The Do’s And Don’ts Of Cross-Selling Medicare

General, Medicare April 3, 2017 0
The Do's and Don'ts of Cross-Selling Medicare | Senior Market Advisors

The health insurance industry is a part of a heavily regulated sector of government, especially when it comes to Medicare and Medicaid sales. Rules and regulations are in place to protect the beneficiaries, carriers, and agents.

One of the biggest rules that every person in the industry must understand is that an agent cannot cross-sell Medicare products, with a few exceptions surrounding ancillary sales. That means that if a client is expecting to hear about one aspect of their health insurance, the agent, in most cases, cannot discuss another sector in that same appointment. These regulations protect the health care industry from becoming a profit-based industry instead of a care one.

Generally, anything discussed in an agent-client Medicare meeting must be under the scope of appointment. Both parties must sign and date a legally binding form (like this one) before the meeting that states what will be discussed. The beneficiary may want to discuss multiple sections (Medicare Advantage, Medicare Supplements, prescription drug plans, ancillary) and that’s okay, as long as it is agreed upon beforehand.

While we recommend that agents always bring along scope of appointment forms for their own protection, they are only absolutely necessary for the sale of Medicare Part C (Advantage) and Part D (prescription drugs).

Scope Of Appointment

Do –

  • Leave Medicare information behind if the appointment is a no-show
  • Call to confirm appointments
  • Request that the beneficiary signs a new SOA if they want to discuss other options
  • Keep SOA documentation for at least 10 years

Do not –

  • Market health care products during a meeting that were not previously agreed to on SOA form
  • Accept walk-in or last minute appointments without a written SOA form
  • Use an SOA for another appointment later. They are only valid for one appointment as stated
  • Market or leave materials for plans beyond the scope or non-health care related
  • Return uninvited if last appointment was not kept
  • Solicit or accept enrollment forms before OEP
  • Ask for referrals
  • Provide food or subsidize meal

Seminars & Educational Events

Medicare seminars are meant to inform the public. If an interested party wants to contact you after your event, great! You have a lead. You cannot ask for permission to contact while conducting or visiting an educational event. It has to be the client’s idea – even if you invited your preexisting clients to the seminar.


Do –

  • Announce all product types and plans that will be covered at the beginning of the presentation
  • Use only CMS-approved presentation materials
  • Provide objective information
  • Respond to questions
  • Provide promotional items/snacks but not meals
  • Display a logo or your name
  • Present business cards if asked

Do not –

  • Demonstrate plan-specific bias
  • Conduct enrollment or sales activities
  • Display or distribute contact information unless personally asked
  • Collect names or schedule appointments
  • Require contact information for attendance
  • Conduct health screening or genetic testing of any kind
  • Attach business cards to educational materials
  • Require SOA forms for educational events

Marketing Activities & Materials

People with higher income are more likely to be able to purchase ancillary policies. They’re more willing to buy policies “just in case” instead of based on need. Even though they’re your best bet for cross-selling, you legally cannot target based on income. You can, however, market to the general public.

Do –

  • Begin marketing for the following year starting Oct. 1st
  • Begin accepting enrollment forms after Oct. 15th
  • Only provide marketing materials from the previous year upon request

Do not –

  • Cherry pick beneficiaries
  • Discriminate based on race, ethnicity, national origin, religion, gender, age, health status, disability, or geographic location
  • Target high-income beneficiaries
  • Intimidate with high-pressure sales
  • Encourage beneficiaries to request a SEP to switch plans
  • Market non-health related products

Anastasia Iliou
Anastasia Iliou
Content Marketing Manager at Senior Market Advisors
Anastasia graduated from Belmont University with a Bachelor's degree in Songwriting. When she's not writing, she's on a mission to visit all 50 states in the U.S (and to date has reached 27). Anastasia loves writing music, hiking, and her pet hedgehog, Luna. She loves animals (but not so much bugs) and spends her free time volunteering for The Elephant Sanctuary in Tennesee.