Coverage for hospice is included in Part B of Medicare.

Initial Enrollment Period (IEP) 

The time when eligible beneficiaries can first sign up for Medicare coverage. It begins three months before your 65th birthday and ends three months after. This is the time that most people enroll in Medicare.

In-network 

When a provider (doctor, hospital, pharmacy, etc.) is in-network, they accept your Medicare plan.  Beneficiaries who use in network providers are covered under their plan when you use in-network providers.

ISNP (Institutionalized Special Needs Plan)  

A type of Medicare Advantage plan for people living in nursing home institutions.

Medicare Advantage (Medicare Part C, MA/MAPD) 

A Medicare plan offered by private insurance companies.  These plans cover everything that Original Medicare covers as well additional benefits like prescription drugs, dental, vision, fitness, etc.  When they are called MAPDs they refer to Medicare Advantage plans that include prescription drug coverage.

Medicare Savings Programs (MSP) 

MSPs are Medicaid-run programs.  These programs help cover Medicare premiums and other cost-sharing expenses for people with low incomes. Eligible Medicare beneficiaries receive help with premiums, copayments, and deductibles.

Medicare Supplements 

A separate, private insurance plan that helps pay deductibles, and copayments for Medicare covered medical services.  These plans work with Original Medicare.

Open Enrollment Period (OEP) 

This enrollment period is available only to Medicare Advantage plan enrollees. It runs from January 1 through March 31. Enrollees can use it to switch between Medicare Advantage plans or to go back to Original Medicare and a PDP plan.

Out-Of-Pocket Limit (MOOP)

Many Medicare plans place a maximum dollar amount beneficiaries can spend out of pocket on their healthcare costs each year. Once they surpass the out-of-pocket limit, Medicare-covered services are 100% covered.

PDP (Part D)

PDP plans provide coverage for prescription drugs and are offered by private companies.

PPO (Preferred Provider Organization)

A type of Medicare plan that provides care through a specific network of medical providers and facilities.  Plan members can seek care outside the network, although it will usually cost more.  In most cases, PPO plans don’t require referrals to see a specialist.

Special Enrollment Period (SEP)

Eligible Medicare beneficiaries with special circumstances are entitled to enroll in Medicare plans outside of the traditional enrollment periods.

TRICARE

This is a healthcare benefit for both active duty and retired service members as well as their families.

Take a look at some of our free agent training videos on YouTube

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Medicare sales and cross selling

If you are selling Medicare, you should think about how to meet all the coverage needs of your clients. That is why Medicare sales and cross selling go hand in hand.  Before you try and do this, be sure you have the necessary product knowledge on anything you intend to offer.

A great way to get insight into your client’s potential needs is with a client needs assessment.  Each agent should tailor the assessment to include the applicable product lines they are licensed to sell and have a good knowledge of.

If your client understands that you are able to offer them coverage for all their personal insurance needs, they will be inclined to call you when they decide to add to their current coverage.  It is best to take care of their most urgent concerns before talking about additional items.

Watch our quick YouTube video on cross selling during AEP

Medicare sales cross selling – be aware of underlying health issues

If you conduct a needs assessment or spend enough time speaking with your client, you will probably find out if your client has any illnesses that will prevent them for obtaining some types of coverage that they will not qualify for.  If you ask about any recent claims they have had, this may be an indicator if they are a good candidate for some types of coverage.

Some other things to find out from your client

Is the client or their spouse presently working?  If the answer is yes, do they have any employer benefits and if so, what are they?

Have they ever served in the military (are they a veteran)?  Sometimes veterans receive benefits.  You need to find out if they do and what those are.

Medicare sales cross selling – Cancer, Heart attack and Stroke coverage

Because many people have a family history of either cancer, heart attack or stroke, this product is not difficult to sell. This product is sometimes called critical illness insurance.  Be sure you understand the client’s budget before you show them quotes from companies that will fill their coverage need.

Cross selling – Long Term Care Insurance

Most people do not have long term care coverage. Although LTC has changed over the years, there are still some good coverage options available.  There are some short-term care policy options that include home health coverage.  There are also some life policies that include an optional LTC rider.  You can ask your client if anyone in the family has needed home health or nursing home care. If they have, ask them if they know how it was paid for. Do they have a way to pay for it if they need it?

Cross selling – Life Insurance

Life insurance is not like LTC coverage because many clients have at least some life insurance coverage.  If you want to start a discussion about life insurance, you need to find out if the client already has coverage and if so, how much.  Once you get the answer, you can ask questions to determine if they have enough to cover what they need it for.

Here are some reasons people purchase life insurance:

To replace income lost due to the death of a family’s financial provider.

If they want to cover their final expenses.  If they have a policy in place, it may not be enough to cover their final expenses.  This means they may want to consider purchasing a policy that provides a bigger benefit amount.

Policies can help pay any outstanding debts owed by the policy holder.

In some cases, the policy holder wants to leave a financial gift to their chosen beneficiary.

If they do not have a policy, you may be able to help them decide if a policy could benefit their loved ones.

Cross selling – Final Expense

Final expense insurance is a kind of life insurance.  If the client does not have life insurance in place, this type of policy can help family members pay for their final expenses and avoid leaving them with a large bill after you are gone.

Cross selling – Annuities

These days many people want a safe place to invest their savings due to low interest rates at banks and stock market volatility. Simply ask your client if they are happy with their current rate of return on investments. Let them know a fixed indexed annuity can provide a dependable place to invest savings and a better return rate than many CDs.  In many cases, you can offer them an annuity product that will provide a better return that what they currently have.

Now that we have given you a few products to consider adding to your portfolio, it is up to you to decide what will be the best value add.

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Medicare fact finder

Each time a Medicare agent meets a new client a Medicare fact finder is a great way to address what they want and what they need.  This is a great tool to help you make personalized suggestions for coverage.

If you are in the senior market, your fact finder should focus on Medicare coverage.  It may also include additional options like hospital indemnity, life products or other relevant products you offer. You should design your fact finder to fit your client’s needs and the services that you have to offer.  The only way to know what the client is looking for is to ask questions.

We have a few examples of Medicare fact finder questions below:

1. Do you understand the different parts of Medicare

This question is very important to ask.  Clients need to understand the parts of Medicare and how they work to know what type of coverage they want and need.  Your job is to make sure they know about all the coverage options available and make an informed decision.  This includes what is covered by Part A, Part B, Part C and Part D.

2. Can you tell me what you like and don’t like about your current Medicare coverage

When you ask this question as part of your fact finder, you gain valuable insight into what type of coverage the client is looking for.  This will help sort out which benefits are important to them, and which are not. This can be very useful in sorting out MA/MAPD plan benefits as there are so many to choose from and they offer different benefit packages.

3. How often do you see a doctor or specialist

The answer to this question can help decide if a Medicare Supplement or a Medicare Advantage plan is a better option for your client. That is a reason to include it in your Medicare fact finder.  Many of your clients’ plan choices will come down to simple mathematics.  Medicare Advantage plans require a copayment for visits to either PCPs or specialists.  The amount of each copay can make a difference in your client’s budget.

4. Are there doctors and medical facilities that you like to use for your health care needs

If a client uses medical care from several providers on a regular basis, they may have a difficult time finding a Medicare Advantage Plan that all their chosen providers participate with.  It is your job to be sure they can continue to use the providers they want and are aware of the cost for each visit.  In some cases, an MAPD plan may not be the best option for the client.

5.  Find out if the client is currently taking any prescription medications and which pharmacy they like to use

Please be aware, it is up to the client if they want to disclose this information.  However, it is important to help them find the best coverage options for their needs and can be very costly if they make an ill-informed decision.   Each MAPD and PDP plan has a specific formulary.  This means they cover each medication differently. There can be very large differences in the cost for prescriptions that may place a burden on your clients when they are trying to maintain their health.

The cost of each prescription also depends on the pharmacy your client chooses to use.  This must be explained to them as well.  Carriers for Part D coverage often have preferred network pharmacies that can save the client money when they fill prescriptions there.

6. Does your client have any chronic health conditions

There are specific Medicare Advantage plans that provide coverage of certain chronic health conditions, such as ESRD.  Although they cannot enroll in most Medicare Advantage plans, these SNP plans cover their specific needs, and they cannot be denied coverage for pre-existing conditions.

7. Do they travel often or have a home in another state

This may be an important question to include in you Medicare fact finder.  Medicare supplement plans are good in any doctor’s office or facility that accepts Medicare assignment. On the other hand, Medicare Advantage plans have a local provider network and clients may not find an in-network provider when they spend months living out of their home state.  This can end up costing quite a bit out of pocket for care. It is important to check the benefits of each plan for travel and residency coverage.

8. Are they covered through a former employer or other organization

In some cases, client have retiree plans that work with Medicare to provide coverage for health care needs.  If this is the case, the client should check with their company’s benefits coordinator to see how a Medicare plan affects their retiree coverage and how they work together.

These are just a few possible questions to use.  It is important to decide which questions to add or subtract based on your personal preferences.

A few more thoughts

Let your client know what you are doing and why.  This will help them understand that you see each client as an individual and will do your best to fill their personal health coverage needs. It is best to finish the questions and go over the answers before you try and make any sales presentation to the client.  Making the suggestions at the end will let the client know you are listening to every answer and using all the information to make the most informed suggestions.

Click here for a SSA Medicare fact sheet

View free Medicare agent training videos on our Youtube channel

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Click here to view SEP_Report as of 4-28-25

Medicare SEPs for emergencies or disasters

There are a lot of moving parts to selling Medicare plans including several choices for Enrollment opportunities.  We will explain a little about the Medicare SEPs for emergencies or disasters.  This SEP may be available to some of your clients.

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