The Sales Presentation for Medicare Advantage Plans

June 24, 2016

Are you providing a compliant sales presentation?

Before you begin your presentation:

• Have you met all of the carrier’s certification requirements?
• Do you have a thorough knowledge of the plan’s benefits and limitations, including the formulary and contracted providers?
• Are you aware the ONLY health question you may ask is regarding End Stage Renal Disease (ESRD)?
• Have you completed a Scope of Appointment form and waited at least 48 hours before your next appointment?

Your presentation:

• Have you completed a thorough needs analysis?
• Present the carrier’s CMS-approved sales presentation and the Summary of Benefits, in their entirety, and leave it with the beneficiary.
• Help the consumer enroll into the most appropriate plan based on their needs.
• Ensure the consumer understands and agrees with the plan’s effective date, premium (when applicable) and benefits.
• Confirm the consumer understands how to access a provider, explaining any network or provider limitations including referrals and/or higher copays, as applicable.
• Review the enrollment application in its entirety for completion and the client’s complete understanding.
• Review the plan’s cancellation and/or disenrollment process.

Before you leave the home:

• Show the prospective member where they can find the plan’s Customer Service phone number.
• Leave at least 3 of your business cards; one for their use and two to hand out to friends (referrals).
• Remind the prospective member to call you with questions.
• Contact your client at the time of the effective date and then every 90-180 days.

As always, we thank you for your support and cooperation. For questions or comments, please email us at Compliance@NSGACommunications.com or you may call the toll-free number listed below.

FOR AGENT USE ONLY. NOT FOR USE WITH CONSUMERS.

Compliance Updates | 2650 McCormick Drive | Clearwater, FL 33759 | 844.206.2927