About Medicare
Understanding Medicare’s Scope of Appointment and the New 48-Hour Rule
Whether you’re working with a Medicare agent in person, virtually, or over the phone, you need to schedule your Medicare consultation at least 48 hours after signing your Scope of Appointment (SOA). For those who are accustomed to comparing Medicare options with a call center agent, the 48-hour rule is a big adjustment that will affect how they schedule these calls moving forward.
The 48-hour rule requires agents to wait two full days between receiving a signed SOA form and meeting with you to discuss Medicare Advantage or Prescription Drug Plans. This change aims to give beneficiaries more time to consider their options and consult with caregivers before committing. It’s designed to prevent high-pressure sales tactics and ensure you make informed decisions.
However, there are exceptions to this rule, including walk-ins or appointments made near the end of the Annual Enrollment Period (AEP) or Open Enrollment Period (OEP). In these cases, the waiting period may not apply. An SOA form, once signed, remains valid for twelve months.
While this rule introduces some logistical hurdles for agents, it ultimately protects beneficiaries by providing ample time to make thoughtful choices about Medicare coverage.
What Is the Scope of Appointment (SOA)?
The SOA is an agreement you sign before discussing specific Medicare plan options with an agent. For telephonic sales, agents will read the agreement to you and ask for verbal consent. In-person or virtual meetings may require you to complete the form on paper or electronically.
What’s the Purpose of the SOA?
The SOA clearly outlines which products you’re interested in discussing with your agent. Agents are not permitted to talk about products not listed on the SOA without your explicit verbal or written consent. This ensures that your consultation remains focused on your needs and prevents any unintentional sales pitches.
Which Plans Are Covered by the SOA?
– Medicare Advantage Plans (Part C) with or without drug coverage
– Stand-alone Prescription Drug Plans (Part D)
– Hospital Indemnity Plans
– Dental and/or Vision Plans
– Medicare Supplement Plans (Medigap)
How Does This Affect You?
When setting up an appointment, you must complete and sign the SOA at least 48 hours before your scheduled consultation. This helps ensure that your agent can provide you with the most relevant and tailored advice.
Where Can You Find the SOA Form?
Your agent should send you the form before scheduling your appointment. You’ll need to provide your name, basic details, and indicate which plans you’re interested in discussing.
Are There Exceptions to the 48-Hour Rule?
Yes, there are two main exceptions:
- If YOU initiate the contact by calling your agent or visiting their office, the 48-hour rule doesn’t apply, but you still need to complete the SOA.
- End of Enrollment Window: If you’re in the last four days of an election period, such as the Annual Enrollment Period (ending December 7th), the 48-hour rule is waived. For instance, if you need help on December 5th, your agent can assist you right away, provided the SOA is completed.
Why Does This Matter?
With AEP just around the corner, working with a licensed insurance agent can save time and reduce the risk of enrollment mistakes. Agents play a key role in ensuring beneficiaries have the right coverage. So, before October 15th, ask your AMAC Medicare agent to send you the SOA form—you’ll be glad you did!
For help with Medicare plans – or any questions you may have about Medicare – contact AMAC’s Medicare Advisory Service at 1-855-611-4856 or request a quote below!
