Medicare Sales Scope of Appointment

Scope of Appointment

Scope of Appointment

Before Medicare insurance agents can meet with you to sell you a plan, they must secure Scope of Appointment documents from YOU, the consumer.

If you call an insurance company or an insurance agency and request to meet with an agent, they’ll typically offer an appointment in your home, or at a library or coffee shop. But before you meet with a sales agent to discuss your plan options, every one of them will require you to fill out a Scope of Appointment.

The Scope of the Appointment outlines what you specifically want to discuss at the appointment whether it is a Part D plan, a Medicare Advantage Plan, or a Medigap plan. The agent is not allowed to talk to you about products that are not included in the scope of the appointment.
When the agent presents you the Scope of Appointment, typically they’ll want you to agree to discuss ALL plan options, which is usually a good idea. That’s because if you think you’re in the market for an MAPD plan, but it turns out you want a Medicare Supplement (Medigap), there’s a problem.  If you didn’t fill out the Scope of Appointment form to ‘OK’ talking about a Medigap plan, then the agent cannot talk to you about it.

Scope of Appointment Not Always Required

The Scope of Appointment form is not required during sales and marketing seminars. So, if you get invited to and attend a seminar to listen to Medicare options, and decide to buy a product at the end of the seminar, you won’t need one.

Scope of Appointment forms often differ from one health insurance plan to another. The form usually indicates the sales agent does not work for the federal government and may benefit from the sale of the health product (will receive a commission).
The forms also bear the notice that signing the appointment form is not a binding agreement to enroll in any plan. The form does not affect your current or future enrollment status in any Medicare plan.

By law, it is not possible for any insurance sales agent to proceed with an in-person appointment unless the beneficiary or the person seeking information on their behalf has signed and submitted the form to the agent.
During the in-person appointment, the following are the actions that the sales agent is legally allowed to make:
1) They can discuss various plan options with you
2) They can distribute plan materials, including the enrollment kit for the insurance product
3) They can distribute or collect enrollment forms
4) They can advise on how to get plan information, for example through mail, a website or customer service
5) They can also provide educational content

However, the sales agent cannot market non-healthcare related products until at least 48 hours after the original appointment.

Related Post: “Do Commissions Influence Medicare Insurance Agents?”

The Takeaway:

The Medicare Scope of Appointment is a form you must fill out before an insurance agent can discuss plan options with you.  It’s best to fill it out completely, marking all of the Medicare plan options you may wish to discuss.

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Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.