Medicare Blog

when is a scope of appointment required with medicare

by Estel Runte Published 2 years ago Updated 1 year ago
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A completed Scope of Appointment is a CMS

Centers for Medicare and Medicaid Services

The Centers for Medicare & Medicaid Services, previously known as the Health Care Financing Administration, is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state government…

requirement for Medicare Advantage Plans and Prescription Drug Plans prior to conducting individual marketing activities. An agent may not market any health care related product

When do you need a Scope of Appointment? The Scope of Appointment form is necessary when the insurance agent is meeting in person with a new, current, or prospective beneficiary. The Scope of Appointment form works in conjunction with the sales of insurance plans and helps to keep you safe from pushy salespeople.Sep 27, 2021

Full Answer

What is a scope of Appointment form for Medicare?

Jan 20, 2022 · If you’re considering signing up for a Medicare Advantage or Medicare Part D plan in person, you’ll need to sign a Medicare Scope of Appointment before meeting one-one-one with a Medicare insurance agent. This form protects you from unwanted solicitations and ensures the agent focuses on the plans that interest you.

When to take the scope of appointment for an appointment?

Oct 25, 2020 · The Medicare Scope of Appointment is a form which Medicare beneficiaries must complete to designate, prior to their appointment with an agent, exactly which items they wish to discuss. In other words, this form is how you tell your agent which insurance products he or she can present to you. The form serves to protect you from unwanted solicitation.

What is the scope of appointment for Medicare Advantage sales presentations?

Apr 14, 2016 · A “Scope Of Appointment” form is required to be signed by prospective clients in advance of an agent discussing their Medicare Insurance plan options. (A Scope Of Appointment form is basically just your written permission for an agent “ only " to discuss the Medicare plan options listed on that form.

Do you need a scope of appointment for a PPO policy?

Oct 11, 2021 · A Scope of Appointment form is a document that must be completed before meeting with a Medicare health insurance broker in Santa Rosa. It provides potential beneficiaries with a list of topics that may be discussed, including Medicare plans and other insurance products, so that you may indicate what you are and are not interested in discussing.

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When should a scope of appointment be submitted?

If the meeting was set up as an in-person appointment, a scope of appointment is required. If the meeting is advertised as a sales event open to the general public, a scope of appointment form is not required. 7.

What is a Medicare scope of appointment?

The Scope of Appointment is a federally required form used to document an appointment between an insurance agent and a Medicare beneficiary to ensure that no other types of products are discussed outside of what the beneficiary originally requested.Apr 28, 2020

Is a scope of appointment required for a telephonic presentation?

Who needs a Scope of Appointment? A Scope of Appointment is required for any individual in-person or telephonic marketing appointment with an agent.

How long are scope of appointment good for?

10-years
CMS requires agents to keep the SOA form for 10-years from the date of the appointment. Even if an enrollment never took place, SOAs should be retained and ready to make available upon carrier, CMS or other regulatory body request.Feb 19, 2021

In which setting is a scope of appointment not required?

It's not required for prospects to complete a Scope of Appointment form if they only want to talk about Medicare Supplement plans or other health-related lines of business. But prior to the appointment, it's recommended that you have prospects fill out an SOA with the intent to also discuss drug coverage.Oct 22, 2019

How long are you required to maintain scope of appointment documentation?

You must maintain SOAs for at least 10 years. And, you'll want them readily available upon request. This includes initial and additional SOAs obtained during appointments.

What is an SOA form?

The Centers for Medicare and Medicaid Services requires agents to document the scope of a marketing appointment prior to any individual sales meeting to ensure understanding of what will be discussed between the agent and the Medicare beneficiary (or their authorized representative).

What of the following is considered unsolicited contact?

Unsolicited direct contact with a consumer that was not requested or initiated by the consumer is prohibited and includes in-person (e.g., door-to-door marketing), telephonic (e.g., outbound telemarketing), electronic (e.g., email, voicemail messages, text messages) solicitation.

How long is an electronic scope of appointment eSOA valid for?

For privacy, the eSOA is only valid for 14 days. If you sent an eSOA to your client more than two weeks ago, and your client did not click on the link to view and sign it, then the link expired and will no longer work. If that happens and the client still needs an eSOA, you can send the eSOA again.Jun 16, 2016

What actions are prohibited during marketing sales events?

Cannot send unsolicited text messages and leave voicemail messages. May call or visit beneficiaries who attended a marketing/sales event prior permission is given and documented. Cannot approach beneficiaries in common areas (i.e. parking lots, hallways, lobbies, sidewalks).

Can a member can add or drop prescription drug coverage during the annual election period AEP?

During the AEP, you can join, change, or drop your Medicare Part D prescription drug plan (PDP) or Medicare Advantage plan (like an HMO, PPO, HMO POS, or PFFS plan) that includes prescription coverage (MAPD) or a Medicare Advantage plan without prescription coverage (MA).

Bad Apples

Stay vigilant. Only do business with reputable agents who have been fully vetted and follow the rules of Medicare.

Your Options When Completing the Scope Form

The Medicare Scope of Appointment form lists several products that you can give your agent permission to talk with you about. These include:

What is a scope of appointment?

What Is a Medicare Scope of Appointment (SOA)? A Medicare Scope of Appointment form is a paper you fill out before you get into a detailed discussion with your agent about your Medicare options. By filling out this form, you are able to control what coverage options are discussed in your appointment.

What is SOA in Medicare?

As a requirement from the Centers for Medicare & Medicaid Services, the SOA protects you from unwanted solicitation and scams. It not only protects your wishes, but it weeds out agents with negative intentions. The products on the form include: Medicare Prescriptions Drug Plans (Part D) Medicare Advantage (Part C) and Cost Plans.

Who is Luke Hockaday?

Luke Hockaday is a Customer Success Rep here at Medicare Allies. Luke has been helping Medicare-eligible clients with their insurance and retirement-planning needs since 2011. Luke is passionate about 3 things, and 3 things only: senior insurance, football, and food!

Do you need to document SOA prior to appointment?

Yes. If—and when—agents encounter unexpected prospect (s) who are present for a properly solicited and documented individual appointment, the additional prospect (s) must document the SOA prior to the beginning of the appointment.

What is SOA in Medicare?

Completing a SOA is a CMS requirement for any appointment that might discuss Medicare Advantage or Prescription Drug Plans (PDPs). Prior to an appointment, the topics to be discussed are agreed upon between the agent and the beneficiary; they are documented by a signed SOA form. There are no exceptions.

But You Should Bring Some for Future Appointments

CMS allows beneficiaries to fill out and sign SOAs at events for future appointments. This could be a good opportunity to collect clients and start your preparations for the annual enrollment period (AEP). Remember: Beneficiaries must never be told (or feel) that filling out an SOA is required.

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