Disclosures
Should you decide to enroll, you must continue to pay your Medicare Part B Premium.
What is Part B Disclosure?
Would it be important to keep any doctors? Would it be important to lower the cost to see your doctors? Would having transportation be beneficial for getting to and from your appointments? Would you be open to a plan that can provide you an allowance for your over-the-counter supplies? Would it be beneficial to have a plan that can cater to your specific d/v/h need?
What are needs assessment questions?
If you are pitching a PPO plan, you do not have to look up doctors since they can see any provider they like?
false
You are speaking with a lead that moved several months ago but never reported the change to Medicare, you can assist them today using the MOVE election period?
Yes, today would be recognized as the official move date.
2 types of ways to submit an application?
Verbal/Electronic
If a medication is not covered by the plan's formulary, you will be responsible for 100% of the cost.
Lead Refuses Rx Lookup
What 2 military coverages do we qualify for?
What is VA/Tricare?
Agent confirms Provider, but fails to verify full address. How would you grade this?
Non Compliant
IEP, OEP, SEP, AEP, OEP-I
What is the proper hierarchy for Medicare Advantage enrollments?
What 3 things do we give the beneficiary at the end of a sale?
A confirmation number, Contact information, Card instructions
Do you give your consent for Medicare Assistant to contact you using an automated dialing system, via phone, mobile device, including text or email. These calls will override any local, state, or federal Do Not Call list which you or the contact numbers you provided may be registered.
What is TCPA?
All Medicaid verification must be done through?
What is a third party?
Compliant or Not- Agent submitted an application on an inbound call.
Compliant
How often can someone with Medicaid or LIS make changes through the calendar year?
Once per quarter (first 3 qrts)
We can assist lead in answering questions on the application if they are confused?
False
I have great news!! Based on your answers, you do qualify to enroll in a Medicare Advantage plan because <states election>. [Caller], let me make sure that we are on the same page. Your goal is to make sure that we cover… Is there anything that I am missing? Would you like to hear about some of the plans available in your area?
What is SOA?
Allows for beneficiaries to change their plan,
What is an election period?
The agent brought up Vision during the Needs Analysis, when she asked the client what was most important to her, the client stated that she needed Transportation. Agent covered only fully covered Transportation benefits during the presentation. Is this Compliant?
Non-Compliant- Agent must cover vision if mentioned. (by agent or by client)
CSNP plans are designed for?
Chronic Conditions
What is the next step for agents after completing the application?
TPV process (third party verification)
“This plan provides you with a prescription drug formulary, are there any prescriptions you would like me to compare against the formulary before we get you enrolled?
What is Rx disclosure?
What two things must be verified as they related to extra help?
LIS/Medicaid
Not gaining this can result in an allegation and the policy being inactive?
What is Consent to enroll?
If the lead's birthday falls on the first of the month, 05-01-2021 and they enrolled on March 21 within the 3-1-3 what will be the plan's effective date?
4/01/21
Agent read signature disclosure, lead stated her name and that she agreed. Agent asked her to say today's date and the lead repeated it. What is this considered?
COACHING the lead