Medicare Advantage Rules of the Road

May 10, 2017

Enrollment

1. Complete a needs analysis prior to any plan discussion.
2. Once the plan has been chosen, carefully review all benefits and the Statement of Understanding.
3. Clarify and confirm that the enrollment is for a Medicare Advantage Plan and not a Medicare Supplement Plan.
4. Enrollment applications must be completely filled in with accurate beneficiary plan data. (Make sure you are marking the correct plan.)
5. Physician information – fill in the primary care physicians’ entire name along with their associated primary care number from the carrier’s on-line physician.
6. Prior to carrier submission, review the application (in its entirety) with the beneficiary.
7. Submit the application within 48 hours of signature (the same day is even better).
8. In the case of an e-application, the Scope of Appointment (“SOA”) form must immediately be transmitted to the carrier.

Post-Enrollment

1. Call the new member and verify that they have received their new ID card.
2. Review benefits, if necessary.
3. Return their phone calls within 24 hours (or less).

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