Medicare
True Or False
Ronald is disabled and has Medicare. He is not yet 65 years old. He turned down Part B and now facing a Part B premium penalty. Ronald will unfortunately be stuck with the Part B premium penalty for the rest of his life, provided that he does not qualify for any assistance programs.
True
This is the first time I am enrolling in Medicare
IEP
Agent must state this on the first call with a new customer before plan information is presented.
Scope Of Appointment
What are the phases(steps) in our call introduction
Greeting
I can help with that
Disclaimers
Transition
Must be level 3 and at least 80% effectuation
Conversion Kicker
Which part(s) of Medicare will usually provide coverage for immunosuppressant drugs?
What Is Part B and D
Delayed Part B while already having Part A
ICEP
THIS STATEMENT IS REQUIRED- On the first call with a customer and the enrollment call before customer's PII/PHI (Customer's DOB, Phone number, Medicare claim number-MBI) is stated by the agent.
Medicare Disclaimer
This step in our call flow helps identify the callers needs. These questions should follow a given format. What is the steps to identifying a callers needs?
open, closed, closed, impact
or OCCI
Should be offered at the end of all or most calls to ensure a exceptional customer experience
CSAT. or Customer Satisfaction Survey
True or False
Generally, people must actively enroll in Extra Help if they have Medicaid and Medicare.
True
My plan is ending it's contract with Medicare.
NON
This is required on the first call with a consumer within the first 5 minutes of the call.
Brand Phone Call
Agent gave their full name and branded the call, "GoHealth" or "GoMedicare" MUST state they are a "Licensed Sales Agent," a "Licensed Insurance Agent," a "Licensed Medicare Sales Agent," or a "Licensed Medicare Insurance Agent" required on the first call with a consumer within the first 5 minutes of the call.
This part of the call flow should open with excitement!
Square or plan presentation
This should be used/stated after the end of each completed enrollment prior to disconnecting from the caller.
Post enrollment script
Most large employer health plans protect enrollees from extraordinarily high medical bills by placing an annual limit on out-of-pocket costs. Does the traditional Medicare program do this?
No, traditional Medicare does not include an out-of-pocket limit
Recently returned to the U.S after living permanently abroad
RUS
Agent Must Present Carrier Name, Premium, Medical and Rx Deductible (if applicable), PCP Co-Pay, Specialists Co-Pay, Hospital Co-Pay (Number of days with a co-pay and co-pay amount), Preferred Drug Tiers as they appear in Marketplace. If the customer has LIS agent may give LIS Rx Co-Pay range ($0-9.20 for 2021) Out of network benefits need to be stated if the customer sees out of network providers.
Plan Presentation
What are the steps in a perfect plan presentation, often referred to as the square method?
You told me
This plan gives you..which means
That a great benefit to have right?
We're on the right track with this plan so far?
Agents who utilize this team on average see a 10% higher effectuation
Telecare
A prescription drug benefit, Part D, was added to Medicare in 2006. Do all Medicare beneficiaries automatically receive the drug benefit when their Medicare coverage begins?
No, Part D drug coverage does not begin automatically for all Medicare beneficiaries when they sign up for Medicare
Individuals enrolled in a plan by Medicare (or their state) ad want to choose a different plan
DIF
The agent engages the customer in a friendly and helpful way. The agent avoids communicating personal/inappropriate information, including but not limited to frustration with systems, personal problems, politics, cursing
Professional and Polite Interaction
This statement should follow the square but should be stated prior to starting the application.
Assumptive close statement.
Starting this month ANY AGENT can earn up to $115 per retained policy ( $135 for Varsity Agents)
Effectuation Levels