Did you know that most people can only enroll in Medicare during a few months out of the year? Read through to figure out what medicare enrollment periods you are eligible to enroll during. If you still need help, one of your licensed agents can answer your questions!
IEP (Initial Enrollment Period)
Most seniors and Medicare eligibles will begin with an IEP. Your IEP begins three months before your 65 birthday and ends three months after, for a total of a seven-month timeframe. Some seniors and Medicare eligibles will be automatically enrolled in Part A and Part B and will receive a Medicare card three months before their 65 birthday. Others will need to elect to enroll and will start to receive coverage within a few months.
If you have an IEP but choose not to enroll, you may be faced with a higher premium because you enrolled late. You will be able to complete your late enrollment during the General Enrollment Period.
(GEP) General Enrollment Period
The GEP is exclusively for those who are enrolling in Medicare for the first time and missed their IEP. It runs from January 1 through May 31 of each year for Original Medicare and April 1 through June 30 for prescription drug plans and Medicare Advantage. If you enroll during the GEP, your coverage will begin in July.
(AEP) Annual Enrollment Period
AEP starts on October 15 of each year and runs through December 7. This is when every Medicare beneficiary can change plans or enroll in new plans. It’s a good chance for you to look at your current coverage, compare it to your healthcare and financial needs, and make adjustments if necessary. If you wait too long, you’ll have to wait a whole year before you can make changes again.
(SEP) Special Enrollment Period
If you qualify for Medicaid, Social Security, or another financial assistance program, you may be eligible for a Special Enrollment Period. If you have an SEP, you do not have to wait until AEP to make changes to your Medicare. Some people will have a continuous SEP, meaning they can make changes at any time. Those who have special circumstances such as moving, losing a job, or moving into a facility will have a 60-day SEP.
Get Help Understanding Your Enrollment Period
Still not sure when you can enroll? That’s ok, it can be confusing. Call us at Medicare Plan Finder and we can help you figure out whether or not you can get into a better plan. Just click here to request a call or call us at 1-844-431-1832.
Get Medicare Financial Assistance with the Medicare Extra Help Program
Did you know that Medicare offers financial assistance programs to those who cannot afford to pay their monthly premiums? The Medicare Extra Help program can help you afford your prescription drug plan.
What is a Low Income Subsidy?
LIS (Low Income Subsidies) is a federal program commonly referred to as Medicare Extra Help. It helps Medicare beneficiaries like you pay for prescription drugs. The program is designed to help those who do not qualify for Medicaid but still need financial assistance.
Medicare beneficiaries with LIS save an average of $3,900 per year on their prescription drugs. Therefore, beneficiaries might pay about $2 for a prescription instead of, say, $40.
What does Medicare Extra Help Cover?
The LIS program provides tremendous support for prescription drug coverage as long as you have a Medicare Part D drug plan or Medicare Advantage. LIS provides help with premiums, deductibles, coinsurance, and copayments. Also, LIS beneficiaries have a continuous SEP (Special Election Period) which means they can change plans or enroll any time of year! No more waiting for AEP (October 15 – December 7).
Additionally, LIS can help you pay for any late enrollment fees you may have. You might have a late fee if you wait too long to enroll in a Medicare prescription drug plan.
You will start by paying for 100% of your drug costs until you hit your deductible ($435 in 2020). Then, you will only pay a small percentage of your drug costs. Once you spend $4,020, you will pay 25% of brand-name drug costs and up to 25% of generic drug costs..
Medicare Extra Help Application
A senior or Medicare beneficiary is eligible for LIS at 150% of the Federal Poverty Level with (2017):
Income ($18,090/yr individual, $24,360/yr marital)
Social Security Administration Wilkes-Barre Data Operations Center P.O. Box 1020 Wilkes-Barre, PA 18767-9910
Medicare Savings Program
If you do not qualify for Low Income Subsidies, you may still qualify for another Medicare Savings Program. Much like LIS, Medicare Savings Programs help those who are not eligible for Medicaid but still need help paying for Medicare costs. Medicare Savings Programs have certain qualifications that include your monthly income and assets (stocks, bonds, savings accounts). The programs are as follows:
Qualified Medicare Beneficiary (QMB) Program:
Helps pay Part A premiums, Part B premiums, and deductibles, coinsurance, and copayments.
Qualified Disabled and Working Individuals (QDWI) Program:
Helps pay for Part A premiums for those who are working, disabled, and under 65 or who returned to work and lost their premium-free Part A. This is not for those who are already receiving state medical assistance (Medicaid).
Qualification limits:
Individual monthly income of $4,132 or less
Married monthly income of $5,572 or less
Individual assets valuing $4,000 or less
Married assets valuing $6,000 or less
Social Security Help
If you receive social security benefits, you may be able to get a greater benefit by enrolling in certain Medicare plans. That’s right, some Medicare Advantage plans (offered by private carriers) include benefits that pay for part of your Part B premiums, which will result in you getting a slightly larger check from Social Security. Talk to a Medicare Plan Finder agent to see if this type of benefit is available to you.
Get Help Completing Your Medicare Extra Help Application
Some Medicare beneficiaries go years without realizing they qualify for Medicare Extra Help (LIS). Licensed agents in your area may be able to help you apply for LIS. If you haven’t already spoken to an agent about applying for LIS, call Medicare Plan Finder now at 844-431-1832 or click here to request a call.
This post was originally published on November 9, 2017, and updated on December 31, 2019.
Spouse Medicare 101
Spouse Medicare 101
Medicare does not work like individual health care plans – there are no family plans. Every individual Medicare beneficiary will have his or her own plan. However, even though you can’t be on the same plan or share spouse benefits, you’re still in it together. You can meet with an agent together, you can pool your income, and you can mail in one check to pay your premiums. Let’s look at how precisely spouse Medicare works.
Medicare Eligibility Requirements
In some cases, both spouses may not meet Medicare eligibility requirements. Usually, one spouse will turn 65 before the other, or one will become disabled while the other is not. This means one person may hold onto their individual marketplace plan while the other person enrolls in Medicare. Eligibility is different for every person. That’s why Medicare beneficiaries cannot be on the same plan.
Medicare Premium Payments
Every single person will have his or her own premium payment each month. However, if you and your spouse have the same plan, you can mail in just one check to pay for both plans.
Make sure that when you are paying your premiums, you send in money for the correct account. If you only want to send in one check, make sure you write clearly on the check which account the payment is for (or write both if it is for both).
Spouse Social Security Benefits
While Social Security and Medicare are regulated by the same government agency, and in most cases pertain to the same age demographic, they are vastly different programs. In fact, spouse Social Security benefits and spouse Medicare benefits are one of the many areas in which they differ.
For example, with spouse Social Security benefits, if your spouse dies, his or her benefits may become available to you. However, this is not the case with Medicare. Since Medicare is an individual healthcare plan, one spouse’s Medicare plan does not provide any benefit to the other. Thus, it is imperative that if both spouses are in need of Medicare, they each have their own plan.
Medicare for Non-Working Spouse
People often wonder if Medicare for their non-working spouse is available. In short: yes, as long as they are eligible. However, your spouse’s costs may be different from yours.
Any individual who has been employed for more than 10 years and has paid taxes qualifies for premium-free Medicare Part A coverage, (hospital insurance), upon turning 65. If you have not worked and paid Medicare taxes, you’ll have to pay a premium for Part A Medicare regardless of your spouse’ employment history.
In many cases, if you qualify for Medicare, when your non-working spouse turns 65, they may qualify based on your work record. However, the same basic eligibility requirements still apply to the non-working spouse. For example, if you are 65 and receiving Medicare, and your non-working spouse is 62, he or she will have to wait until they are 65 to start receiving benefits. Conversely, if your spouse is older, Medicare for your non-working spouse will be available to purchase Medicare will have to pay a premium for Part A until your premium-free benefit kicks in at age 65.
Medicare Family Coverage
In general, Medicare is not applicable to non-qualifying spouses or dependants. However, if your child has a qualifying disability, they may be eligible for a Medicare plan of their own. It is important to note that there is often a two-year waiting period for Medicare coverage for people with disabilities, including children. For example, if your child was born with a disability, he or she might have to wait until their second birthday to get Medicare. (Though, if your child has End-Stage Renal Disease or Lou Gehrig’s disease there is generally no waiting period for Medicare coverage.)
Medicare Plan Spousal Discounts
While Medicare does not provide spouse benefits, there are some plans that offer household discounts.
You should always confirm with your agent whether or not a household discount exists as some companies may have specific requirements regarding spousal discounts.
Medicare Extra Help and Income Limits
The one thing that marriage will affect when it comes to Medicare is whether or not you qualify for the Extra Help Program, otherwise known as Low-Income Subsidy (LIS). LIS exists to help people with limited income pay for their prescription drugs. Those who qualify for the program pay less in drug premiums, copayments, and coinsurances, and are also covered during the Coverage Gap.
Single and married beneficiaries have different requirements for what constitutes a low income level. For example, to qualify for LIS (a prescription drug savings program), single beneficiaries must make less than approximately $18,000 per year, but married couples must make less than approximately $24,000 per year.
Meet with one of our agents to find out if you qualify for savings.
Joint Meeting with a Licensed Agent
Even if you and your spouse have different Medicare plans, you can still share a medicare agent! Sharing an agent will make your enrollment process easier and help you build a relationship with someone who knows everything about Medicare and can help you find savings.
Do you have a licesned agent? Have more questions about spouse Medicare? Give us a call today to set up a free meeting. Our agents are licensed to sell several different plans, so they can offer you an unbiased opinion and help you find the plan that truly works best for your needs. Call us at 1-844-431-1832.
This post was originally published on 3/8/18 and updated on 9/25/18
Why Use a Licensed Agent for Medicare Plans?
How are you enrolling in Medicare? Have you considered using a licensed agent? Licensed agents are experts who can help you navigate the confusing world of health care and select the best Medicare options for your needs. There are no extra costs associated with them!
Why should I use a Licensed Agent?
Licensed agents who sell Medicare plans dedicate their careers to helping Medicare-eligible Americans find the best health care plans for their needs. They are experts in their field and are available to answer any questions you have and help you go through the Medicare plan enrollment process.
If you attempt to enroll in Medicare Advantage, prescription drug plans, or other coverage options without using a licensed agent, you’ll have to speak with someone over the phone or go through the process online by yourself. That means you’ll have fewer opportunities to ask questions and more opportunities to make mistakes. We don’t blame you – Medicare is confusing. That’s why we have licensed agents in 38 states!
Our licensed agents are certified and contracted to sell plans from several different carriers. That means that they do not have any bias when it comes to helping you select a plan! They get paid no matter what plan you choose. That means that in most cases, if two plans that are available to you are almost exactly the same but one will cost you less, they can sell you the cheaper option.
Are there Medicare Fees Associated with Licensed Agents?
There are no additional Medicare fees associated with licensed agents. Whether you enroll over the phone, online, or through a sales representative, you will pay the same price. Licensed agents do earn commission from their plan sales, but that does not impact your price.
It’s like buying a car. Most car salesmen earn commission on the cars that they sell, but that doesn’t mean that the cars are more expensive. A $30,000 car is still a $30,000 car whether you purchase it from a commission-based salesman or not. A $300 health plan premium is still a $300 premium whether you purchase it from a commission-based sales agent or not. There are no extra Medicare fees for purchasing from a sales agent.
Licensed Agent Websites and Finding Your Sales Agent
Some agents will have their own websites promoting their services. While there’s nothing wrong with doing your own research and finding your own agent, we do offer a service to connect you with a licensed agent near you and schedule an appointment for you. You don’t have to do any of the work!
How do I find a Licensed agent for Medicare near me?
We can send a sales agent in your area to your home (or another place that you select, like a public library) to go through your Medicare options and help you select the best plans for your needs. To begin, click here or call us at 1-844-431-1832.
This post was originally published on 2/1/18 and updated on 9/25/18.
What is a Medicare Advantage Special Needs Plan?
A Medicare Advantage Special Needs Plan, or SNP, is a Medicare Advantage plan that is designed to provide coordinated care for Medicare beneficiaries with special needs. These plans have specific qualifications but offer expanded and specialized coverage.
Medicare Advantage SNPs are specific to your needs whether that be diabetes, Alzheimer’s, heart disease, or another chronic illness. Plus, all SNPs must include hospital coverage (Part A), medical coverage (Part B), and prescription drug coverage (Part D). Other benefits include $0 or lower beneficiary cost sharing, extended benefits coverage for inpatient care, and longer coverage periods for specialty medical services.
Like all healthcare plans, SNPs have provider networks. In most cases, you will need to select a primary care physician or health coordinator to be your main source of healthcare.
Medicare Advantage Special Needs Plan Eligibility
To start, you’ll need to be enrolled in Original Medicare. You also must live in an area that supports a SNP plan as they are not available everywhere. Then, to be eligible, you must have a special need. In the case of SNPs, special needs can mean Medicaid-eligible/low-income (D-SNP), institutionalized (I-SNP), or diagnosed with a severe or disabling chronic condition (C-SNP).
What is a dual eligible special needs plan (DSNP)?
The “dual” in Dual Special Needs Plan indicates that you are eligible for both Medicare and Medicaid. If you are over the age of 65 and have low income, there is a good chance that you fall into the D-SNP category! If you are eligible, most of your costs will be covered for you. To learn more about the Medicaid eligibility categories that could place you in a DSNP plan, click here.
What is an Institutional Special Needs Plan (ISNP)?
To be eligible for an I-SNP, you must live in or be moving into a long-term care skilled nursing facility, inpatient psychiatric facility, or another care facility. You must require the facility’s services for at least 90 days to qualify for an I-SNP.
What is a Chronic Condition Special Needs Plan (CSNP)?
CSNPs are generally designed for specific types of illnesses and disabilities. For example, a Chronic Condition Special Needs Plan for someone with chronic heart failure may provide additional coverage for heart treatments, while a CSNP for someone with chronic substance abuse may offer extra coverage for therapy and rehabilitation. Qualifying conditions can include chronic alcohol or other substance abuse, neurological disorders, heart failure, and more.
How to Enroll in a Medicare Advantage Special Needs Plan
If you are eligible for a Medicare Advantage special needs plan, you are eligible for a Special Enrollment Period. This is great because you can enroll any time of year and don’t need to wait for a specific enrollment period! If you are looking to enroll in a Medicare Advantage Special Needs Plan in your area, a licensed agent can guide you through the process. In fact, our agents at Medicare Plan Finder can answer any questions about SNPs and eligibility. There is no cost to you and never an obligation to enroll. To get in contact, fill out this form or call us at 844-431-1832.
This blog was originally published on 6/14/18, but was updated on 3/22/19.
Medicare and Telehealth
Do you have trouble getting to your doctor’s appointments? Do you have a disabling condition or a lack of adequate transportation? Medicare and Telehealth may be the solution for you.
What is Telehealth?
Telehealth is a way for you to access quality care without having to leave your home. It began as a way for patients in rural areas and those who are too sick to leave home to speak with their doctor, but now it’s becoming a way of the future.
“Telemedicine” refers to diagnosis and monitoring through technology, while “telehealth” refers to any and all digital health management or education. There are four main types of telehealth:
Live Video – a real-time interaction between patient and provider.
“Store-and-forward” – recorded photo and video (like x-rays) sent to a specialist
RPM (Remote Patient Monitoring) – an electronic transfer of medical data
mHealth (Mobile Health) – care and education (like alerts) via cell phone, tablet, or computer
Telehealth Growing in Popularity
AARP reported that in 2013, the Telehealth industry was earning only $14.3 billion. It is expected to reach $36.2 billion by next year! It has been said that the baby boomer population, who are all around the age of 65 in 2020, have greatly contributed to telehealth’s popularity. Seniors are excited about the idea of not having to leave home to speak with their doctors because leaving home has frankly gotten difficult.
Telehealth Providers
It’s always best to see a doctor in person so that they can perform the best physical examination possible. However, if you find yourself in a situation where you can’t get to your doctor’s office, you can schedule an appointment or speak with a doctor at a digital clinic. HealthTap, Teladoc, and MDLive are just a few examples of virtual clinics. If you think you need a prescription or if you want to talk to a physician or counselor but can’t find a way to go do it, log into one of these websites instead!
Keep in mind that if you are hoping for a controlled medication prescription, such as for a steroid or antidepressant, you will most likely need to see a provider in person.
What Kind of Doctors use TeleHealth?
Telehealth isn’t just for primary physicians. You may be able to find a specialist doctor on a telehealth service as well!
Mental Health: Psychiatrists and therapists can talk to you via webcam or even phone call. A webcam is always ideal so that your therapist can read your body language and look you in the eyes while talking to you. Not only is this more convenient for everybody, but depressed patients may have an easier time picking up the phone than having to leave the house.
Teledermatology: Webcams may not be clear enough for a doctor to spot a skin issue, but telehealth also allows your doctors to coordinate care. If your primary physician spots a skin condition but wants you to see a dermatologist for a second opinion, your doctor may be able to use a telehealth system (the store-and-forward method) to send a high-quality picture of your skin condition to a dermatologist, saving everyone time and money.
Teleophthalmology: Similarly to dermatology, doctors can exchange high-quality photos of your eyes so that you can get the care you need even if there is not an ophthalmologist nearby. This is most useful for people living in rural settings where there is not an abundance of doctors and specialists.
Teleoncology: A cancer diagnosis may mean that frequent doctor trips are required, which can be tough for those living in more remote areas and for those who have a hard time leaving home. Teleoncology can allow doctors and patients to discuss care plans, monitor vital signs, and even exchange important images without ever having to meet in person. This can drastically cut down on costs and the toll that it can take on a person with a cancer diagnosis to have to frequently travel to a doctor’s office.
What Illnesses can be Treated by TeleMedicine?
Since doctors can prescribe treatments electronically, common illnesses like diabetes, allergies, arthritis, infections, and depression can be treated through telemedicine. As long as your doctor is able to connect with you and prescribe the appropriate treatment, telehealth works.
Telehealth Medicare Coverage
Medicare has strict guidelines as to what telehealth service can be covered.
The “store-and-forward” system is only covered by Medicare in Alaska and Hawaii. That means that if a patient who lives in Alaska or Hawaii has a medical concern but there is not a specialist available in those states, a doctor can use the store-and-forward system to submit medical records and imaging to a specialist in the continental United States.
To be eligible for coverage for telehealth medical appointments, you must live in an area that is outside of a metropolitan statistical area or is in a rural area with a primary or mental health care shortage. This tool can help you determine whether or not your address is eligible.
Additionally, the 2018 CHRONIC Care act allowed Medicare Advantage plans to provide more alternate coverage. This includes telehealth for anyone who lives in an HPSA, or Health Professional Shortage Area.
To find a Medicare Advantage plan with telehealth coverage, contact us! We can have an agent help you pick the best plan that is best for your needs. Just click here to request a call or call us now at 844-431-1832
*This blog was originally published on May 17, 2018, and updated on September 13, 2019.
New Medicare Benefits Thanks To CHRONIC Care Act
Last month, Congress introduced the CHRONIC Care Act. The title “CHRONIC” stands for “Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care.” It is designed to help seniors and Medicare beneficiaries with chronic illnesses and disabilities and those who benefit from both Medicare and Medicaid.
New Medicare Advantage Benefits
With the CHRONIC Care Act, Medicare Advantage plans can now cover “nonmedical” benefits. Before the act passed, your Medicare Advantage plan would only cover “Durable Medical Equipment (DME).” DME includes items like blood sugar monitors, wheelchairs, hospital beds, and other items deemed medically necessary and durable (reusable for at least three years). Now, Medicare Advantage plans can cover home modifications (like wheelchair ramps, chair lifts, and bathroom handlebars) if medically necessary.
Additionally, Medicare Advantage plans can now provide more telehealth services. That means that your plan may provide coverage for virtual health services, like talking to your doctor via phone or video chat. Previously, Medicare had very strict guidelines about who was eligible to receive coverage for telehealth from Medicare. Now, the CHRONIC Care Act is expanding telemedicine.
Additional Home Care
The CHRONIC Care Act also expands your access to home care. Kidney disease patients can now access in-home dialysis treatments. This means that in the future, it may be easier for your doctor to come visit you.
Additionally, the Independence at Home program is expanding from 10,000 patients to 15,000. Independence at Home is a small program that allows doctors to visit patients on house calls and receive Medicare coverage. The program increases care quality and lowers care cost. While the program is still quite limited, this expansion means that more and more chronically ill patients are gaining access to home care.
Better Care Coordination
Lastly, the new act allows Accountable Care Organizations (doctor and hospital groups) to pay patients up to $20 when they come in for primary care services. This is an incentive to get people to visit Accountable Care Organizations. While ACOs may not be the best solution for everyone, they are beneficial because you can find all your doctors and providers located in one convenient place.
All of these updates and changes mean that it’s going to be much easier for seniors and Medicare beneficiaries with chronic conditions and illnesses to access the best possible care and coverage.
We are making every effort to help people like you enroll in the right plan with the right coverage.
Looking for help picking a plan? Give us a call at 1-844-431-1832.
Is Medicare Better Than Individual Plans?
Are you turning 65 soon and preparing to switch from your individual marketplace plan to Medicare? Or are you eligible for Medicare but trying to decide if you want to keep an alternative form of coverage? Generally, there are four types of health care plans and it can be hard to figure out which one you need. Your options are employer coverage, private coverage, Medicaid, and Medicare (additionally, Tricare and VA coverage for Veterans). Some people can have more than one of those options at any given time.
Let’s talk about the differences.
Employer Coverage
You can purchase health insurance through your employer, as long as it meets the coverage limits set by the federal government.
Private Coverage
You can purchase insurance from an exchange like Healthcare.gov, directly from your state, or directly from a health insurance company. Generally, purchasing private insurance is more expensive than employer coverage, and much more expensive than Medicare and Medicaid.
Medicaid
Medicaid is a federal health program. Each state has slightly different rules and each state has its own funding. It can cover any person of any age with low income (according to the Federal Poverty Level). Most Medicaid beneficiaries will have either no or very small premiums. If you have a low monthly income AND are over 65, you may qualify for both Medicaid and Medicare!
Medicare
Medicare is a federally funded health program for adults with disabilities, end-stage renal disease, or kidney failure. It also covers any person over the age of 65. Some parts of Medicare are free, while others require premiums. Most people will not have to pay nearly as much for Medicare as they would with an individual or private health plan.
You may think that individual plans provide more coverage due to the higher premiums, but that is not always the case. All Medicare plans include preventative services. Plus, you can choose to enroll in Medicare Advantage, which is like a private plan for Medicare. With Medicare Advantage, you can roll all your benefits – medical, dental, vision, prescription drugs, and even fitness – into one convenient plan.
We specialize in Medicare and serving the underserved senior and Medicare-eligible population. Do you or a loved one need help selecting a Medicare plan that truly helps? Set up a free appointment with one of our licensed agents in your area to get bias-free assistance. Call us to set it up at 1-844-431-1832.
How Seniors Can Combat Addiction
Are you or a loved one suffering from addiction? It’s actually quite common for seniors to suffer from addiction to drugs or alcohol due to lack of mobility, isolation and loneliness, and depression. Plus, seniors are more likely to have prescriptions for addictive drugs and are more likely to receive prescriptions that they don’t really need and become overmedicated.
The Recovery Process
The recovery process for seniors to combat addiction is not much different than the process for younger adults. There are two steps to every addiction recovery process: physical and psychological. Affected seniors will have to train their bodies to not be dependent on alcohol, drugs, or whatever they’re addicted to, but that starts with psychologically training the mind to not want those items. Most affected individuals will go through a withdrawal period that can bring symptoms like nausea, shakiness, sweating, loss of appetite, and anxiety.
Treatment centers often coach not only the affected senior but also the person’s family members or friends. That way, people can learn how to take care of their loved ones. Group therapy options are also available.
Treatment Coverage
Mental health and addiction treatment is one of the ten required services under the Affordable Care Act. That means that Medicare marketplace plans are required to cover addiction treatment. As long as services come from a provider or facility who participates in Medicare and a doctor states that the services are medically necessary, addiction treatment must be covered.
The Breakdown
Medicare Part A will pay for any hospitalization related to substance abuse and addiction treatment, but out-of-pocket costs (according to your individual plan) will apply. That means that you have to pay any copays or deductibles that you are normally responsible for. However, there is a limit. Medicare will only cover up to 190 days spent in a psychiatric hospital for an entire lifetime.
Medicare Part B will pay for substance abuse and addiction treatment at a doctor’s office or if you are a hospital outpatient. As usual, Medicare will pay 80% and you will be responsible for the other 20%. This coverage includes things like therapy, hospital follow-up visits, and hospital drugs. For other drugs, you will need a Part D or Medicare Advantage plan.
Are you or your loved one covered?
If you or someone you know has a problem with substance abuse or addiction, we can help make sure they have the best coverage possible. Our agents are licensed to sell products from multiple carriers, so we can supply the unbiased care they deserve. Call to set up a no-cost appointment at 1-844-431-1832.
What Is The Scope Of Appointment Form?
What Is The Scope Of Appointment Form?
Health care is personal, financial, and crucial. It can be difficult to hand your information over to strangers so they can start charging you fees, so you’re probably cautious about signing forms and documents. However, the Scope of Appointment form, or SOA, is an important one for you to sign.
The Centers for Medicare and Medicaid Services, CMS, requires that Medicare and Medicaid sales agents fill out the SOA at or before every appointment. The form documents exactly what the parties plan on discussing. The information is confidential but required for the agent to proceed.
Why?
SOA forms are just one way that CMS tries to protect you, the consumer. It prevents agents from trying to sell you more than you need or start discussing products illegally. By law, Medicare and Medicaid sales agents are only allowed to discuss the information they agreed to on the SOA form. The form is not required for Original Medicare enrollment. However, it is required for Medicare Advantage, Medicare Supplement, Part D (Prescription Drug) plans, Hospital Indemnity, and Dental/Vision/Hearing plans.
Fraud, Waste, and Abuse
SOA forms are one of the countless rules that Medicare and Medicaid sales agents are required to follow. An agent who breaks a CMS rule is considered guilty of fraud, waste, or abuse.
If an agent attempts to sell you a product that you did not agree to discuss, you can file a fraud, waste, and abuse complaint with The Centers for Medicare and Medicaid Services.
At MedicarePlanFinder, we’ll set you up with a Medicare Health Benefits agent who knows to always file an SOA and stick to it when meeting with you. Do you have any questions at all about your Medicare plan? Are considering changing or adding a plan? Call us to set up a meeting with one of our licensed and experienced agents at no cost to you. Call us at 1-844-431-1832.
