The latest Medicare Improvements for Patients and Providers Act (MIPPA) has rocked the Medicare industry, and many producers are just now having the opportunity to let the dust settle. So what does it all mean, and how do agents maximize sales in this new environment?
The fact is, agents should be working year-round to get the most out of the official Medicare sales season. The following is a timeline of what producers should be doing throughout the year to make sure that they stay top-of-mind with clients and see big gains during enrollment season.
Lock-in period: April 1 – Sept. 31
Take a big sigh of relief — the main Medicare Advantage selling opportunities are now complete. So what’s next? First, remember there are no enrollment period restrictions for the following:
- Dual-eligible beneficiaries (those with Medicaid and Medicare coverage)
- Beneficiaries in a Medicare savings program, such as Qualified Medicare Beneficiary (QMB), Special Low-Income Medicare Beneficiary (SLMB), or Qualified Individual (QI)
- Institutionalized beneficiaries
Those newly eligible for Medicare Advantage qualify for the Initial Coverage Election Period (ICEP), and the Medicare-eligible who have recently moved qualify for a Special Enrollment Period (SEP). For more information about all those who qualify for the ICEP and SEP and the specific time periods during which they are allowed to enroll, you should contact your Medicare Advantage organization (MAO).
Second, don’t let the preparation process become overwhelming. The best way to approach the next six months is to break it down into a workable calendar and make sure that you are organized. Here is a breakdown of what you should be doing throughout the lock-in period.
April – June: Spring cleaning and goodwill months
April through June is a great time to reorganize your files and create goodwill in your market area. The following items should be on your to-do list:
- Organize your customer and prospect files. CMS is vigilant about compliance with data collection. Make sure you store all information, such as the lead source data, scope-of-appointment records, enrollment forms, and a record of all prospect and client communications in individual files (either paper or electronic) in case of an audit. CMS requires that records be stored for no less than 10 years.
- Create goodwill in your community. Get involved in your local community. Whether it is coaching Little League or joining local business associations or community groups, explore all opportunities to build your reputation in the community and create your own grassroots goodwill.
- Build awareness in the Medicare community. Throughout the spring, you should be conducting educational seminars and building your reputation in the Medicare community. There are excellent educational tools at www.medicare.gov to help you build seminars. An educational event should inform a potential enrollee about MA or other Medicare programs, but not steer, or attempt to steer, a potential enrollee toward a specific plan or limited number of plans. Remember that you cannot distribute marketing materials at educational events.
June – August: Customer follow-up and education opportunities
During the summer months, you may think it is the time to sit back and soak up the sun — but don’t be complacent. There are important opportunities to take advantage of during this time period.
- Call your customers and make sure they are happy. By now, many of your customers have had an opportunity to utilize their health plan and have started to generate positive and negative feedback. This is a great time to call each of your customers. Make sure you follow up with your clients if they experience problems. The best way to develop strong customer retention is to become the problem solver.
- Ensure your educational credits are up to date. Take classes and earn the necessary credits to keep your license current and in good standing.
- Knowledge is power. The more you understand your products, the industry, and your competition, the better you can sell yourself and your products.
August – September: Training, communication, and list cleaning
Many times we refer to this time as the calm before the storm. But don’t be fooled: Now is prime preparation time for the upcoming season.
- Schedule and study for your Medicare training. MIPPA guidelines state that agents must take the required annual training, which includes Medicare rules and regulations as well as the specific details of the plan products you are selling. You must pass with a score of 85 percent or better, so study carefully.
- Get your prospect list in order. Review your prospects and make sure you have deleted all prospects who have become customers. You also want to be sure to remove the names of those who are deceased and update any changes of address.
- Be in close contact with your MAO and know the lead distribution and follow-up processes. Get firm date commitments for the distribution of marketing materials to build marketing and sales schedules and possible sales seminars. Verify that you have destroyed all old marketing and enrollment materials.
- Practice your sales presentation; be the expert. If you do not evoke confidence and know how to properly respond to prospect questions, you will not be able to close the sale. Make sure your sales presentation is approved by CMS and your MAO — and practice, practice, practice.
- Know the latest CMS regulations and guidance. Become the expert in your community. You need to be the person in your community who everyone calls with questions.
Annual Election Period: Oct. 1 – Dec. 31
If you developed and followed your calendar, then you will be ready to hit the ground running during this busy time of year. Because of CMS enrollment requirements, MAOs cannot accept Medicare Advantage enrollments until Nov. 15. This time period can be separated into marketing and sales strategies.
Oct. 1 – Dec. 31: Marketing and lead generation
- Direct mail. Agents should be sending mail to their prospect file in early October and should follow up by mail once or twice during the AEP. Outbound telephone and email follow-up are not allowed.
- Seminars. These are very good opportunities to generate leads and sales because you do not need a scope-of-appointment form for seminars. The invitation is considered to be the scope-of-appointment. Scope-of-appointments are only signed when a prospect requests a one-on-one meeting for a later date. If the prospect requests an individual appointment immediately after the group appointment, ask the prospect to sign the scope-of-appointment at the time the follow-up meeting is made.
- Scope-of-appointments. Get scope-of-appointments signed or recorded 24 hours before the scheduled appointment time.
Nov. 15 – Dec. 31: Sales enrollment process
- Scheduling appointments. Schedule as many appointments as possible to maximize your opportunity — but make sure you are able to make every appointment on time. When you are late for an appointment, you create a negative first impression.
- Be organized and have all the required CMS-approved materials for your sales appointments. This increases credibility and makes the sales process go smoothly.
- Double check to verify that the enrollment form is completely filled out. Be sure to submit all enrollment forms in accordance with the plan rules.
- Ask for referrals and request name and address only.
Open Enrollment Period: Jan. 1 – March 31
During the Open Enrollment Period, the emphasis should be on marketing and sales. Activities should include the following:
- Conducting advertising and marketing campaigns
- Holding sales seminars
- Setting up in-home sales presentations
- Manning the phones or desks for walk-in and phone-in prospects, if applicable
In March, as you are heading toward the home stretch of the OEP, the lead-generation process will begin to slow, and you should concentrate on follow-up and sales enrollment. You should review all qualified leads from the AEP and OEP and follow up with a letter. Remember, MIPPA no longer allows you to follow up with a phone call. Send a short, friendly correspondence referencing your appointment, and mention that you are following up and would welcome the opportunity for another home visit to review the different types of Medicare products available in the market. Make sure that the letter is on your agency letterhead. Also, ask for the name and address of referrals of friends or family members who may need coverage.
By utilizing the above timeline, you can use the entire year to maximize your Medicare sales when the enrollment season comes around. Plan ahead, and you will see your practice grow.
John Gorman is chief executive officer of the Gorman Health Group. He can be reached at 202-364-8283 or firstname.lastname@example.org.