What Can MAPD Insurance Agents Do Prior to AEP?

The Medicare Annual Enrollment Period officially starts on October 15, but you don’t have to wait until then to get a leg up on your sales! October 1 is when you can begin marketing the next year’s plans to your clients.

We’re here to tell you how to maximize those first two weeks before AEP begins.

Recognize Change

For 2025, it will be especially useful for you to understand the Inflation Reduction Act changes taking effect, the new Medicare Prescription Payment Plan, and Dual Eligible Special Needs Plans changes.

As an Medicare Advantage Prescription Drug (MAPD) insurance agent, you should already have a good understanding of plan offerings prior to the first of the month from the advance plan info you get from your FMO. You can get exclusive “First Look” emails from Ritter when you register with our site! These emails can help you access plan details for the coming year on the products available in the market. Additionally, we offer product preview webinars and portfolio reviews.

With the help of your FMO, you’re responsible for assessing how much plans are changing, if there are drastic differences, and if you think it’s in your clients’ best interest to switch.

Before October 1 approaches, identify which clients may want to adjust their plans. Those are the clients you should prioritize meeting with during the first two weeks of October.

Before October 1 approaches, identify which clients may want to adjust their plans. Those are the clients you should prioritize meeting with during the first two weeks of October.

Start Meeting with Clients

As a licensed sales agent, you have knowledge of both the plans and your clients’ needs, so begin meeting with them as early as October 1 to discuss next steps.

“You can’t discuss plan information or changes before October 1, but you can contact clients in September to let them know if you expect any changes to their plan. You can also send out the Scope of Appointment in September but schedule an appointment for October, since their SOA will be good for 12 months.” — Jake McGeoy, Senior Manager of Agent Relations — DC, DE, & MD

If your clients are currently enrolled in a Medicare Advantage or a Part D plan, they should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from their plan’s carrier. You should help your clients review these notices for any changes in their plan’s costs, benefits, and/or rules for the upcoming year. It’s very likely your clients will receive ANOCs that show changes such decreased benefits or higher costs with all the 2025 Medicare market disruptions and changes. It’s important you help them understand what’s going on and what their options are for the upcoming plan year.

After a thorough review, your client may choose to stay in their current plan or enroll in a new one to avoid increased costs, a change in their network, or unwanted benefits changes. You are permitted to leave enrollment forms with your clients or share the plan link on PlanEnroll.com, but you are not permitted to submit the application until after the start of AEP on October 15.

Listen to Your Clients

When you meet with your clients, you’re allowed to give a full product presentation and consultation. It’s important that you go over several potential plans with them to see what they think will best fit their needs. While pre-enrollment materials contain helpful information, they are plan-specific, meaning they can only cover one plan at a time. Get to know your clients so you can determine ahead of time what may be a good choice for them, but still lay out all the options.

For example, in some cases, Medicare beneficiaries are willing to pay more for a plan that allows them to continue seeing their doctor. If the cost of their primary care provider increased due to changes in their current plan’s network, it’s a good idea to know what other plans have that doctor in network so your client can pay lower rates.

Try to think of potential questions or concerns that may arise while you are presenting plan info to your clients.

Try to think of potential questions or concerns that may arise while you are presenting plan info to your clients. What is my deductible? How much are copays? How does this differ from my current plan? The more prepared you are, the smoother your meeting will go. Your clients will definitely appreciate your knowledge and effort!

Familiarize Yourself with New Sales Technology

If you haven’t explored the new sales technology you plan on using this AEP, there’s no time like the present. Not only will taking the time to try out your tools now save you time during appointments, but it will also make you appear more professional, knowledgeable, and trustworthy to your clients.

Taking this step will be important this AEP for all Ritter agents starting out using MedicareCENTER and PlanEnroll. As a Ritter Agent, you have access to even more sales tools to seamlessly enroll clients, generate fresh leads, and manage client data through our partnership with Integrity. Discover LeadCENTER to revolutionize your business. New this AEP, you can also utilize Client Connect and Client Sync, which are brand-new MedicareCENTER and PlanEnroll features that allow you to easily contact clients as well as gather information, a permission to contact, and a signed Scope of Appointment.

To make sales go even more smoothly, you should make sure your CRM is up to date now. Then, when it’s time to make a call or give a quote, it’s possible with just a few clicks!

Stay Compliant

As always, start by documenting a Scope of Appointment (SOA) 48 hours prior to meeting with potential enrollees, including those already in your book since they may potentially switch plans. Every enrollment should have an SOA.

Remember, all sales, marketing, and enrollment, including retention marketing, calls must be recorded in their entirety. You must also adhere to all of the other Centers for Medicare & Medicaid Services’ third-party marketing organization requirements.

Prior to October 15, agents may not encourage completion of, solicit, or accept paper or telephonic enrollments. They also cannot encourage mailing, take possession of, or “just hold onto” any applications for the 2025 contract year.

Agents are allowed to leave enrollment applications with a beneficiary during pre-AEP (October 1 through October 14), but there are some stipulations that must be adhered to before AEP officially opens.

• Agents must not assist beneficiaries in completing an AEP enrollment application.

• The enrollee must complete the application on their own, sign it with the current date, and mail it to the carrier using the envelope usually included in the sales kit. If for whatever reason they are unable to do so, you must come back to meet with them on or after October 15.

• The carrier is obligated to investigate any application received before October 15 to determine if it was agent-assisted. Because of this, it is best for your clients to wait to enroll until the start of AEP.

These pre-AEP restrictions also apply to prefilled enrollment apps for the next year’s plans on PlanEnroll. Agents cannot prefill any applications for clients prior to the beginning of AEP on October 15.

If these rules are deviated from, the application may be rejected, resulting in a loss of commission for you. It is imperative you follow the guidelines to avoid issues for you or your client.

From October 15 to the end of AEP on December 7, the process for filling out and filing applications is normal, and you may complete the entire “For Agent Use Only” section.

AEP may not start until October 15, but there is still much to do before that date rolls around. Do your research and stay up to date with your sales market. An agent who is knowledgeable about plan offerings and goes above and beyond for their clients is sure to have a successful AEP!

Editor’s Note: This post was originally published September 2018. It has been updated to include information relevant to the 2025 Annual Enrollment Period.