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Medicare Scope of Appointment Rules


The form is a Scope of Appointment is a paper you fill out before an agent comes to your home. This form lets the agent know beforehand which coverage options are open for discussion. Its purpose is to determine which plans to discuss, protecting you from scams and high-pressure salespeople. If you don’t select one of the coverage options, the agent won’t discuss it with you unless you fill out a new Scope of Appointment. The SOA protects you and the agent. When an agent uses this form and sells you a policy, they can use this form to say that you understood the things that were up for discussion. Below learn more about the Scope of Appointment and how it can protect you!

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Medicare Scope of Appointment Form

The Scope of Appointment is a requirement for in-person appointments.  Agents must document their meetings with potential and current beneficiaries. The form goes on file for ten years and protects all parties. Sadly, many people have used a sales approach to profit from misunderstandings of the insurance world.

This form helps to protect people from falling victim to scams. Also, it allows the agent to prepare material for the meeting that can help you understand your best options.

Electronic Scope of Appointment

To help ease the SOA form process, the CSG Actuarial developed an Electronic Scope of the Appointment Process. The method includes an automated storage system and a backup plan that adheres to all standards for compliance. Insurance agents can obtain the information, search for their SOA forms, and save all documents. They can even perform quotes for you within this program.

The previous Scope of Appointment documents can also be uploaded into the electronic system to maximize proficiency. As a beneficiary, you must ensure to initial all checkbox selections. Simply checking the box is inadequate. An agent can only discuss options initialed by you and cannot pressure you into buying anything beyond what you’ve agreed to review.

Scope of Appointment Rules for In-Person Meetings

Legally, to discuss insurance plans, an agent must have the beneficiary complete a Scope of Appointment form. A Scope of Appointment form is necessary for all in-person meetings that you have with an insurance agent when shopping for policies. You’ll select each box that you choose to discuss with the agent, and they legally can’t talk about plans you haven’t chosen first.

Online SOA Form

To ensure you get all the information you want, we use a similar form to the Scope of Appointment form. Since agents are unable to utilize the Scope of Appointment form during telephone consultations, our team here at MedicareFAQ uses a unique document of our own.

Our goal here at MedicareFAQ is to make sure you get access and knowledge about the insurance plan that’s best suited for you. Our form indicates which insurance you want to discuss.

Medicare Advantage plans are an alternative to Medicare and usually include Part D. Part D plans cover the costs of prescription drug costs you’d otherwise pay. Medicare Supplement plans work hand in hand with Medicare to pick up the out-of-pocket costs that Medicare doesn’t cover. Vision, Dental, and Hearing plans are separate insurance policies that offer routine care.

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Hospital Indemnity plans are the insurance plans that cover your hospital visits and stays. Long-Term Care Insurance comes in handy if you need custodial care. We’ll need to record the best number to reach you at your full name and the best email address for you. All this information then goes to one of our agents; they reach out to you, assist you with all your questions, and provide you with a quote.

Plan rates vary depending on location, so this information is critical in providing you with the most accurate quote. Also, health history can affect cost and eligibility for different plans.

FAQs

When do you need a Scope of Appointment?
The Scope of Appointment form is necessary when the insurance agent is meeting in person with a new, current, or prospective beneficiary. The Scope of Appointment form works in conjunction with the sales of insurance plans and helps to keep you safe from pushy salespeople. You’ll need a scope of appointment for an HMO or a PPO policy.
How long must a Scope of Appointment form be kept?
A Scope of Appointment form must remain on hand for ten years. You can request a copy of this form and get a copy without any issues.
Is a Scope of Appointment required for a telephonic presentation?
To ease any stress that the SOA process may bring, you can choose a telephonic meeting. As a consumer, you can speak with your agent via telephone and consent to an oral agreement. Your phone recording will then serve as a Scope of Appointment.

How to Get Help with your Scope of Appointment

Our team of experts can prepare quotes for the best plan options for you. Complete our online rate form to get a free quote, and we'll begin working for you! Or, if you'd prefer, you can give our team a call directly at the number above. Our experts are here for you every step of the way!

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

10 thoughts on “Medicare Scope of Appointment Rules

  1. I had a walk-in at Walmart Kiosk. Not knowing what plan the beneficiary wanted, I only had access to a Humana SOA form to be signed before presentation. They signed the form, however, signed up with another carrier. I wasn’t able to connect to the other carrier for a AVR as it was the day before enrollment ended, and phone lines were busy. I therefore, enrolled them in the plan, but only had a SOA form from a different carrier. Have not submitted the SOA they signed, however, have learned that the beneficiary was disenrolled in the plan. They said the beneficiary disenrolled, however, the beneficiary says they never disenrolled. My concern is that they may have been disenrolled due to not having an SOA on file. I have been in contact with the carrier and explained the situation, they told me that I would have to submit “their” SOA. OK, I get that, however, within less than 4 days of enrollment the enrollment is disenrolled?? No, feedback, no follow-up, no notice of disenrollment. I only found out by inquiring and they couldn’t even tell me why exactly, only said the code says “they disenrolled”. Something wrong here or not right! I think it is ludicrous that a specific carrier SOA has to be submitted. I get that an SOA is required, however, it would make more sense to have a generic SOA form, that could perhaps be identified by NPN # and beneficiary’s last 4 digits of Medicare #, or something similar. As CMS requires an SOA before giving a presentation, and as a broker who offers multiple carrier plan(s), not knowing which plan the beneficiary may elect, which SOA should they sign? Why shouldn’t all SOAs regardless of carrier be accepted? Why should we imposition the beneficiary with yet another form to sign after they have already signed one? I hate the fact that I will have to ask them to sign another form that they already signed but because they choose a different carrier they have to sign another. This is redundant and inefficient.

  2. Can I use my own docusign account to obtain the scope of appointment form using a CMS approved SOA form?

  3. Hello, If a beneficiary signed a SOA and did not select a plan on the scheduled appointment date, and scheduled another appointment later, would they be required to sign a new SOA?

    1. Hi Susy – an SOA must be obtained prior to the appointment. A new SOA may be required to discuss new plans or options.

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