10 Tips to Submitting an Error-Free Medicare Enrollment Application

Any time an insurance application gets flagged during the submission process, it’s a delay on your clients’ coverage and your commission. What if we told you we can help you avoid stalled Medicare applications?

Throughout the year, agents and agencies submit hundreds of Medicare enrollment applications. To help you ensure your submissions quickly pass through the system, we’ve put together some tips for completing a Medicare application form.

Move Online

Before we get into the nitty-gritty, we’d like to mention an overarching suggestion — move your Medicare application online.

Did you know nearly 58 percent of adults applied for Social Security online in September 2024? Paper applications grow more obsolete as carriers perfect their online forms, FMOs create useful tools, and more and more people over 65 use the internet. In addition, using technology to collect client information and sign them up for Medicare can allow you to spend more time finding the best plans for your clients and generating leads.

Ritter and Integrity offer proprietary tools, like MedicareCENTER and PlanEnroll, that simplify how to apply for Medicare online and manage your business! First-year agents who use Integrity technology are nearly 50 percent more productive than those who don’t. And experienced agents using Integrity technology write 64 percent more apps than those who don’t!

Take the first step toward enhanced online productivity and register for free with our site now, then follow our tips to submitting Medicare applications that are error free below.

1. Prepare Thoroughly

Before you begin an application, make sure you have all the necessary client information, like their full name, contact information, date of birth, and Medicare Beneficiary Identifier (MBI), all in one place. If you must navigate away from an insurance application, you increase the risk of losing your spot or making a mistake.

Prepare Online with MedicareCENTER & PlanEnroll

Put in place good processes for collecting the necessary data for an application, like utilizing a good customer relationship management (CRM) system. Integrity’s CRM, MedicareCENTER makes it easy to store and access client information as well as both inbound and outbound sales calls. Best of all, it syncs with your clients’ PlanEnroll profiles — where they can enter and update their own contact, health, and prescription drug information and preferences on their own time!

You can gain access to these tools and Integrity’s full Suite of Solutions by completing one sign up here!

2. Write Neatly and Legibly

If you’re completing a paper Medicare application, use a pen with blue or black ink and do your best to keep your handwriting easy to read. If there’s any room for interpretation, the carrier will end up circling back to confirm what’s meant, which delays the process.

If you can’t read the application, it’s likely others can’t either. It never hurts to review the application with the client to ensure its accuracy before moving it through the submission process.

Keep It Neat Online

If you submit the Medicare application online, no one has to worry about reading your handwriting!

3. Keep in Compliance with SOA Rules

CMS’ rules on Scopes of Appointment (SOAs) dictate that agents must complete an SOA 48 hours before making an appointment with a beneficiary. Exceptions to this rule include when a beneficiary is four days or less from the end of a valid enrollment period (e.g., Annual Enrollment Period, Open Enrollment Period, Special Enrollment Period, Initial Coverage Election Period) or unscheduled in-person meetings (walk-ins) initiated by the beneficiary.

The SOA is also only valid for 12 months, and you will need to get a new one if the original expired. We recommend tracking the start and stop date within your CRM.

Please note, you cannot complete SOAs for AEP before October 1.

On the SOA itself, make sure that at least one of the selected types of contracts to be discussed on the SOA matches the plan that’s chosen on the application. Additionally, make sure that each field is filled out in its entirety and is legible, if you’re filling out a paper SOA. If during your meeting, you and the client decide you’d like to discuss additional plan types, you’ll have to compliantly collect another SOA before discussing those products.

The SOA is a good point of reference for agents to easily access clients’ contact information in the future. Even if certain fields are “optional” on the SOA, it’s in your best interest to make sure everything is filled out.

SOAs must be kept on file for 10 years per CMS rules, regardless of if a sale occurred or not. Keep in mind, even as CMS rules change, some carriers may maintain their current policies. You’re still responsible for following the procedures of the carriers you represent.

Even if certain fields are “optional” on the SOA, it’s in your best interest to make sure everything is filled out.

4. Provide Details Where Required

If an applicant answers “yes” to any health question that requires additional information, be sure it’s provided on the application. Additionally, if the SEP requires any extra information (e.g., a chosen PCP, Medicaid, PDP, or Extra Help info), it must also be on the application.

Store Details in Your Client’s Profile

On top of basic information, you can store a myriad of client details in MedicareCENTER — conditions, providers, preferred pharmacies, and prescriptions — or your clients can store these details in their PlanEnroll profile, which syncs with MedicareCENTER.

When you go to fill out an application, you’ll have all the details you need stored in one place — your client’s profile in MedicareCENTER.

5. Select a PCP When Necessary

If an applicant would like a carrier to auto-assign a primary care physician (PCP), be sure to note that in the appropriate field. Some plans require a PCP selection, so leaving this field blank could hold up an application’s approval.

Typically, applications for HMO plans require the applicant to specify an in-network PCP. Check to make sure an in-network PCP is on any application for an HMO plan to prevent roadblocks in the enrollment process.

As with most application information, it’s always better to have more information rather than not enough. Therefore, if your client can list a PCP, request they do so regardless of the requirement.

Copy & Paste from Your Clients’ Records

As mentioned above, MedicareCENTER can organize much of your clients’ information. It can also prefill certain fields into an application. Not everything may prefill, so don’t forget the power of copy and paste. Pull up one web browser window with your client’s profile. Pull up another with the application. Then, copy and paste information from your client’s file into the application without having to retype everything (and without increasing the chances of mistakes).

To start, highlight the info by clicking at the start of it and dragging your mouse to the end of it. Next, either use the shortcut ctrl + c on your keyboard to copy or right-click on your mouse and select Copy. Then, click where you need to paste it and either use the shortcut ctrl + v to paste or right click with your mouse and select Paste. Alternatively, leave it blank and request that the client fill in this information after you send the prefilled app.

6. Match the Attestation with the Election Period

The selected period in the Attestation of Eligibility section needs to align with the selection of IEP, AEP, or SEP in the Agent/Office Use section of the application.

If the election period requires a date (such as the date a client is losing coverage), make sure it’s present and accurate. Additionally, if the SEP requires any extra information such as Medicaid, PDP, or Extra Help info it must be on the application.

If the SEP requires any extra information such as Medicaid, PDP, or Extra Help info it must be on the application

If you need clarification for which period to select, you can ask your Ritter sales specialist.

The Service Area Reduction SEP

Those whose Medicare Advantage or Part D plan will be discontinued for the upcoming plan year can use the SEP for service area reduction, coded as SEP SAR or Service Area Reduction. This SEP is valid December 8 through the end of February.

7. Never Alter a Client’s Signature

Even though you may have the best of intentions, altering a client’s signature, or the associated date, on an application is strictly prohibited.

This rule extends to the SOA or any other documents that go with the application, and even your own signature or date as the agent. It’s always better to start a new application with your client than to forge and falsify a legal document.

Even though you may have the best of intentions, altering a client’s signature, or the associated date, on an application is strictly prohibited.

Digital Signatures

Emailing or texting a prefilled application to a client provides a safeguard against signature alteration. The client controls when the application is signed, and nobody can alter it.

8. Make Sure the Application Is Complete

Every part of the application is important to us, the carrier, and your client, so it’s vital you make sure the application is complete. Check and double-check to make sure you’ve finished the application before submitting.

9. Submit the Application on Time

Once you’ve taken the time to review the application, be sure to submit it with the appropriate cover sheet, and any other required documents, within the specified time-period.

Applications can arrive at the carrier no later than 48 hours from the agent’s signature date. If you’re late, you risk being penalized by the carrier. Plus, why hold things up? A delayed enrollment is a delayed commission.

10. When in Doubt, Call for Help

Your business is serving your clients, and our business is serving you. If you have any questions about submitting an application, don’t hesitate to call Ritter for assistance.

Submit a Request Online

Besides calling us for help, you can always submit a question or request by clicking the Ticket icon in the upper right-hand corner of the Ritter Platform’s agent dashboard.