Medicare Advantage

✅ Action Plan: How to Sell Medicare Advantage Plans

🧾 1. Get Licensed (If Not Already)

• Must have a state health insurance license.

• This allows the agent to legally sell Medicare-related products.

📚 2. Complete AHIP Certification

• AHIP (America’s Health Insurance Plans) is required by most carriers.

• Covers Medicare basics, compliance, fraud, and marketing rules.

• Cost: ~$175 (often reimbursed by carriers once you’re contracted).

🔑 Tip: Take your time — passing score is 90%.

🤝 3. Contract with Medicare Advantage Carriers

• Choose which companies to represent (e.g., Aetna, Humana, UHC, WellCare).

• You’ll partner directly with our team — your personal support hub for contracting, training, and long-term success

• Each carrier will require additional certifications (usually online and free).

🔑 Start with 2–3 core carriers based on your region’s strongest plans.

📖 4. Learn the Plans & Market

• Understand:

  • Monthly premiums

  • Doctor networks

  • Drug formularies

  • Extra benefits (dental, vision, OTC)

• Know how each plan compares to Original Medicare and Med Supps.

🔍 Study what’s available in your target zip codes. Local knowledge = strong sales.

💬 5. Practice Your Presentation

• Be ready to explain:

  • What Medicare Advantage is

  • The pros and cons

  • The enrollment process

• Use tools like:

  • Scope of Appointment forms (required before discussing plans)

  • Plan comparison tools from carriers or Medicare.gov

📆 6. Understand Enrollment Periods

• AEP (Annual Enrollment Period): Oct 15 – Dec 7

• OEP (Open Enrollment Period): Jan 1 – Mar 31

• SEP (Special Enrollment Periods): For qualifying life events (moving, loss of coverage, etc.)

• ICEP (Initial Coverage Election Period): When a person is first eligible for Medicare

🔑 Enrollment timing matters — know your windows!

📣 7. Start Prospecting & Marketing

• Create your lead strategy: referrals, community events, direct mail, social media, seminars, etc.

• Follow CMS-compliant marketing rules (no misleading info, no “bait and switch”).

• Get branded materials through your carrier or FMO.

🧾 8. Meet With Clients & Collect Scope of Appointment

• Must complete Scope of Appointment form at least 48 hours in advance (CMS rule).

• Go over plan options clearly.

• Be transparent about copays, networks, and prescription coverage.

🖊️ 9. Enroll Clients Ethically & Accurately

• Use approved enrollment tools (paper, online, or carrier apps).

• Confirm:

  • Provider participation

  • Drug coverage

  • Client understanding

• Submit the application and follow up to confirm acceptance.

🧠 10. Stay Updated

• Medicare rules and plans change every year.

• Renew your certifications annually (including AHIP and carrier trainings).

• Stay in touch with your upline or FMO for news, compliance, and leads.

🎯 Quick Checklist for New Agents:

• ✅ State License

• ✅ AHIP Certification

• ✅ Carrier Contracts & Trainings

• ✅ Learn Local Plans

• ✅ Understand Compliance

• ✅ Have a Marketing Plan

• ✅ Practice Presentations

• ✅ Enroll Clients with Confidence

You can sell Medicare Advantage (Part C) plans during specific enrollment periods, with the main window being the Annual Enrollment Period (AEP).

✅ Key Selling Timeframes:

1. Annual Enrollment Period (AEP)

📅 October 15 – December 7 (every year)

• You can enroll, switch, or drop Medicare Advantage plans.

• Your clients’ new coverage will begin January 1 of the following year.

2. Open Enrollment Period (OEP)

📅 January 1 – March 31

• Only for existing Medicare Advantage enrollees.

• They can switch to a different Medicare Advantage plan or return to Original Medicare (with or without a Part D plan).

• You can only market one-to-one (no mass advertising allowed).

3. Initial Enrollment Period (IEP)

• Starts 3 months before the month a client turns 65, includes the birthday month, and ends 3 months after.

• New beneficiaries can choose Original Medicare or a Medicare Advantage plan.

4. Special Enrollment Periods (SEPs)

• Available for certain qualifying events, such as:

  • Moving out of a plan’s service area

  • Losing current coverage

  • Gaining eligibility for Medicaid or Extra Help

  • Living in or moving into/out of an institution (like a nursing home)

If you’re a licensed agent, you must also follow CMS marketing guidelines and complete AHIP certification or equivalent each year before selling.