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The goal is to get the participant’s buy-in to speak with a licensed agent who will assess their current situation and provide guidance on enrollment into parts B, C, & D. Warm transferring should be the first priority. Schedule an appointment if transferring is not an option.
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As you may already know, Medicare part A covers hospital and Medicare part B covers Dr. visits.
According to our records, you are already enrolled into part A along with your employer coverage but not yet enrolled into part B, is that correct?
If unsure, have them pull out their red, white, and blue Medicare card and verify if there is an eff date for part A/B. They should also have a group card to confirm employer coverage. If still unsure, provide the number to the SSA office (800 772-1213) and move to the closing section.
Medicare generally covers 80% of all medically necessary procedures. This is great, but the 20% not covered may result in significant costs. This is where Medicare Advantage plans, supplement plans, and prescription drug plans come into play…these plans will cover most of the remaining 20%.
For example, Medicare Advantage Prescription Drug plans are a great option for most Medicare-eligible participants. These are regulated by Medicare. They combine Medicare parts A, B, C, and D into one. Many have little to no premium, although you . You will continue to pay the Medicare part B premium which, for most participants, is $164.90 per month in 2023. These plans are required to provide coverage at least as good as parts A/B and . They often include additional coverage not included with A/B such as dental, vision, hearing, transportation, gym, OTC, part B giveback, etc.
Medicare Advantage plans are often more cost effective than group plans or offer coverage which group plans do not cover. It is worth taking a few minutes to compare and to see if this applies to you.
There is a lot of information which can be provided but this a deeper dive will later be covered handled by the agent so there is no need to provide excessive information. The goal is to ensure the participant understands the value of speaking with an agent in order to transfer or schedule an appointment with an agent.
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The next step is to get you over to a licensed agent to compare your group coverage with against Medicare plan options. May I go ahead and transfer you?
If Yes: Please hold for a moment while a transfer you. I’ll stay on the line to ensure the transfer goes smoothly.
Place on hold and transfer. Follow follow the Warm Transfer Process.
If No: Ask probing questions to understand why they are not interested in transferring. If they don’t have time today, offer to schedule an appointment. Emphasize the value of receiving enrollment assistance into parts part B. Emphasize the value of receiving enrollment assistance into MAPDs/Gaps/PDPs. If they continue to decline, offer to schedule an appointment.
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It’s been a pleasure speaking with you. You may reach a licensed agent at the following number in case you decide to call prior to your appointment: 833-775-8521. TTY users may dial 711. Our hours of operation are 9:00 AM - 7:30 PM EST, Monday - Friday. Have a great day!
Participant is within the 3 month SEP age-in
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window prior to turning 65:
Greeting
These participants have an SEP and usually drop group coverage to enroll into Medicare A & B along with a Medicare Advantage plan or a supplement + PDP.
Hello, may I please speak with _____? Yes, this is ____ calling from Medicare Transition Services. We have received notice that you have recently had a change in your employer medical coverage. The purpose of this call to review your current status to ensure there are no gaps in your health coverage. We can also review Medicare options available and to help determine if Medicare is a good fit. The call will only take a few minutes and together we can ensure you are taking advantage of all the benefits you are entitled to.
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Generally speaking, Medicare part A covers hospital and Medicare part B covers Dr. visits.
According to our records, you will be aging into Medicare on [date which should be in the coming 3 months], is that correct?
When you turn 65, you will most likely automatically be enrolled into part A and some participants are automatically enrolled into part B.
Medicare generally covers 80% of all medically necessary procedures. This is great, but the 20% not covered may result in significant costs. This is where Medicare Advantage plans, supplement plans, and prescription drug plans come into play…these plans will cover most of the remaining 20%
For example, Medicare Advantage Prescription Drug plans are a great option for most Medicare-eligible participants. These are regulated by Medicare. They combine Medicare parts A, B, C, and D into one. Many have little to no premium, although you . You will continue to pay the Medicare part B premium which, for most participants, is $164.90 per month for most participants. They in 2023. These plans are required to provide coverage at least as good as parts A/B and . They often include additional coverage not included with A/B such as dental, vision, hearing, transportation, gym, OTC, part B giveback, etc.
There is a lot of information which can be provided but this a deeper dive will be covered handled by the agent later so there is no need to provide excessive information. The goal is to ensure the participant understands the value of enrollment into MAPD’s/Gaps+PDPs to get buy-in for transferring or scheduling speaking with an agent in order to transfer or schedule an appointment with an agent.
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If Yes: Please hold for a moment while a transfer you. I’ll stay on the line to ensure the transfer goes smoothly.
Place on hold and transfer. Follow follow the Warm Transfer Process.
If No: Ask probing questions to understand why they are not interested in transferring. If they don’t have time today, offer to schedule an appointment. Emphasize the value of receiving enrollment assistance into parts A&B if applicable. Emphasize the value of receiving enrollment assistance into MAPDs/Gaps/PDPs. If they continue to decline, offer to schedule an appointment.
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