Medicare has rules and regulations in place to help avoid high-pressure situations and scams, in order to protect Medicare beneficiaries. When it comes to making changes to your Medicare Advantage plan, many beneficiaries are looking to work with a licensed insurance agent.
These days, there are several ways that we communicate. Therefore, different types of meetings may be set up between an agent and a beneficiary like you. Regardless of the type of meeting being held, understanding how the Scope of Appointment applies is crucial to making the appropriate changes in your healthcare for the following year.
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. If you’re working with a licensed insurance agent to enroll in or change Medicare Advantage coverage, the Scope of Appointment Medicare 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 and to 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 Medicare requirement allows time for your agent to prepare materials for the meeting that 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 e SOA to say 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 to ensure 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 a Scope of Appointment Good For?
Your Medicare Scope of Appointment is good for 12 months from the date of signing. However, it’s important to note that you can’t speak about coverage you don’t elect to when filling out your Scope of Appointment, without signing a new one.
For example, if you wish to discuss different Medicare Advantage plans, fail to elect Medicare Supplement plans, but discover that you would like to explore those options after all within the 48-hour waiting period, you’ll need to sign a new SOA in order to proceed. Therefore, your timeline would restart. This includes any other policy regulated by the federal Medicare system.