FAQ

To confirm your completion of Marketplace registration and training for the current plan year, follow these steps: 1. Check the Registration Completion List: Verify that your National Producer Number (NPN) is listed on the publicly available Centers for Medicare & Medicaid Services (CMS) Agent and Broker Federally-facilitated Marketplace (FFM) Registration Completion List. 2. Use the Marketplace Registration Tracker: Access the Marketplace Registration Tracker to confirm your training and registration status, as well as your identity proofing and NPN validation. Enter the ZIP Code and NPN listed in your agent/broker profile. Need Help? For additional assistance, contact the Marketplace Service Desk at 1-855-267-1515.

No, the Marketplace registration and training for Plan Year 2022 does not qualify for state licensure continuing education credits, as it is not offered through an approved continuing education vendor. Need Help? If you need further assistance, contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

Completing Identity Proofing: 1. Create Your User Account: After setting up your user account on the Centers for Medicare & Medicaid Services (CMS) Enterprise Portal, you will need to complete identity proofing as part of the Marketplace registration process. 2. Enter Personal Information: You will be prompted to enter and confirm your personal information and answer identity verification questions. 3. Log Out: Once you complete the identity proofing process, you will be asked to log out of the CMS Enterprise Portal by clicking the “OK” button. 4. Confirm Your Status: You can verify your identity proofing status using the Marketplace Registration Tracker. Enter your ZIP Code and National Producer Number (NPN) to check your status. Annual Requirement: Returning Agents and Brokers: If you have previously completed identity proofing for a prior plan year, you typically do not need to repeat this process during the annual registration renewal. Need Help? For assistance with manual identity proofing, contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

If your NPN is not listed as validated on the RCL, it means that the Centers for Medicare & Medicaid Services (CMS) has not confirmed its validity against the National Insurance Producer Registry (NIPR) database. To be validated, your NPN must have an active licensure status and a CMS-approved health-related line of authority (LOA) in your resident state. Common reasons for NPN validation issues include: 1. Incorrect Information: A typo or incorrect license number or NPN might be entered into your agent/broker profile. Learn how to update your NPN. 2. Inactive or Expired License: Your license might be inactive or expired, or your NPN may not have a valid health-related LOA. Verify your licensure status via the NIPR database. If you have questions about your licensure status, contact NIPR customer service or your state Department of Insurance (DOI). If your NPN does not match licensure records, you can submit a dispute using the Fair Credit Reporting Act form. 3. Invalid Health-Related LOA: The LOA associated with your NPN might not be on the list of CMS-approved health-related LOAs. Check the list of approved health-related LOAs to ensure your LOA is valid. Important Note: Beginning in Plan Year 2023, CMS implemented updated licensure validation methodology to ensure agents and brokers have a valid health-related LOA in their resident state. Agents and brokers without an approved LOA are not allowed to assist consumers with Marketplace enrollment. Need Help? For additional assistance, contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

If you’re having difficulty accessing the MLMS, try the following steps: Use the Latest Browsers: The MLMS works best with the latest versions of Google Chrome or Mozilla Firefox. Adjust Browser Settings: Make sure your pop-up blocker is turned off, Adobe Flash Player is installed, and both JavaScript and Adobe Flash Player are enabled on your computer. Check PDF Settings: If you’re using an Adobe Acrobat plug-in or similar, ensure that PDF files load within your web browser rather than the plug-in. Clear Cache and Files: Clear your browser’s cache and temporary internet files before trying to access the MLMS again. Optimal Access Times: For best results, try accessing the system before 11:00 AM ET or after 5:00 PM ET. If you still experience issues, contact the Marketplace Service Desk at 1-855-267-1515 or the MLMS Help Desk at MLMSHelpDesk@cms.hhs.gov.

For Agents and Brokers New to the Marketplace or Those Who Didn’t Complete Training Last Year: 1. Create a CMS Enterprise Portal Account: Go to CMS Enterprise Portal. Set up Multi-factor Authentication (MFA). Request the Agent Broker Training Access Role. Complete remote identity proofing through the Identity Management (IDM) System. 2. Set Up Your Profile: Complete your agent/broker profile on the Marketplace Learning Management System (MLMS) via the CMS Enterprise Portal. 3. Complete Training: Log in to the CMS Enterprise Portal. Update your MLMS profile. Complete the full Marketplace training via the CMS Enterprise Portal or through an HHS-approved vendor. Read and accept the applicable Marketplace Agreement(s). Print your Registration Completion Certificate. Confirm your registration using the Registration Completion List (RCL). For Returning Agents and Brokers: 1. Log in to the CMS Enterprise Portal: Set up or update your MFA device. 2. Update Your Profile: Update your MLMS agent/broker profile. 3. Complete Shortened Training: Log in to the CMS Enterprise Portal. Complete the “Marketplace Training for Returning Agents and Brokers,” which typically takes about 60 minutes. This training includes a self-paced review of Marketplace resources and updates. Read and accept the applicable Marketplace Agreement(s). Print your Registration Completion Certificate. Confirm your registration using the Registration Completion List (RCL). Need Help? For additional assistance, contact the Marketplace Service Desk at 1-855-267-1515.

Yes, each individual agent or broker who assists consumers with enrolling in Marketplace coverage must complete their own Marketplace registration and training using their unique National Producer Number (NPN) before assisting consumers. Key Points to Remember: Individual NPNs: Every agent or broker must register and complete training with their individual NPN. Corporate NPNs: If your agency has a corporate NPN that will be used on Marketplace applications, it must also be registered with the Marketplace. Only the authorized individual should enter the NPN for the business entity section of their profile. Business Entity Registration: Business entities that wish to participate in the Marketplace must register and sign the appropriate agreements through the Marketplace Learning Management System (MLMS). An authorized official can complete the registration on behalf of the business entity while completing their individual agent or broker training. Updating NPN Information: If you have multiple NPNs (e.g., one for yourself and one for your business), you can add the business NPN after completing the training. Your Registration Completion Certificate will list both NPNs, which will register your business with the Marketplace. Correct NPN Entry: Ensure that NPNs are entered correctly during registration without any leading zeroes. Please note that currently, the Marketplace only validates individual NPNs, not business entity NPNs. As a result, business names and contact information are not displayed on the Find Local Help tool. Need Help? For additional assistance, contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

For support with Marketplace registration and training, you can contact the following help desks based on your specific needs: 1. Marketplace Service Desk Phone: 1-855-267-1515 Handles: CMS Enterprise Portal password resets and account lockouts Other CMS Enterprise Portal account issues or error messages General registration and training questions not related to a specific training platform 2. Agent/Broker Email Help Desk Email: FFMProducer-AssisterHelpDesk@cms.hhs.gov Handles: Escalated general registration and training questions not related to a specific training platform Issues with the Agent/Broker Registration Completion List 3. Agent/Broker Training and Registration Email Help Desk Email: MLMSHelpDesk@cms.hhs.gov Handles: Technical or system-specific issues related to the Marketplace Learning Management System (MLMS) User-specific questions about navigating the MLMS site or accessing training and exams For a faster response, provide your FFM user ID and National Producer Number (NPN) when contacting any of the Marketplace Help Desks. Helpful Resource: Agent/Broker Help Desks

No, there are no continuing education requirements specifically for the Marketplace. To participate, you only need to complete the annual Marketplace registration and training requirements for agents and brokers. Please note that these Marketplace requirements are separate from any continuing education requirements mandated by your state’s Department of Insurance (DOI) or other state regulatory agencies. Need Help? For additional assistance, contact the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

Before assisting consumers with Individual Marketplace coverage, you need to review and electronically sign the Individual Marketplace General Agreement and the Privacy and Security Agreement. These Agreements are available on the Marketplace Learning Management System (MLMS), which you can access through the CMS Enterprise Portal. To execute the Agreements: 1. Log in to the CMS Enterprise Portal and access the MLMS. 2. Locate the Agreements: Find the Individual Marketplace General Agreement and the Privacy and Security Agreement on the MLMS. 3. Review the Agreements: Carefully read through the Agreements and their appendices. To review an appendix, click on the appendix link within the Agreement’s module. The appendix will open in a new window for review. No further action is needed on the appendix page. 4. Execute the Agreements: When prompted, select the “I Agree” button. This acts as your electronic signature and indicates your acceptance and agreement to abide by the terms and conditions of the Agreements. Need Help? For additional assistance, contact the Marketplace Service Desk at 1-855-267-1515.

The Marketplace Learning Management System (MLMS) is an online platform provided through the Centers for Medicare & Medicaid Services (CMS) Enterprise Portal. It offers training content and resources needed for agents and brokers to complete their annual Marketplace registration and training. To access the MLMS: 1. Log In: Go to the CMS Enterprise Portal and log in using your FFM User ID and password. After logging in, you will be directed to the "My Portal" home page. 2. Navigate to MLMS: Click on the "Marketplace Training - Agent Broker" tile. Select the "MLMS Training" link. 3. Update Information: Enter or update your business and/or professional contact information. Click the “Save” button and then the "Next" button to proceed. 4. Access MLMS Training: You will be taken to the MLMS training landing page where you can access the training modules. For New Users: If you have not previously registered with the Marketplace, you will need to create a CMS Enterprise Portal user account before you can access the MLMS. Learn more about creating a user account and becoming a Marketplace-registered agent or broker. Need Help? For additional assistance, contact the Marketplace Service Desk at 1-855-267-1515. Helpful Resource: Quick Reference Guide: Avoiding the Creation of a Duplicate CMS Enterprise Portal Account

Registration Completion List (RCL): The Centers for Medicare & Medicaid Services (CMS) Agent and Broker Federally-facilitated Marketplace (FFM) Registration Completion List (RCL) includes the National Producer Numbers (NPNs) for agents and brokers who have completed Marketplace registration for the current plan year. This list is updated frequently, often daily. Purposes of the RCL: To confirm that an agent or broker has successfully met the registration requirements for the Marketplace or State-based Marketplace on the Federal Platform (SBM-FP) for the Individual Marketplace and/or the Small Business Health Options Program (SHOP). To support states and other stakeholders in oversight, monitoring, enforcement, and consumer education about agents and brokers who are available to assist with Marketplace coverage. If Your Information Is Not Showing: 1. Check Your Licensure and LOA: Ensure that your licensure status and line of authority (LOA) are in good standing with the National Insurance Producer Registry (NIPR). You can check your license and LOA status by accessing the NIPR Producer Database (PDB). Obtain a copy of your PDB Report here. 2. Contact Support: If your status is correct in NIPR but not validated in the RCL, contact the FFM Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.

Yes, agents and brokers must complete Marketplace registration and training annually to participate in the Marketplace and assist consumers with enrolling in Marketplace coverage. The Centers for Medicare & Medicaid Services (CMS) offers this training through the Marketplace Learning Management System (MLMS). For Returning Agents and Brokers: If you registered with the Marketplace for the most recent plan year, you will be automatically enrolled in the "Marketplace Training for Returning Agents and Brokers." This abbreviated training typically takes about 90 minutes to complete. You also have the option to take the full training course if you prefer, once it's available. Need Help? If you need additional assistance, you can contact the Marketplace Service Desk at 1-855-267-1515. Helpful Resource: Check out the "Returning Agents’ and Brokers’ Guide to Plan Year 2022 Marketplace Registration and Training (PDF)" for more detailed information.

Advocate will train you how to get leads in our thorough ProfitableProspects training course. Compliance is key to protect yourself in this regulated Medicare Insurance arena, and keeping you above board is a top priority for us as your partner. We do periodically receive carrier leads during the enrollment season, but never use it as an enticement. Honesty is the best policy.

We are the independent insurance professional’s free expert consultant. Advocate Financial Life & Health Brokerage was started in 2009 by a father and son team with over 35 years experience specializing in Medicare Insurance, Life Insurance, and Annuity products and since then has grown to be one of the nation's foremost premier FMO marketing firms working with independent agents nationwide. As a national marketing firm (FMO/NMO/IMO), we recruit, contract, train, and support licensed insurance agents building their business, all at no cost to the agent. We have held a consistent “A+ Rating” with the Better Business Bureau for years - so you can partner with confidence knowing we are third-party verified and proven. And agent’s love working with us! See our testimonials. We are an Agent’s #1 Advocate, and a powerful catalyst for business growth.

By speaking with one of our team members we can determine how to setup your e-contracting. We work with agents across the country and every year they do this with tremendous success, since they have so many clients over 65, and they already have an established relationship. Whether a large or small agency, we have the resources, team members, and path to help make your new contract a great success.

Advocate coordinates with the carriers to help pay for 50-100% of your lead budget when you enter our VIP Agent Program (restrictions apply). We are your lead experts. We help agents develop robust pipelines of year round leads to fit any budget.

AEP is a booming bustling time for certified agents - and they love it. There are over 50 MILLION people on Medicare, and every year they need to review their plans with an agent to make sure they maximize their benefits and have the right fit. The problem is there is a shortage of licensed agents. This means big opportunity for the agents getting into the Medicare arena. During the Annual Enrollment Period (Oct. 15 - Dec. 7) seniors can change their insurance plan with the help of a certified agent. It’s a very busy time for licensed agents in the field, and one of huge growth. There are also year round selling windows, and that’s what makes this such a big opportunity for new revenue with great lifetime renewals. Seniors need your help.

No. Working with Advocate you are 100% independent. We are just an extension of the insurance company helping you grow your business. You can pick and choose what carriers make sense with Advocate, and which don’t. We strive to earn all of your business, but it’s not a requirement.

We work with over 50 of the nation’s very best, top, industry-leading insurance carriers in the areas of Medicare Insurance, Life Insurance, Annuities and Ancillary Products. And the list grows every year as we are constantly evaluating markets and product environments. There are hundreds of carriers in the industry, but we don’t need them all - only the best ones. You’ll see that with our offering - reputable, reliable, with robust service & support units, agent friendly, and growth focused for you.

Yes, according to the Pew Research Foundation! Medicare Insurance is a rapidly-emerging, booming, niche that industry savvy agents are flocking to for real growth and to better serve their client and prospect base. There is a shortage of licensed agents and a surge in senior demand. The service requirements are low, the lifetime renewals are high, and the need is great. Now is the time to get involved, trained, and certified.

You do, 100%. That’s not always the case with other FMOs. Again, working with Advocate is 100% free. We are your expert consultants at no cost to the agent. The insurance company compensates us for our time, based on results. You are 100% independent! It is a win-win. Some industry FMOs do not operate this way, and actually own your book of business. With Advocate, only you own your book of business, and you own the renewals, and you contract directly with the carriers. You also get paid direct. Our goal is to build you up and give you full control. There is no downside to working with an independent FMO. That’s why 9/10 agents do. It’s important to know this!

Advocate has built its sterling reputation on integrity, unmatched service, fast-track training, 24/7 support, and seasoned expertise. We are proven, loyal to our partners, and committed to our agents - and it GREATLY sets us apart from a sea of other FMOs. Because of this passionate dedication to our agents - agents believe in us and see our relationship as a true, trusted partner helping them grow their business, and winning together. It’s the Advocate Advantage. We are honored to work with our agents. We are your free expert consultant.

99% of the time you are contracted and paid direct from the company. That’s how we prefer it. We don’t want to be in the accounting business if we don’t have to be. A select few smaller carriers require us to pay out commissions, but it’s rare.

NMO - National Marketing Organization / FMO - Field Marketing Organization / IMO - Independent Marketing Organization. We are one of the nation’s highest producing marketing firms in the areas of Medicare Insurance for the top 5 largest carriers in the nation. We connect agents with the industry's leading products and insurance carriers and help them thrive. The team at ADVOCATE FINANCIAL Life & Health Brokerage has worked very hard over the years helping agents succeed, and is proud to be a part of this very short list of premier national marketing firms in this category.

We are available 24/7/365 via phone and live chat. A huge, distinct advantage. And our support and expertise set us apart even further. We always have marketers on standby to help you help your clients and make sales. Where other FMOs take days or weeks to respond, we work in minutes or seconds. And we love agents! We see our relationship as a true partnership. We are in it for the long haul. Our goal is a lifelong relationship, and our actions show it. Give us a call or attend one of our upcoming local agent trainings and you’ll see why more agents are choosing Advocate. We are truly an agent’s #1 Advocate. We only succeed when you do. Our top goal is growing your business as your free expert consultants.

Zip, zero, zilch! There is no cost to work with Advocate. And YOU own 100% of your book of business. We are your free expert consultants. There are no fees, no hidden charges, no commission splits. The Insurance Companies compensate marketing companies like us for efforts training and support agents, and it’s completely free to the agent. That’s why nine out of ten licensed agents use FMOs (Field Marketing Organizations). FMOs are a thick extra layer or support, expert insight, top notch training, and provide marketing opportunities not provided by going direct to the insurance carriers.

No. Medicare Supplement companies do not coordinate with CMS in this way. You will have to cancel your supplement plan direct with the company.

Access to care and critical time sensitive issues that need immediate attention should be called in to customer service for real time guidance and solutions. This will allow you to escalate the issue real time with a supervisor and or manager. 1-800-457-4708 (MAPD) 1-800-281-6918 (PDP) 1-800-866-0581 (Medigap/Med-Supp)

Click here for Medicare.gov's full answer

You CANNOT say/or have on your card: • Medicare Expert (this is not a designation) • Medicare Agent • Or have the word “Medicare” in your title, generally speaking • $0 Premium, or other Benefit Information is prohibited also • Using company names will also require pre-approval You CAN use proper titling, and generic information such as: • Licensed Agent, Independent Agent, Insurance Adviser, AHIP CERTIFIED etc. • Specializing in Medicare Advantage, Supplements, Medicare Insurance, etc We recommend tag lines to generate business like: • Are you a veteran? • I greatly appreciate your referrals! • I specialize in : Medicare….Life Insurance…Annuities…etc. list all products • Phone number, Email www.VistaPrint.com is the cheapest place to get great business cards and magnets. Its super simple to make it on your own with their easy templates. For the most up to date information reference the Medicare Marketing Guidelines or AHIP.

The "Agent Support" section in our Agent Portal feature a plethora of resource links, creating a road map for agents ensuring ease of doing business with our exceptional carriers.

The Shingles vaccine (Zostavax) is generally billed as a Tier 3 or 4 drug - depending on the plan - sometimes a Tier 3 (call Membership Services for specific member/specific plan verification). Most competitors are reported to bill it also as a Tier 3 or 4 - so it seems to be a level playing field when it comes to this benefit. There are rare circumstances where a client's doctor can contact Humana and request a "Tier Exception" making a case for the drug and downgrade it to a Tier lower, etc. With a Tier 3 or 4 drug there are often Deductibles (again depending on plan). Zostavax which is a new vaccine to prevent shingles is covered for PDP and MAPD members as Part D 60 years of age or older. Steps for Medicare payment for the Zoster vaccine outlined below. So a sample Shingle Shot purchase + administration would bill a client as the following - JANE DOE, Sample PPO Plan (completely hypothetical) : Stage 1 : Buying the Vaccine (Zostavax) : Hypothetical PPO Plan features $250 Deductible (Tier 4 and 5 only.) ~$200 - Total Cost of Shingles Vaccines (At a Pharmacy XYZ). Client Pays $200 since deductible was not met yet. Tier 4 Copay - a percentage (~$60-90 for this drug cost) normally charged is not applicable (since deductible not met, in this example). Stage 2 : Administering the Vaccine (Zostavax) : Recommended: Administration of the vaccine is generally free at large network pharmacies that have techs on staff that administer other vaccines (should call prior to ask of course). Not Recommended: If you receive it at a doctors office their very well might be an administration fee, and since the doctors can't bill Humana for drugs, Client will have to pay full price of drug and admin fee (normally all more expensive), then submit a claim form (with Doctor bill) to Humana for reimbursement. If you have any further questions please contact Humana Agent Support at 800-309-3163 or as mentioned above with specific BENEFIT questions by PLAN call in to Membership Services at (800)457-4708. Membership Services will be able to provide specific dollar amounts for services to be received. They are a great resource! To find out exactly what tier and pricing Zostavax is on your plan - go to https://www.medicare.gov/find-a-plan/questions/home.aspx

Click here to learn about the Medicare Savings programs, income limits and more. Click here to learn about saving money on Part D and Drugs :Click here

Buy a policy when you're first eligible The best time to buy a Medigap policy is during your 6-month Medigap open enrollment period, because you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you're 65 and enrolled in Medicare Part B (Medical Insurance). After this enrollment period, you may not be able to buy a Medigap policy. If you're able to buy one, it may cost more. During open enrollment Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy. However, if you apply during your Medigap open enrollment period, you can buy any Medigap policy the company sells, even if you have health problems, for the same price as people with good health. Find your specific situation at www.Medicare.gov Outside open enrollment : If you apply for Medigap coverage after your open enrollment period, there's no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements, unless you're eligible due to one of the situations below. In some states, you may be able to buy another type of Medigap policy called Medicare SELECT. If you buy a Medigap SELECT policy, you have rights to change your mind within 12 months and switch to a standard Medigap policy. Buy a policy when you're first eligible.

In a nutshell, no. If you enroll a Tricare senior into MAPD it will make the MAPD plan primary largely eliminating the benefits of Tricare.

ICEP : is for MA only, or if part A and B dates are different. (SEP: 3 Months Before Part B Eff. Date) IEP: if it's MAPD, or PDP only, or part a/b dates are the SAME. (SEP: 3 Months Before, Month of, and 3 Months after Part B Effective Date) Click here for a short video explaining! See Graph Below! Or Click Here for Graph ​ Initial Election Period (IEP) The Initial Enrollment Period (IEP) refers to the first time an eligible person can enroll in the federal Medicare program. It’s a period that starts three months before the month of your 65th birthday, continues through your birth month, and lasts for three months after it. Signing up for Medicare during your IEP is one way for you to avoid any late-enrollment penalties. Most people are enrolled automatically ahead of their 65th birthday, but the IEP is the first time people can enroll manually if they have to. You also have the option of enrolling in a stand-alone Medicare Prescription Drug Plan at this time, as long as you are entitled to Medicare Part A or enrolled in Part B. Initial Coverage Election Period (ICEP) This is the first time a newly eligible person can enroll in a Medicare Advantage plan (also called Medicare Part C). Medicare Advantage plans are sold through independent insurance companies and must provide at least the same amount of coverage as Original Medicare, Part A and Part B. In order to “activate” your Initial Coverage Election Period (ICEP), you have to be enrolled in both parts of Original Medicare. The ICEP can run parallel to the Initial Enrollment Period, if you enroll in both Medicare Part A and Part B when you are first eligible. Because you must pay a monthly premium for Medicare Part B, you can opt out of this coverage during your Initial Enrollment Period. Doing this means that you cannot enroll in a Medicare Advantage plan. If you choose to enroll in Medicare Part B at a later date — for example, during the General Enrollment Period (January 1 — March 31) — then your Initial Coverage Election Period won’t begin until then. When you do enroll, the Initial Coverage Election Period will only be the three months prior to your Medicare Part B effective date. For example, if you enroll in Medicare Part B during the General Enrollment Period, it will be effective July 1 of that year. Your Initial Coverage Election Period to enroll in a Medicare Advantage plan would be April 1 through June 30. If you get disability benefits from the Social Security Administration (or certain disability benefits through the Railroad Retirement Board), your Medicare coverage begins on the 25th month of benefit receipt. Your Initial Coverage Election Period begins 3 months before the month your Medicare Part A and B coverage takes effect, and ends 3 months after the month of eligibility. For example, if your 25th month of disability is June, your Medicare Part A and Part B become effective June 1, so your Initial Coverage Election Period will be March 1 – September 30.

Normally on the 20th of each month.

If you have Original Medicare, and the amount a doctor of other health care provider is legally permitted to charge is higher than the Medicare-approved amount, the difference is called the excess charge.

Resetting your login info is simple for Humana's ipad imapa app, just use this formula. Password and Login will be : PA$$ + today's date - (ie : 1005) for October 15th, so : "PA$$1005" - for login & password line...that will prompt you to reset it all. Call ASU at 800-309-3163 if tech issues persist!

Once your hospice benefit starts, Original Medicare will cover everything you need related to your terminal illness, even if you choose to remain in a Medicare Advantage Plan or other Medicare health plan. If you were in a Medicare Advantage Plan before starting hospice care, you can stay in that plan, as long as you pay your plan’s premiums. If you stay in your Medicare Advantage Plan, you can choose to get services not related to your terminal illness from either providers in your plan’s network or other Medicare providers.

Applications are generic nationwide (e-app available too: via ipad or portal) Summary of Benefits can be ordered through ASU (800-309-3163) Or SOB can be printed at www.Humana-Medicare.com Drug Calculators, EOC's, Doctors, and Networks info can be found there also! (www.Humana-Medicare.com) Make sure to submit your license for that state and follow up (Fax to : 920-339-2160)

Marketing Materials Agents create and use a variety of marketing materials to advertise Medicare Advantage and Part D products. These include, but are not limited to, letters, postcards, posters, brochures, scripts, radio and television ads, billboards, banners, signs, yellow page ads, church bulletin ads and websites. Any marketing material that is an advertisement must follow the CMS Medicare Marketing Guidelines. See below for some direction in this area. Marketing Materials Guidance Branded vs. Generic Marketing Material Branded material — marketing material that contains carrier and/or product information (e.g., plan name, plan costs/benefits). Must be CMS approved. Generic material — self-created marketing material that is free of any plan or product information, brands or carrier logos (e.g., agent’s flyer for his/her business). Does not need to be CMS approved, but must comply with CMS guidelines. Note: MA and PDP carriers may allow use of their logo in certain circumstances such as websites, but agents must get carrier approval first. Required Disclaimers “Not connected with or endorsed by the U.S. government or the federal Medicare program.” — should be on all generic marketing materials “This is an advertisement” — is required for all mailers; must be on the front of the envelope or postcard If a phone number is listed on an advertisement, it must be obvious to the consumer they will be calling an insurance agent. If not obvious, must use a disclaimer like “Call 800-786-5566 to speak with one of our insurance agents today.” If you are trying to obtain Permission to Contact through a business reply card, there must be a statement informing the customer who will contact them and by what method. Recommended statement: “By providing the information above, I give permission for a licensed sales agent to contact me by phone or email to discuss Medicare Advantage and Part D Prescription Drug Plans.” Prohibited Marketing Content Agent titles — CMS prohibits the use of the word “Medicare” and/or any language that implies additional knowledge, skill or certification above licensing requirements. Example — “Medicare Specialist”; “Medicare Advisor” Use of government symbols — Consumer facing material cannot mimic or resemble a CMS or government agency design. Use of symbols (e.g., American flag, eagle or Medicare ID card) is strictly prohibited. Websites/ Social Media Consumer-facing websites and social media are held to the same regulations as traditional marketing materials. CMS Medicare Marketing Guidelines apply, as well as carrier rules. All websites and social media pages should be kept generic, should not post any plan or benefit information and should not use of carrier logos without prior approval. Websites Electronic business reply cards must adhere to the same regulations as traditional business reply cards. Website Registration Requirements — Agents are required to report any third party marketing or enrollment websites that include Medicare lead generation to the MA-PD carriers. Social Media A social media page is much like a website page. Agents CAN list the name and address of their business and indicate the type of product offered (e.g., Medicare Advantage, Prescription Drug Plans, Medicare Supplement insurance plans, etc.) offered. Agents still have to be otherwise compliant with CMS rules, though (clearly identifies as a licensed insurance agent, has the necessary disclaimer “Not connected with or endorsed by the United States government or the federal Medicare program.” etc.). There are a few other limitations to keep in mind regarding unsolicited contact: CMS guidelines state that if an individual comments, likes or follows on social media, this does not constitute agreement to receive any communications. So a consumer liking or commenting on a Facebook page does not give the agent permission to contact. Agents must not reach out to potential clients with an advertisement through Facebook messaging. Agents are required to report social media pages to the MA-PD/Part D carriers, akin to reporting their other websites. Business Cards: Tips Governed by state law If you are listing carrier names or logos, you need carrier approval, and response time is often long and tough to get Identify yourself as an insurance agent or independent insurance agent Do not give off the impression that you are part of the federal government or state government MA guidelines do not apply if using business card in the traditional sense. But, if you post your business card like an ad in the newspaper or use it as a marketing piece than CMS marketing guidelines do apply. The business card may not be attached, i.e. stapled or paper clipped, to CMS approved marketing pieces or enrollment forms. It can be included in the envelope, though In CA, need license number on business card

With every Medicare and MEDICAID client in the large metro areas in OHIO you MUST make sure to OPT your clients OUT of the MyCareOhio program ANNUALLY at time of their Medicaid effective anniversary date. Please follow the instructions on the form picking a MEDICAID provider, and then OPTING OUT for MEDICARE services, so you can enroll them in your plan. See below! Click here for the mandatory opt out client form

This SEP exists for individuals who are losing group health coverage. Losses include the individual opting out of the Company/Group coverage during the employer’s annual benefit selection season, changes due to life events and discontinuation of employment or the Company/Group ceases to offer group health coverage. The SEP begins the month of the loss of coverage and continues for two additional months. The individual may choose a plan effective date up to 3 months after the month in which the individual completed the enrollment request.

QMB (only) (Qualified Medicare Beneficiary) – Medicare Part A and Part B premiums; cost sharing for Part A & Part B benefits. QMB Plus – Medicare Part A and Part B premiums; cost sharing for Part A & Part B benefits; Full Medicaid benefits. SLMB (only) (Specified Low-Income Medicare Beneficiary) – Medicare Part B premium. SLMB Plus – Medicare Part B premium; Full Medicaid benefits. QI (Qualifying Individual) – Medicare Part B premium. Other FBDE (Full Benefit Dual Eligible) – Medicare Part B premium; Full Medicaid benefits. QDWI (Qualified Disabled & Working Individual) – Part A premium.

The Open Enrollment Period (OEP) is a 6 month period where the client can buy any Medicare Supplement policy without being denied. The 6 month period begins in the first month the client signs up for Medicare Part B. During this time the client will not be denied for a Medicare Supplement policy or be charged more due to their health history. (Can enroll in ALL Medsupp plans available!) Guaranteed Issue (GI) in the Medicare Supplement terms is defined as the rights the client has in certain special situations when insurance companies are required to sell or offer the client a Medicare Supplement policy. An example of this is the Special Election Period that occurs when a person comes off of group coverage. (Cannot enroll in plans G or N without underwriting!)

Yes! The CMS Trial Right gives clients the right to switch to a Medicare Supplement after a 12 month period of trying an advantage plan. Click here for CMS' explanation Two common examples: 1. ​You dropped a Medigap policy to join a Medicare Advantage Plan (or to switch to a Medicare SELECT policy) for the first time, you’ve been in the plan less than a year, and you want to switch back. (Trial Right) You have the right to buy : The Medigap policy you had before you joined the Medicare Advantage Plan or Medicare SELECT policy, if the same insurance company you had before still sells it. If your former Medigap policy isn't available, you can buy a Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in your state. You can/must apply for a Medigap policy: - As early as 60 calendar days before the date your coverage will end - No later than 63 calendar days after your coverage ends 2. You joined a Medicare Advantage Plan or Programs of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare. (Trial Right) You have the right to buy any Medigap policy that’s sold by any insurance company in your state. You can/must apply for a Medigap policy: - As early as 60 calendar days before the date your coverage will end - No later than 63 calendar days after your coverage ends

Yes it CAN fluctuate year to year for your members based on the national average. Click here for Medicare.gov direct link to calculating your members penalty. It's easy!

It does qualify for a valid SEP. They can change plans monthly. Click here for guidelines and eligibility

Sign up for a Medicare Advantage Plan or a Medicare Prescription Drug Plan Your Medicare coverage begins 24 months after you get Social Security or Railroad Retirement Board (RRB) disability benefits. When? During the 7-month period that starts 3 months before your 25th month of getting Social Security or RRB disability benefits and ends 3 months after your 25th month of getting disability benefits. Your coverage will begin the first day of the month after you ask to join a plan. If you join during one of the 3 months before you first get Medicare, your coverage will begin the first day of your 25th month of entitlement to disability payments. I am already eligible for Medicare because of a disability, and I turned 65. What can I do? Sign up for a Medicare Advantage Plan and/or a Medicare Prescription Drug Plan. Switch from your current Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan. Drop a Medicare Advantage Plan or a Medicare Prescription Drug Plan completely. When? During the 7-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you sign up for a Medicare Advantage Plan during this time, you can drop that plan at any time during the next 12 months and go back to Original Medicare.

According to Section 1140 of the Social Security Act, it's forbidden to use the words or symbols including "Medicare," "Centers for Medicare & Medicaid Services," "Department of Health and Human Services," or "Health & Humana Services" in a way that would indicate the approval, endorsement, or authorization of Medicare or any other government agency. Additionally, agents shouldn't use the word "Medicare" on their business card in any fashion that suggests they represent Medicare, like putting the words "expert," or "specialist" behind it.

Call MRS Tele-Interview: (866)664-0083. Their hours are from 8am-9pm CT (M-F). Sat (8am-3pm CT). SUN (Closed). They do the rest. It's an incredibly easy process, with a stellar product.

Email MSOP - The Medicare Service Operation Support Team. MSOP Support is a dedicated email box to handle escalated customer service issues for agents, like : 1. Agent Errors Letters 2. Issues With Medicare Enrollment Email : MSOPSupport@humana.com.

Per CMS guidelines: the agent must submit - A dated member statement (ie simply: I want John Doe to be my agent) In the member’s handwriting Signed by the member Email copy to agentsupport@Humana.com The statement must include the member’s ID number Or Medicare claim number New AOR SAN, Name, and Signature And effective date No form letter will be accepted Please format the email subject line as: " Medicare AOR Change Request – Monroe, Marilyn – 123456789A or Member ID " Within 4-8 weeks you'll begin getting paid monthly on their policies. It's a great way to service orphan clients and build your renewal stream!

Click here for enrollment instructions : http://www.va.gov/healthbenefits/apply/veterans.asp

Humana has received questions regarding the SEP that is available to people, particularly Veterans, who want to disenroll from their Medicare prescription drug coverage to maintain or enroll in another type of creditable drug coverage, such as VA or TRICARE. Members who wish to enroll in or maintain other creditable coverage (such as TRICARE or VA coverage) may use the SEP-OCC to disenroll from a Medicare Advantage Plan with drug coverage (MAPD), a Medicare Supplement, or a stand-alone PDP. Additionally, individuals enrolled in an MAPD/PDP/Medicare Supplement plan who have or are enrolling in other creditable drug coverage (such as TRICARE or VA coverage) may use this SEP within 2 months of the disenrollment date to enroll in an MA-only plan. In this scenario, individuals may enroll in any available MA Only plan (HMO, PPO, or PFFS) because they are removing the Medicare PDP that would initiate the PFFS MA Only option requirement. Note: PDP members who want to enroll in an MA only PFFS plan with their Other Creditable Coverage need to first submit a disenrollment request from the PDP plan. After that, they can submit an application for an MA only PFFS plan using the SEP-OCC. MAPD members would be automatically disenrolled from their current plan when the MA only application is processed and do not need to submit a disenrollment request to their plan. Example: A veteran is enrolled in an MAPD with Humana and discovers that he can obtain his prescription drugs through the VA. Once qualified, he can disenroll from the MAPD plan, obtain VA Rx coverage, and enroll in an MA-only plan, as opposed to having Original Medicare.

Agents should obtain the completed Scope of Appointment (SOA) at least 48 hours prior to any personal individual/ marketing appointment (e.g., in-home, conference call, coffee shop, etc.) to ensure the client understands the topics that will be discussed. If it is not practical for the agent to collect the SOA 48 hours before the personal individual/ marketing appointment, it should be taken as soon as possible up to the start of the sales presentation. SOA's taken just prior to the sales appointment must have documentation as to why it was taken at the time of the appointment. As always if any product is not clearly noted on the SOA, the agent will not be allowed to discuss that product or group of products during the appointment unless the beneficiary initiates a request to discuss them. If, during the course of the presentation, the agent feels other products would be beneficial to the beneficiary but the beneficiary does not request at the time to discuss, the agent must secure a new SOA and adhere to a required 48-hour waiting period, when practicable, before the products can be presented. A Humana Scope of Appointment can be executed one of four ways: Paper – Humana Barcoded Paper SOA forms can be ordered through Agent Support. Barcoded forms must not be photocopied, scanned, or reproduced in any way. Completed Paper SOA forms must be mailed to the address on the back of the SOA form for scanning and processing. Paper scopes can also be faxed in with the paper app to (877) 889-9936. Generic paper SOA forms can also be used, but the agent / broker then accepts the responsibility to retain the document for 10 years as required by CMS. MAPA – An SOA form can be taken in MAPA and signed with the digital signature pad. MAPA SOA’s are uploaded along with any enrollment forms by the agent. Each MAPA SOA receives an MAPA SOA ID number. IVR – An SOA can be taken through the IVR process on a recorded line. The IVR captures all required information through touch‐tone and voice recordings. Each IVR SOA receives an IVR Recording ID. Agents can three-way call into the IVR with the member and follow the prompts. The IVR phone numbers are: Delegated 1-866-945-4471 CarePlus 1-888-685-8606 Telesales – An SOA can be taken through the lead setting process by Humana Career Telesales Agents. The DMS scripting guides the Telesales representative though all required information. Each DMS SOA receives an IVR Recording ID and will be indicated on the lead.

​The Pre-Enrollment Period or Pre-AEP as we call it is October 1-14th. During this time agents can: Tell Medicare beneficiaries about the NEW MA & PDP plan benefits (after signing a scope of course) And take "PRE-Enrollments" How do I "pre-enroll" a customer? Every company is a little different, but the general rule of thumb is: Do the FULL compliant sales presentation DO NOT sign OR date the application CUSTOMER must hold the application until 10/15 (agents cannot be in possession of it) Then on 10/15 have a drop off party, or collect the apps from your clients It's critical to stay in touch with them! Its highly recommended to put a bright RED cover sheet on the Pre-Enrollment the client is holding stapled with your card with similar instructions : "DO NOT MAIL UNTIL YOU MEET WITH ME YOUR AGENT - JOHN SMITH - AT OUR APPLICATION DROP OFF PARTY 10/15/18 AT DUNKIN DONUTS AT 2PM AT THIS ADDRESS -----------. APPLICATION IS NOT COMPLETE. PLEASE CALL ME WITH ANY QUESTIONS 888-000-0000" Etc. If the application is mailed in you could receive a violation depending on carrier When done properly, the Pre-Enrollment Period can be a GREAT way to gather clients and build a pipeline of apps to turn in 10/15 !

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Kidney disease comes in five stages. Stage 5 (also known as end stage renal disease, or ESRD) is when kidneys function below 10 to 15 percent of their normal capacity. This essentially is known as kidney failure. Stages 1-4 are not considered End Stage and are eligible for Medicare Advantage Plans. Stage 4 kidney disease normally requires dialysis but is not considered "End Stage". ​ Further education available here : - http://www.davita.com/kidney-disease/kidney-failure/esrd - https://www.davita.com/education/kidney-disease/stages/stage-4-of-chronic-kidney-disease

1. Guggenheim sends out anniversary letters 45 day's before the policy date anniversary. 2. Within 30 day's before the annual anniversary policy date you must submit 1035 exchange forms and all new application paperwork to Guggenheim. They will accept faxes at 317-229-6475. (Remember to call to confirm receipt) 3. On the anniversary day they will transfer the funds to the requested plan. 4. If you allow the automatic continuation "renewal", IE: of a 5 year MYGA into another 5 year MYGA you will receive 50% commission automatically. Guggenheim requests you call them and confirm what your client is planning on doing if they are changing into another annuity.

CMS has made available a new Special Election Period for those beneficiaries that were non-U.S. Citizens and became lawfully present in the United States. The beneficiary may use this SEP to request enrollment in any MA plan for which he/she is eligible, including an MAPD. This SEP begins the month the lawful presence starts and ends when the individual makes an enrollment request or two (2) full calendar months after the month it begins, whichever occurs first. Please note that individuals are not required to provide evidence of U.S. citizenship or lawful presence status with the enrollment request, nor is Humana/CarePlus permitted to request such information or documentation. CMS systems will be queried to determine the lawful presence status of a non-U.S. citizen, including the start and, if applicable, the end date of the unlawful presence status of the individual. The application will be denied if the status is not reflecting in CMS’s system upon processing, and the beneficiary will need to get that information corrected/updated. What Does This Mean to Agents Agents are not to collect proof from the beneficiary in order to determine if they qualify for this new SEP. As agents objectively go through the various SEPs that are available to a beneficiary, agents may ask “Are you a non-U.S. Citizen who recently became lawfully present in the United States?” If the beneficiary says “Yes”, the agent may take that as verbal attestation, complete the enrollment application and submit to Humana/CarePlus for processing. On an enrollment application, agents must use SEP “OTH” and indicate the reason in the notes section: “Obtained lawful presence on <date>”. ( Issued 10/1/2015 )

F2F - Face to Face GCS - Guidance Center Seminar GCW - Guidance Center Walk-in INH - In Home Appointment OTH - Other RET - Retail Partner SEM - Seminar WAL - Walmart TEL - Telephonic

​Normally on the 3rd of each month.

Open Enrollment Period (OEP) - January 1st to March 31st MA Plan Members can make a one-time election annually from January 1 through March 31 to switch MA plans (with or without drug coverage) or to disenroll from an MA plan and obtain coverage through Original Medicare (with or without a stand-alone PDP). In addition, newly eligible MA individuals who enroll in an MA Plan can use the OEP, but only during the first three months in which they have both Part A and Part B. Members enrolled in stand-alone PDP plans are not eligible for the Open Enrollment Period election because the OEP is only available to those enrolled in an MA plan.

Go on page "Supply Central" on Agent Portal and select Humana to order supply.

Qualifying Factors : • Single Hoosier - Monthly Income: $1,835 • Counted Assets: $7,280 total • ​Hoosier Couple - Monthly Income : $2,476 • Counted Assets: $10,930 total • Non Countable Assets : Home, Car, Burial Plot, $10,000 Burial expenses and Personal Items See if they qualify by calling : • SHIP 1-800-452-4800 • Medicare 1-800-633-4227 • Humana 1-866-561-5040

For Guggenheim contracts up for renewal if the client wishes to renew into a new guarantee period the agent must circle the term on the renewal letter (mailed to the client and CC to agent). Agents and clients receive a copy of this renewal letter. This will need to be sent in with an updated suitability form. If the client wants interest paid please also attached a signed letter requesting it along with the other documents.

Click here for the Top Railroad Benefit Questions & Answers!

​There are a number of ways to get compliant top tier leads. Check out our leads section for in depth expert insight! Click here to get started.

Fill out the Agent Statement for Enrollment Correction form and submit to Humana RSOS. Please ensure your subject line to AgentRSOS@Humana.com is formatted correctly for accurate and timely processing. Subject Example : "Monroe, Marilyn – 123456789A – MEDICARE" REMINDER – Please only submit ONE AOR form per email to : AgentRSOS@Humana.com. You can check the status after submission by calling agent support at: 800-309-3163 . Click Here for MA & PDP Correction Form Click Here for MedSupp Correction Form

The "Getting Started" page tells you all you need to know about getting compliant, contracted, and ready to sell. Filled with resourceful links, this page is a full action plan.