Overview
The goal is to get the participant’s buy-in to speak with a licensed agent. Warm transferring should be the first priority. Schedule an appointment if transferring is not an option.
Participant is 65+ years old:
Greeting
These participants are enrolled into part A along with group coverage. They have the option to drop group coverage and enroll into Medicare part 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 are working with your employer to educate employees on 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.”
If yes: Great, what I’ll do on today’s call is provide you a basic overview of Medicare. Next, I’ll verify the information we have on file for you and then I’ll transfer you to a licensed agent who will review plan options with you. Does that sound ok?
In case we get disconnected, may I call you back at this same number?
Medicare Overview
Make sure you are familiar with Medicare Basics as outlined in Medicare.gov. Here are the main points to cover:
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. 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. 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 to see if this applies to you.
There is a lot of information which can be provided but a deeper dive will be 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.
Transfer
The next step is to get you over to a licensed agent to compare your group coverage 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 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 part B. Emphasize the value of receiving enrollment assistance into MAPDs/Gaps/PDPs. If they continue to decline, offer to schedule an appointment.
Scheduling Appointments
If now is not a good time to explore your options with a licensed agent, I can schedule a time for an agent to call you. Does that work for you?
If Yes: Move to the next section - Information Verification
If No: Ask probing questions to understand if there are underlying concerns with speaking to an agent. Try to overcome concerns and schedule the appointment.
Appointment Form
Enter the information into the Appointment Form as you gather it.
Next, I’d like to verify the information we have in our records.
Your address is [address including street, apt, city, county, state, zip] correct?
May I have your email address please?
Your DOB is [DOB] correct?
Do you currently have part A?
If No: Will you be eligible for part A on or before March 1, 2023?
Do you currently have part B?
If No: Will you be eligible for part b on or before March 1, 2023?
Agents are available Mon-Fri. Which weekday works best for you?
Does [Time 1], [Time 2], or [Time 3] work best?
Scope of Appointment
Medicare Transition Services offers Medicare Advantage HMO's and PPO's along with Supplement and Part D plans? Do you agree to discuss these plan types with a licensed agent at the time of your scheduled appointment?
If Yes: Proceed to next section - Wrap Up
If No: Medicare regulations require your permission to discuss plans. Giving permission does not automatically enroll you into any plans, it only grants the agent permission to review options with you. Without your permission I will be unable to complete the appointment. With that said, do you agree to discuss these plan types with a licensed agent at the time of your scheduled appointment?
Wrap Up
Great, we have you scheduled for [date & time]. A licensed agent will be calling you at this time, please mark you calendar. It’s possible they’ll call a little late if they are wrapping up another call. Do you have any other questions for me before I let you go?
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 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 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.
If yes: Great, what I’ll do on today’s call is provide a basic overview of Medicare. Next, I’ll verify the information we have on file for you and then I’ll transfer you to a licensed agent who will review plan options with you. Does that sound ok?
In case we get disconnected, may I call you back at this same number?
Medicare Overview
Make sure you are familiar with Medicare Basics as outlined in Medicare.gov. Here are the main points to cover:
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. 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. 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 a deeper dive will be 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.
Transfer
The next step is to get you over to a licensed agent to further assist by reviewing the plan options available in your county. 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 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.
Scheduling Appointments
If now is not a good time to further explore your options with a licensed agent, I can schedule a time for an agent to call you. Does that work for you?
If Yes: Move to the next section - Information Verification
If No: Ask probing questions to understand if there are underlying concerns with speaking to an agent. Try to overcome concerns and get buy-in for the appointment.
Appointment Form
Enter the information into the Appointment Form as you gather it.
Next, I’d like to verify the information we have in our records.
Your address is [address including street, apt, city, county, state, zip] correct?
May I have your email address please?
Your DOB is [DOB] correct?
Do you currently have part A?
If No: Will you be eligible for part A on or before March 1, 2023?
Do you currently have part B?
If No: Will you be eligible for part b on or before March 1, 2023?
Agents are available Mon-Fri. Which weekday works best for you?
Does [Time 1], [Time 2], or [Time 3] work best?
Scope of Appointment
Medicare Transition Services offers Medicare Advantage HMO's and PPO's along with Supplement and Part D plans? Do you agree to discuss these plan types with a licensed agent at the time of your scheduled appointment?
If Yes: Proceed to next section - Wrap Up
If No: Medicare regulations require your permission to discuss plans. Giving permission does not automatically enroll you into any plans, it only grants the agent permission to review options with you. Without your permission I will be unable to complete the appointment. With that said, do you agree to discuss these plan types with a licensed agent at the time of your scheduled appointment?
Wrap Up
Great, we have you scheduled for [date & time]. A licensed agent will be calling you at this time, please mark you calendar. It’s possible they’ll call a little late if they are wrapping up another call. Do you have any other questions for me before I let you go?
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!