Medicare Advantage sales: rules, rules, and more rulesby Denise Early on Oct. 13, 2009, under Health
Insurance agents have turned up at the homes of seniors stating they are from Medicare and that they need to talk about the senior’s Medicare coverage. Health fairs have invited seniors in for flu shots and free food, with hopes of getting leads for insurance agents who can follow up with sales calls.
These are just a few examples of problems that have plagued the Medicare market over the years. Now rules are in place and secret shoppers are lurking to make sure insurance agents comply with the many new rules concerning sales and marketing of Medicare Advantage plans.
Here are a few of the rules related to Medicare Advantage sales and Marketing:
- While knocking on seniors’ homes without an invitation has always been against the rules, now agents are forbidden from initiating contact with Medicare beneficiaries in any way, except by mail. Agents can call their own clients, but they cannot call someone they have never worked with.
- Agents can ask clients for referrals of friends and relatives, but they cannot receive phone numbers to call these prospects. If a senior wants to help a friend, she needs to give her friend the agent’s phone number so the friend can initiate contact with the agent.
- When an appointment is made between an agent and a senior to talk about Medicare Advantage, both parties must clearly agree on what will be discussed. A form called a “scope of appointment” must be signed by the senior before Medicare Advantage plans are discussed. This form should be mailed to the senior and the senior must mail the form back to the agent after signing it and agreeing to the scope of the appointment.
- Agents have the option of recording the phone call during which the terms of the appointment are reviewed and agreed upon.
- If a neighbor shows up for the arranged appointment, she must sign a scope of appointment before the discussion of Medicare Advantage can begin.
- Educational events, such as health fairs, can include insurance agents, but agents cannot present any plan-specific Medicare Advantage information to attendees. Agents cannot give their card to attendees – unless an attendee asks the agent for his/her card.
- Educational events are defined as any event that provides free food.
- Sales events must be registered in advance with Medicare so secret shoppers can attend to be sure agents are compliant in their sales presentations about Medicare Advantage.
I’m not going to editorialize about these rules for fear of breaking any rules.