Senior Insurance Acronyms

for New Medicare Brokers

Compiled by RBI’s Senior Sales Coordinator: James Gramp

Are you a newly licensed Health producer?  Can’t wrap your head around the seemingly endless list of Senior Insurance Acronyms? Look no further!  This post is just for you, a new agent who’s looking to get started in the Senior Health Insurance (Medicare) market.

Consider your options: Best Contracting Partners

A few things before we jump in that you should be thinking about when choosing to work with an agency or contract directly with the insurance company:

1. Do new agents receive training opportunities?
2. Does marketing support come with the contract?
3. Are the most competitive products in my area available with this partner?
4. Does this partnership include CRM systems or other tools to keep track of your clients and potential clients?

The bottom line is, your FMO should work for you.  In the post I just linked to, Justin Bever, our Director of Marketing, highlights exactly how your FMO should work for you and ultimately help you reach and exceed your business goals!

Without further ado, I present you with the ultimate abbreviation cheat sheet!

Senior Insurance Acronyms for New Medicare Brokers:

MA – Medicare Advantage

MAPD – Medicare Advantage Prescription Drug plan

HI – Hospital Indemnity

FE – Final Expense

SOA – Scope of Appointment form: Permission slip to talk to beneficiaries who aren’t already your clients about specific benefits of MA plans.  The SOA should be signed by the beneficiary 48 hours prior to appointment.

HMO – Health Maintenance Organization: Type of Health plan, must use plan doctors for covered services.  Members are assigned a Primary Care Physicians and require referrals to see Specialists (dermatologists, cardiologists, etc.)

PPO – Preferred Provider Organization:  Type of Health plan where members can go out of network for care.  Going to in-network providers offers better co-pays/co-insurance

PFFS – Private Fee For Service: type of MA plan that may or may not cover prescriptions.  Only MA plan that you can buy a stand-alone PDP as long as the PFFS doesn’t already cover prescriptions.

SNP – Special Needs Plan: Medicare Health plans for people with special needs.  There are 3 different kinds of SNP’s; I-SNP, D-SNP, and C-SNP.

I-SNP – Institutional Special Needs Plan: plan for beneficiaries needing treatment from a LTC facility for more than 90 consecutive days.

D-SNP – Dual Special Needs Plan: Designed for people with Medicare and Medicaid

C-SNP – Chronic Special Needs Plan: Designed for people with chronic health conditions

Med-supp/Medigap – Medicare Supplement: offers plans A through N.  These plans are standardized and offer the same benefits regardless of carrier.

PDP – Prescription Drug Plan: Rx coverage, typically sold with Medicare Supplements.

LIS – Low Income Subsidy: Federal program to help with Rx costs.  Need to make under 150% of the Federal Poverty Level to qualify.

MSP – Medicare Savings Program: Federal program designed to help with premiums, co-pays, and co-insurance. Different levels of help are: QMB, SLMB, QI-1. Make under 135% of the FPL to qualify.

AHIP – America’s Health Insurance Plans: company that provides the core medicare certification required to sell Medicare Advantage plans.

AEP – Annual Enrollment Period: 10/7 through 12/7, period when Medicare beneficiaries can enroll in a MA/MAPD or a PDP.

SEP – Special Enrollment Period: period that you can enroll in an MA/PDP plan outside of AEP

IEP – Intial Enrollment Period: 3 months before, the month of, and 3 months after your 65^th birthday.  Can enroll in any Medicare Health Plan during this time.

OEP – Open Enrollment Period for Medicare Supplement: 6 months after a Medicare beneficiary is enrolled in Medicare Part B and is 65 or older.

If you’re looking for a partner to grow your new business, look no further! We love helping agents get started — whether you’re a brand new agent, or you’re getting back into the market after being away: welcome! Call us today to learn about opportunities to work together: 1-800-997-3107!