Countdown to AEP

What can your clients do during AEP?

Medicare Advantage
Leave original Medicare and enroll in a Medicare Advantage plan (or vice versa).

​Switch from one Medicare Advantage plan to another.

​Switch from a Medicare Advantage plan that doesn't have drug coverage to one that does (MAPD).
Prescription Drugs
Enroll in a Prescription Drug Plan (PDP).

​Switch from one Prescription Drug Plan to another.

​Drop Prescription Drug coverage completely.

Carrier Tools & AHIP
How much does AHIP certification cost?
The standard cost of AHIP certification is $175, but most carriers will offer a $50 discount making your cost $125.
How many times can I take the AHIP test?
You have 3 attempts to get a passing score of 90% for the final exam.  Some carriers will even allow you to pay another $175 and take the test 3 more times.
What will I learn by taking AHIP?
Access training for both Medicare and Fraud and Waste and Abuse (FWA). AHIP's online program gives you the background to make informed decisions on Medicare, including plan options, marketing, enrollment requirements, and FWA guidelines. If you only sell Medicare Supplement products, you do not need to complete AHIP training. Below are items you'll learn from taking AHIP.
  • The basics of Medicare fee-for-service eligibility and benefits
  • Different types of Medicare Advantage and Part D prescription drug plans
  • Eligibility and coverage
  • Nondiscrimination training
  • Marketing and enrollment under the Medicare Advantage and Part D program requirements
  • How to identify Fraud, Waste and Abuse (FWA)
  • An overview of the industry efforts in detecting fraud
  • Legal tools to combat FWA
  • Understanding both the human and financial cost of FWA
  • Review of Medicare Parts C and D
  • General Compliance requirements
  • Who commits FWA
  • Reporting FWA; loopholes and obligations​
How do I study for AHIP?
You can download slides from each module for review and take practice quizzes. The actual exam is open book, so you can rely on your notes and practice quizzes to help you. ​The final exam is made up of many questions from the review quizzes which is helpful.
How long does it take to complete training?
You have 2 hours to complete the final exam, but the training modules are not timed, allowing you to pace yourself. Most agents complete the final exam in less than 2 hours and it contains 50 questions. 
Do I have to take the AHIP exam?
Most carriers require AHIP certification before you can take their training to sell their Medicare Advantage or Prescription Drug plans. There are a few exceptions, but it is definitely recommended that you complete AHIP Certification if you plan on selling Medicare Advantage or PDP plans.
How do I transmit my AHIP score?
You can transmit your scores directly from your AHIP account. You can also log into the carrier site where you would like your score transmitted and use their internal links to connect to AHIP’s website to transmit your score.
What happens after I complete certification?
Once you’ve completed your certification and exam, you will receive a link to a printable copy of your certificate.
How long does my AHIP certification last?
Your certification lasts 12 months and you must re-certify each year.
Training Events Training Events

Inflation Reduction Act & Medicare

This year’s AEP brings important changes to the Medicare market due to the Inflation Reduction Act - most notably to prescription drug coverage. In 2022 the Inflation Reduction Act was passed and was designed to benefit several populations - including Medicare recipients. The IRA’s changes have already started affecting carriers, which will then affect plans and consumers. Some key changes to note are:
“Donut hole” coverage gap phase has been eliminated with an annual max cap of $2,000 on out-of-pocket costs and payments for these out-of-pocket costs can be spread out over a year.
Part D plans will pay less during the initial coverage phase: 65% instead of 75% and will now pay more during catastrophic phase: 60% instead of 20%.
Drug manufacturers are now required to discount brand-name drugs 10% during initial coverage and 20% during catastrophic coverage phase.

MAPD & PDP Commission Rates

Updated July 29, 2024
Product
Region
2024 Initial
2025 Initial
2024 Renewal
2025 Renewal
Medicare Advantage
National
$611
$626
$306
$313
Medicare Advantage
CT, DC, PA
$689
$705
$345
$353
Medicare Advantage
CA, NJ
$762
$780
$381
$390
Medicare Advantage
PR, USVI
$418
$428
$209
$214
Prescription Drugs
National
$100
$109
$50
$55
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Checklist Review

Finish any contracting you may have started, complete it and review any carriers you wish to add.​ Carriers have blackout dates where you can no longer move your contract.
Be sure to complete your AHIP training. Many carriers offer discounts, but you must access the training through the carriers' agent websites to receive that discount. Additionally, you must complete all product training. You'll get notified by the carrier when you’re eligible to begin selling. Watch your Inbox carefully for important RTS (Ready to Sell) emails.
Review our MA & PDP Sales Checklist.
Download our IRA & What it Means for Medicare presentation as well as our 2025 AEP Readiness guide which will help you understand this topic and prepare you for a successful and productive AEP.
Begin marketing yourself early, and be sure to request our complimentary, marketing materials.
Login to MedicareCENTER and be sure to download the mobile app, Integrity for Agents, available in the App Store and the Google Play Store.
Become a PlanEnroll agent and offer your clients and future clients a personalized website where they can reach you and create their own profile that will sync their important health information with you.
If you're not selling Prescription Drug Plans be sure to download our Part D Plan finder guide to help walk your clients through the process of enrolling in a Part D plan on medicare.gov.

Contact Rules

What You Can Do
You must always receive proper permission to contact a potential client before calling or meeting with them.

​You are allowed to make unsolicited phone contact to your current clients in the following scenarios:
  • At any time about their current plan
  • At any time to discuss plan business 

You may use the following methods to make unsolicited direct contact with potential Medicare Advantage or Prescription Drug Plan clients, provided they meet all federal, state, carrier, and MCMG guidelines
  • Conventional mail and other print media (direct mail, ads, banners, websites, etc.)
  • Email, provided all emails contain an opt-out method and a process is in place to ensure further emails are not sent to those who opt-out

​If you have a pre-scheduled appointment with a potential enrollee who is a “no-show”, you may leave information at that potential enrollee’s residence.
What You Can't Do
You may not use the following methods to contact potential Medicare Advantage or Prescription Drug Plan clients
  • Leaving information at a residence
  • Going to a residence without a previously schedule appointment for that date and time
  • Going to a residence because of a returned reply card or other documentation whereby a potential client requested additional information and provided their address
  • Approach potential clients in common/public areas (parking lots, hallways, lobbies, etc.)
  • Phone solicitation (cold-calling), texts, or electronic voicemails
  • Make unsolicited calls about other lines of business
  • Make unsolicited calls based on referrals 
  • Make unsolicited calls to former clients who have dis-enrolled
  • Make unsolicited calls to potential clients who attended a sales event, unless they gave express permission at the event for a follow-up call  and there must be documentation of permission to be contacted
  • Make unsolicited calls to prospective enrollees to confirm receipt of mailed information​

Marketing Rules
In April 2023 CMS updated the following rules for marketing and communications with regard to offering Medicare Advantage and Prescription Drug Plans. When marketing these plans the following language must include one of the options below:
  • Verbally conveyed within the first minute of a sales call.
  • Electronically conveyed when communicating with a beneficiary through email (email signatures), online chat, or other electronic means of communication.
  • Prominently displayed on agent/agency websites and in email signatures.
  • Included in any marketing materials, print materials and advertising.​​
If you do NOT sell ALL plans in the service area, the disclaimer must read: “We do not offer every plan available in your area. Currently we represent [insert number organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.”

If you DO sell ALL plans in the service area, the disclaimer must read: “Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program for help with plan choices.” The disclaimer is not required if you only sell plans on behalf of one Medicare Advantage carrier or PDP carrier.

Additionally, CMS prohibits the use of the Medicare name, CMS logo, or products or information issued by the Federal Government, including the Medicare card, in a misleading manner. Use of the Medicare card image is only permitted with authorization from CMS. ​
You may NOT collect SOAs or set up personal marketing appointments at educational events.  You may receive beneficiary contact information, including Business Reply Cards at these events. 

Scopes of Appointment are valid for 12 months following a beneficiary’s signature date. Business reply cards or requests to receive additional information are valid from the beneficiary’s signature date or the date of the beneficiary’s initial request for information. A 12 month limit will help a beneficiary to give permission annually to be reminded about the next AEP, and the opportunity to evaluate (or re-evaluate) their Medicare Advantage and Part D plan options. 

You must agree upon and record the Scope of Appointment with the beneficiary ​48 hours prior to the scheduled marketing appointment, except for: SOAs that are completed during the last 4 days of a valid election period for the beneficiary OR unscheduled in person meetings (walk-ins) initiated by the beneficiary. 

Call Recording Requirements

All Third Party Marketing Organizations (TPMOs), which includes licensed insurance agents, must record all sales, marketing, and enrollment calls with Medicare beneficiaries in their entirety, including the enrollment process and pre- and post-sales calls. This requirement pertains to phone, virtual, and online conversations. Only the audio portion of calls using web-based technology must be recorded.

Recordings must be stored in accordance with CMS storage requirements for a duration of no less than 10 years. Please note, face to face appointments are not required to be recorded and are exempt from this guidance.

We do not dictate which technology you must use for call recordings. However, we do offer call recording capabilities through MedicareCENTER which allows you to record and store your calls for free.
You must notify beneficiaries that the call is being recorded at the start of the call and must receive consent to proceed. Should a beneficiary decline to have their call recorded, you should attempt to schedule an in-person meeting with the beneficiary.

Call recordings will be available within 24 hours, should a carrier, CMS or your upline request them.
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Medicare Supplement Applications

  • Open Enrollment
  • Guaranteed Issue
  • Underwritten
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Open enrollment applies only to people who are first enrolling in Medicare Part B or turning age 65.
Guaranteed Issue applies only to Medicare beneficiaries who are losing (or dis-enrolling from) their current healthcare coverage under a qualifying Guaranteed Issue provision. These applications must include proof of credible coverage which supports the qualifying Guaranteed Issue event. (Guaranteed Issue provisions vary by state; if in doubt, call the carrier's Underwriting department before taking a Guaranteed Issue application. You must attach proof of credible coverage to the application (paper or e-App). The document must be from each applicant’s current health insurer, include each insured’s name, and include the date each applicant’s current coverage will end.
​Underwritten applies to applications where the applicant must answer health questions.