Medicare has rules and regulations in place to help avoid high-pressure situations and scams, in order to protect Medicare beneficiaries.
The Medicare Scope of Appointment is a form that Medicare beneficiaries must complete to designate, before their appointment with an agent, exactly which items they wish to discuss. In other words, this form is how people tell their agent which insurance product they can present.
These days, there are several ways that we communicate. An agent and a beneficiary can set up different types of meetings. Understanding how the Scope of Appointment applies is important. It helps in making the appropriate changes in your healthcare for the following year, regardless of the type of meeting set up.
It’s also worth mentioning that thanks to the 2024 CMS final rule, important changes are going to affect how you enroll in Medicare Advantage (Medicare Part C), Medicare Part D prescription drug plans, or Medicare Supplement plans. Navigating these changes doesn’t have to be overwhelming.
Below, we’re reviewing the Medicare Scope of Appointment requirements, changes, and everything you need to know about setting your appointment with a trusted professional.
WHAT IS THE SCOPE OF APPOINTMENT FORM FOR MEDICARE?
The Medicare Scope of Appointment is a requirement for in-person and over-the-phone appointments. When you’re working with a licensed agent to enroll in or change coverage, the Scope of Appointment must be presented to document the meeting. This may also be referred to as the Medicare 48-Hour Rule.
Agents must document their meetings with both potential and current beneficiaries using the Medicare Scope of Appointment form. The SOA form remains on file for ten years and protects all parties. It can also be collected verbally.
Sadly, many people have used a sales approach to profit from misunderstandings in the insurance world. Medicare Scope of Appointment rules are in place so that bad actors can be weeded out. They protect people like you from falling victim to scams.
However, you can also benefit by helping your agent get to know your needs a bit better before you sit down to make the actual changes.
The 48-Hour Rule requirement allows time for your agent to prepare materials for the meeting. This can help you better understand the right options for your needs.
You’ll fill out the form at least 48 hours before an agent is able to discuss plans with you or comes to your home. The SOA form lets the agent know beforehand which coverage options are open for discussion.
It’s also important to note that if you don’t select one of the coverage options on the Scope of Appointment. Medicare requires the agent to avoid discussing it with you unless you fill out a new SOA form.
The SOA protects you and the agent. When an agent uses this form and sells you a policy, they can use an SOA as proof. It shows that you only discussed the things that were determined to be up for discussion. Be sure to always fill a form out before the meeting and to do so thoroughly. This ensures your agent can review all the coverage options you may have questions about. This is a requirement before any set appointments, or unexpected calls/meetings.
HOW LONG IS THE SCOPE OF APPOINTMENT GOOD FOR?
Your Medicare Scope of Appointment is good for 12 months from the date of signing.