OUTBOUND CALLS

Gathering essential customer information to meet our partner’s or

client's requirements. Our partners specialize in Medicare Planning, they
provide accurate and timely information to seniors and recommend
customer's plan that fits their budget while carrying every benefit that
they need.

JOB DESCRIPTION:

- Health Insurance
Basically - pre-qualifying for health insurance
Specifically - Medicare Supplements Plan

FUNDAMENTALS---
What: Healthcare Account (US)
Where: North & South Carolina, Georgia, Missouri, and Montana
Who: Senior Citizens who are 65 yrs. old and above and capable of
having health insurance, life Medicare and/or Medicare supplement plan
 CALL PROCESS:
1. Speak to the right person

Potential Customers:
- Person of the Dialer (POD)
- Spouse of the POD
- Other Medicare beneficiary
- Spouse of the other Medicare beneficiary that is living in the same
household

QUALIFIED PERSON TO PROVIDE INFO

- Person of the Dialer (POD)
- Spouse of the POD
- 3rd Person
> son/daughter
> sister/brother
> father/mother
> in-laws
> caregiver
2. Gather all information needed
- Medicare Part A (Hospital Insurance) and Part B (Medical Insurance)
- Secondary Insurance
- Retirement Plan or Took it out on their own
- *Government Assistance
- Company name
- Cost
- *Age and YOB
- *Smoking habits
- *Marital status

3. Determine the Insurance Coverage

> Original Medicare
> Medicare Advantage Plan
> Medicare Supplement Plan
> Other Insurances
4. Identify the validity of the lead
> Qualified lead
> Unqualified lead
 DNQW – Does not qualify as Workable
 DNQW – Does not qualify non-Workable

5. Call Disposition – (End result of the call)

Medicare – is a federal health insurance program

for people 65+ in older and 18+. You also need to
be a United States Citizen or Legal Resident. If
you are a legal resident, you must live at least 5
years in a row.

Each person must:

Qualify
Enroll
Choose coverage

2 ORIGINAL PARTS OF MEDICARE

Part A and Part B
 PART A – Hospital Insurance – it covers patient care
- Rooms, Meals, Nursing Services, Equipment, Operating Room

 PART B – Medical Insurance

- Doctor Visits & Services, Out-patient care, Clinic Visits,
Emergency Room, Ambulance, Preventive Care, Medical
Devices
What is the cost?

Part A – free after ten years of work

- If you’re working to pay taxes or your spouse’s taxes for at least 10
years, then you get a Plan A Premium Free otherwise you will pay
the premium.
- Premium, Deductible, Copay, Coinsurance
- You only pay while using Part A Services such as when you go in
the hospitals

Part B – deducted from Social Security

- Premium, Deductible, Copay, Coinsurance
Other options:
Part C – Medicare Advantage Plan
- Offered by Private Insurance Company (Covers Part A and Part B)
o Includes Prescription Drugs, Dental Vision and Hearing
o 0% Premium
o Copay, Coinsurance
o OUT OF POCKET LIMIT

Part D – Prescription Drug Coverage

- Medicare Advantage Plan or Stand Alone Part D Plan
o Premium, Copay
Medicare Supplement Insurance – Medigap
- Out of Pocket health costs
Example:
Script

(Good morning) I am looking for Mr. /Mrs. _____?

My name is _____. I am calling from the Medicare Supplement Division. We are conducting a brief survey in
your area that will help Medicare recipients lower their Medicare Supplement costs.

1. So I am assuming that you have a Medicare Supplement Program. Is that correct? X`

a) YES: Proceed to no. 2

b) NO: “But are you on Medicare?”

 YES: "And do you have a secondary insurance that pays for your hospital and
medical expenses?"

o YES: Proceed to no. 2

o NO: "Just to confirm, you are on Medicare only, correct?"

- Then proceed to starred (*) questions only

 Not on Medicare
o Use NOT ON MEDICARE spiel.

2. Is this a retirement plan or did you take this plan out on your own?

a) Took it out on their own: proceed to no. 3

b) Retirement plan: "Are you paying a portion of it?"

3. *Do you receive any type of government assistance such as Medicaid?

a) NO

b) YES: "Just to confirm, you are on Medicare and Medicaid, correct?"

4. From what company do you have your supplement with?

(Are you with Blue Cross Blue Shield, Aetna, United Healthcare, Mutual of Omaha, Cigna or Humana..?)

--- If the customer doesn’t pay anything don’t ask Q5 (check Q2)
5. What does your plan currently cost you on a monthly basis?

a) Refused/Not sure: "Just a ballpark figure, is it safe to say that you are paying over $100 a month or less
than that?"

b) Over $100 monthly: Medicare Supplement

c) Less than $100:

 Probing question no. 1: "Just to verify, is this Medicare Supplement or Medicare

Advantage plan, I mean a PPO or HMO plan?”

o PPO/HMO: Medicare Advantage. Proceed to no. 6

o Own
o Medicare Supplement/Medicare Advantage plan/not sure/refused

 Probing question no.2: "Do you pay small copayments whenever you visit your
doctor or specialist?"
o NO: Medicare Supplement
o YES/Not sure
(Check the Q3 if YES > Exp 1 = Ask for RX-P3
If NO > MedSupp = Proceed to Age)

 Probing question no. 3: "Is your prescription drugs covered by (Humana) or do you
have a separate plan for it?" (is your prescription drugs covered by your secondary
insurance)
o YES/Covered: Medicare Advantage Plan. Proceed to no. 6
o NO/Not covered/Separate plan or company: Medicare Supplement
o Cannot determine: "Is your prescription drugs covered all in one package
or do you have a stand-alone prescription drug plan?"

Just for the record:

6. *What is your current age? ____ Were you born in___ or ___? (Birth Year)

7. *Do you smoke or use tobacco products? (“How long has it been since you stop smoking?”)

8. *Are you married?

a) YES (has secondary insurance): "Is your husband/wife covered as well under the same type of plan?"

 YES:
o Does he/she receive any type of government assistance such as Medicaid?
o From what company does he/she has his/her supplement with?
 o What does his/her plan currently cost him/her on a monthly basis?

– (Ask probing questions if needed)

o What is his/her current age? ___ was he/she born in ___or___?

o Does he/she smoke or use tobacco products?

o NO: "But is he/she on Medicare?" – Continue with the script

o YES: "And does he/she have a secondary insurance that pays for his
hospital and medical expenses?"

- YES: go back to question no. 2 referring to the spouse and continue with the script

- NO: "Just to confirm, he/she is on Medicare only, correct?"

 Then proceed to starred (*) questions only referring to the spouse

o NO: Use NOT ON MEDICARE spiel

b) YES (No secondary insurance): "Is your husband/wife on Medicare?"

 YES: "And does he/she have a secondary insurance that pays for his/her hospital
and medical expenses?"
o YES: go back to question no. 2 referring to the spouse and continue with the
script
o NO: "Just to confirm, he/she is on Medicare only, correct?"

- Then proceed to starred (*) questions only referring to the spouse

 NO: Use NOT ON MEDICARE spiel

i. Let me just verify are you still located at (Street address, City, State, and Zip Code)?

ii. And the phone number that I dialed to reach you is ___-___-____, is that correct?

iii. a. I have your name here as ____, correct? And your husband/wife’s name is?

iii. b. I have your husband/wife’s name here as____, correct? And for the record, what is your first
name please?

a. Have Medicare Supplement

"Ok great! I really appreciate your time in taking the survey. A Medicare specialist will just review your
information and will get back to you within a couple of days regarding what you are currently paying, what
you should be paying and will discuss your options further from there. Thank you very much and have a great
day!"

b. NO Medicare Supplement (Other coverage except for Medicare Supplement)

"Ok great! I really appreciate your time in taking the survey. A Medicare specialist will just review your
information and will get back to you within a couple of days. Remember it is free and you are not under any
obligation. Thank you very much and have a great day!"

c. Both customer are INVALID and no one in the household is on Medicare

"Alright, that’s all the information I need. Thank you for your help and have a great day!"

Honestly, I watched the Medicare Videos once and take down notes. I clicked the
Exams, just wanna check the questions and items. When I read the first question, it
was hard to understand, I think its because I am still confused about how does it
work and not fully understand the Medicare Basics, and my notes, unfortunately,
my daughter accidentally closed my notes, I don’t know what happens, and when I
go back and check again the training materials it’s already locked. So yeah, I am so
doomed!

POSSIBLE ANSWERS OF THE CUSTOMER

1. So I am assuming that you have a Medicare 4. If I may just ask, from what company do you have
Supplement Program. Is that correct? your supplement with?

 Yes  (Medsupp company)

 No  (Medicare Advantage plan company)
 I have Medicare.  (not sure)
 I'm not sure.  (refused)
 I have Medicare advantage Plan.  (Federal plan)
 I have it with (Medsupp company)  I got it with BCBS from the state of NC
 I have it with (Med adv company)  I got it from my teacher's retirement
 I have Medicare and Medicaid  (none of those)
 I have HMO  (one of those)
 I have (Plan G)  abbreviation of company name (ex: bcbs,CSI)
 I have VA  incomplete company name (united, bankers,
omaha)
2. Is this a retirement plan or did you take this plan out  provided 2 company name
on your own?  provided the company that they worked from (ex:
General Motors)
 Took it out  provided Prescription Drug plan company
 Both (silverscript, express script)
 Retirement Plan/Disability Plan  I got it with AARP through United Healthcare
 I got it from my job  VA/ChampVA
 I got it when I retired
5. What does your plan currently cost you on a monthly
 I got it from (company)
basis?
 I got it from VA
 I'm not sure/i don't know what you're talking  exact amount (over $100)
about
 exact amount (over $100)
 they take it out on my account
 not sure (less $100)
 i got an agent
 not sure (over $100)

3.*Do you receive any type of government assistance  not sure/refused

such as Medicaid?  comes from my check (ret/disability)
 taken out from social security
 No  $0
 Yes  over $300 for both
 what do you mean by that  over $300 for each
 I have SocialSecurity  paying less than $50
 I have Medicare/I only have Medicare  payment being reimbursed
 I have VA
 I'm not sure.
 I have the red white and blue card
 Medicare? Medicaid? What’s the difference?
"(“Just to verify, is this Medicare Supplement or a
Medicare Advantage plan? I mean a PPO or HMO
plan?”)"
  MedSupp/MedAdv/Notsure  I’m on my 70s, 80s
 HMO/PPO  I’m on my 60s
 Plan G  I was born______
 Provide different YOB
"Do you pay small copayments whenever you go to
your doctor or specialist?)"
7)*Do you smoke or use tobacco products?

 Yes
 Sometimes
 No
 Yes, no
 sometimes
 Occasionally
 I don't go to the doctor
 I already quit
 i'm not sure
 refused  I’m trying to quit

 $20 co pays
8)*Are you married?

“Is your prescription drugs covered by your (Humana)

or you have a separate plan for it?”  Yes
 No
 Yes, it's covered  Widowed
 Separate  Divorced
 Yes/No  Single
 I have no prescription  Separate
 Not sure  I have a BF, GF
 I have it with the same company but different  Refuse
plan
 VA covers it Is your husband/wife covered as well, under the same
 I pay co pay for my prescription type of plan?

 I pay for it on my own

 Yes
 I’m not paying for my prescription
 No
 It covers all of it / it covers everything
 He has his own

6)*What is your current age?_____________. Were you  He got it from his job
born in_______or_______? (Birth year)  He’s with the VA
 He’s a 100% disabled vet
 provide exact age
 He has teacher’s retirement
 Refused to provide age
 He’s not on Medicareyet
 Over 65