10 Ways to Avoid Rapid Dis-Enrollment

Business Development, Customer Retention, Sales April 18, 2016 0
10 Ways to Avoid Rapid Dis-Enrollment | Senior Market Advisors

Retention is very important in any industry because it creates loyalty and leads to repeat customers. This is also true when selling Medicare Advantage. From January 1st- February 14th people have the opportunity to leave their current plan or switch to another. There are many different reasons a person would choose to dis-enroll. For example many people simply misunderstand what their plan covers. Others may find out they qualify for a different plan, then choose to enroll in that one. Some people forget what the agent discussed with them previously and start to doubt the plan they have chosen.

Preventing dis-enrollment is much easier then generating a completely new lead, then hoping to make the sale. Happy customers tend to continue to come back, which will increase business. Satisfied customers are more likely to promote the company, which will then lead to new customers.

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Rapid Dis-enrollment happens mostly from:


  • HMO plans
  • D-SNPs
  • C-SNPs
  • PDPs
Rapid Dis-Enrollment-is when someone dis-enrolls within 3 months of the plan's original effective date.Click To Tweet

10 Ways to Avoid Rapid Dis-enrollment

  1. Always be preparedHave all sales materials easily accessible, ask appropriate warm-up questions, and lay the foundation for referrals.
  2. Conduct a thorough Needs Analysis to help the prospect sign up for the most appropriate plan based on his/her needs.
  3. Present the Enrollment Kit in its entirety and leave it with the customer.
  4. Ensure the prospect understands and agrees with the plan’s effective date, premium, and benefits.
  5. Encourage the prospect to select a PCP instead of having one auto-assigned.
  6. Ensure the customer understands how to access a provider and explain any network/provider limitations (including referral requirements when applicable).
  7. Provide the physical address in the residential address portion of the P.O Box. Located in the building address portion of the enrollment application, if applicable.
  8. Explain that a Authorized Representative must provide documentation to the health plan and or CMS if requested.
  9. Review Enrollment Application cancellation process with the customer.
  10. Review the Outbound Education and Verification (OEV call or letter) process with the customer.

Common Mistakes an Agent Makes:

  • Does not conduct a thorough Needs Analysis with the enrolled.
  • Uses only the printed directory to verify the provider at the point of sale.
  • Does not look up all drugs in the plan.
  • Does not review all plan benefits and limitations as listed in summary of benefits.
  • Does not provide contact information therefor is not accessible to answer follow up questions.

To find more tips, keep a look out for SMA University which is coming soon!

Jessica Haase
Jessica Haase
Content Marketing Manager
Jessica is a Murray State Graduate with a Master’s Degree in Journalism and Mass Communications an an under graduate degree in Graphic Communications Management. Basically, Jessica is a professional communicator. She’s also a Pinterest addict and has a love for all things HGTV and Food Network. Yes, she’s that girl. However, Jessica is a Walking Dead and Game of Thrones fan girl, so we consider her interests very diverse and well-rounded.