Recording disclosure first, then a warm identification that frames the call as a return — not a cold reach.
State that you are on a recorded line. Do not skip this step.
This applies to every outbound call without exception. Recording disclosure is a regulatory requirement.
Hello, is [Client Name] available?
Hi [Client Name], my name is [Your Full Name] and I am a local Medicare Advisor with [Your Agency], on a recorded line. I am calling because you recently submitted a request for information about Medicare plans. I just wanted to reach out personally to help you right here in [City / State / your area].
Read naturally, not robotically. They submitted the lead, so you are returning a request — not cold-calling. Sound like it.
Ask the trigger question, branch into the matching track, then confirm current coverage before bridging into compliance.
Quick question before we dive in — when you were looking at Medicare plans online, was there something specific that caught your eye? For example, were you looking at a grocery benefit, dental coverage, money back on your Part B premium, or something else?
These leads clicked a specific benefit ad before submitting. Their answer tells you exactly where to take the conversation. Do not skip or assume.
Based on their answer, pick a tab
Great — that grocery allowance is one of my favorites to talk about. That benefit is available on certain plans for people who have both Medicare and Medicaid. Quick question — are you currently on Medicaid or receiving any state assistance with your health coverage?
Dual eligible. High likelihood of qualifying. Proceed with full plan review focused on grocery and OTC allowance.
The grocery benefit may not be available, but there are still strong plans we can look at. Pivot to dental, vision, or copay reduction.
Good — that is one of my favorite benefits because it actually puts real money back in your Social Security check every month. To see if that is available to you, are you currently paying the standard Part B premium — around $185 a month?
Strong candidate. Plans with Part B giveback are available in most Kentucky counties. Proceed.
Part B may already be covered. Redirect to other strong benefits.
Great — dental is one of the most underused benefits in Medicare Advantage. A lot of people do not realize it is even available. Do you currently have any dental coverage at all, or are you paying out of pocket when you go to the dentist?
Strong motivator. Lead with dental in your plan presentation.
Ask what it covers and whether they are happy with it. Position a plan upgrade.
Good — that spending allowance can add up fast. It is basically a quarterly allowance you can use on things like vitamins, pain relievers, blood pressure monitors, even some personal care items. Are you currently on a Medicare Advantage plan or do you have Original Medicare?
Compare current OTC benefit to what is available. Upgrade opportunity.
Strong case to move to MA. OTC benefit is exclusive to MA plans.
No problem at all — a lot of people just want to make sure they are not missing out on something. Let me ask you this: what does your current coverage look like? Are you on a Medicare Advantage plan or do you have Original Medicare?
What is your current coverage — are you on a Medicare Advantage plan right now, or do you have Original Medicare?
Once you know their benefit trigger, confirm their current coverage. This sets you up for the value statement and keeps the conversation connected to what they actually want.
Great, so you have [repeat coverage back to them]. That is one of the plans we represent. Let me pull up your information and we will see what is available to you.
No worries, I can still help you with that. Would you mind grabbing your insurance card for me?
Bridge into compliance, set the value statement for the current period, then read the two verbatim disclosures.
As I mentioned, I am licensed and appointed with the top Medicare carriers in your area. What that means for you is that I will do a deep dive into your coverage options today to make sure we are maximizing every benefit you are entitled to. One important thing to know about these plans is that they change every year. Copays, out-of-pocket costs, and additional benefits can all shift. That is why it is important to shop and compare your coverage each year. Before we get into the specifics, I need to read you two quick disclosures. It takes less than a minute and then we can focus on finding you the best plan.
"Two quick disclosures, less than a minute" pre-frames the verbatim. Without it, the disclosures land cold.
Pick the value statement for the current enrollment period
Right now we are in the Medicare Advantage Open Enrollment Period, which means we have an opportunity to look into your current plan and see if there are any benefits such as dental, vision, lower copays, or lower drug costs that you may be missing out on.
[Client Name], first I want to compliment you on getting ahead of the AEP rush. My goal today is to help you shop and compare your current coverage to make sure you are maximizing the benefits you are entitled to going into the new year. We may be able to lower your copays and add dental, vision, hearing, grocery benefits, or a flex card.
[Client Name], my goal today is to review and compare your current coverage to make sure you are maximizing the benefits you are entitled to for the remainder of the year. We may be able to lower your copays and add dental, vision, hearing, grocery benefits, or a flex card.
[Client Name], do you have any additional coverage such as Tricare, VA, or employer coverage?
Tricare, VA, and employer coverage interact with MA plans in specific ways. Note their answer for the plan presentation step.
We do not offer every plan available in your area. Any information I provide is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Please be aware that you are not required to give any health-related information unless it is needed to determine your eligibility to enroll in a plan. There is no obligation to enroll. Your current or future Medicare enrollment status will not be impacted, and automatic enrollment will not occur. Any information provided during this call will not affect your ability to request enrollment in a plan.
Word for word. Any deviation is a regulatory violation. Practice this until it sounds natural — but do not paraphrase.
We offer Medicare Advantage plans, Medicare Supplement plans, and Prescription Drug plans. Do you want to continue discussing these plan options on [today's date]?
Any affirmative response counts as verbal SOA confirmation. Document the date immediately in the platform.
Are you looking into coverage for yourself or someone else?
If they are calling on behalf of a parent or spouse, you need a different SOA. Catch it here, not in the application.
Confirm SEP eligibility through three questions and a 5-star lookup, then state the SEP type and effective date out loud.
Outside of AEP, the client must have a qualifying Special Enrollment Period before you can enroll them in a new plan. Verify SEP before presenting anything.
No SEP, no enrollment outside AEP. Period. The platform will block you, but the time to know is now.
Now I am going to verify your information inside the Medicare system to see if you have a Special Enrollment Period that will allow us to make a change today.
"Verify in the Medicare system" reads as professional and neutral. They are being looked up in a real system; you are not gatekeeping.
Ask each of the following
Do you receive Extra Help or Medicaid?
Have you made any changes to your Medicare plan in the last 90 days?
Have you recently moved? If so, have you notified Medicare of your new address?
Look up whether there is a 5-star plan available in their area.
When you confirm a SEP, make it a moment. Say something like: "Great news — you do have a Special Enrollment Period available, which means we can look at making a change today if we find something that works better for you." You must also state the SEP type and proposed effective date before presenting any plan.
Confirming SEP is a small win for the client. Treat it like one. State type + effective date — this is part of compliance, not flair.
One benefit is not enough to close. Stack 3–4 buying reasons on top of the discovery trigger, then repeat them back.
When it comes to Medicare Advantage, many plans include dental, vision, hearing, over-the-counter, and transportation benefits. What separates the plans is the amount of each benefit and the copays. Which of these matters most to you?
Build 3–4 buying reasons before you present any plan. One benefit is not enough to close. You already know their primary trigger from discovery — stack on top.
If they list only one or two, build more with these prompts
- What about dental — do you see a dentist regularly?
- Do you wear glasses or need vision care?
- Do you require hearing aids?
- Would transportation to appointments be helpful?
- What about your over-the-counter benefits?
- What if we could lower your maximum out-of-pocket costs or your copays? (if not on Medicaid)
I will make sure to find a plan that gives you the most [repeat the benefits they chose].
Repeating their list back is the seal on this section. They hear "she heard me." That is what you are doing.
Capture all four medication fields before touching doctors. Order matters — formulary mismatches sink plans more often than networks do.
Always get medications before doctors. Do not skip this step even if the client says they take no medications.
Reversing the order is a common rookie mistake. Drug formulary mismatches sink plans far more often than network mismatches.
Before we look at plans, I want to make sure any medications you take will be covered. Are there any prescriptions we need to check on?
"Make sure they are covered" is the right framing — you are protecting them, not auditing them.
Go ahead and grab your medication list and I will add them now. I will need the medication name, the form it comes in, the strength, and how many you take per month.
Not a problem. Before we move on, I want you to know that not all plans cover prescriptions the same way. If you think of anything, let me know and we can check before we finalize anything.
Required fields for each medication
- Drug name
- Form (tablet / liquid)
- Strength
- Quantity per month
Incomplete medication entry is a service and compliance failure.
Missing a field today usually means a wrong-tier surprise at the pharmacy in 30 days. Get it right now.
Now let's make sure your doctors are covered. Do you have a primary care doctor or any specialists you want to make sure are in the network?
Offer to help find one near them. This is a service win — and removes the biggest reason an HMO sale falls apart at activation.
[Client Name], I am going to do my best to make sure your doctors are covered. As we discussed, we will focus on getting you all the benefits you are entitled to today.
"Do my best" is honest. If a doctor is not in network, you will surface that in the recap and find an alternative. Promise the effort, not the outcome.
Hold, return with one plan, walk through in order, recap with real numbers, then read the enrollment confirmation verbatim and stop talking.
Present no more than 2 plans. Presenting more creates confusion and hurts close rate. Lead with the plan that best matches what the client told you.
This is both a compliance guideline and a sales discipline. More options is not more service.
What I am going to do now is place you on a brief hold while I sort through the options to find a plan that covers your doctors, your medications, and gives you the additional benefits you are entitled to. It will just be a moment.
Use it to have your recommendation ready. Never come back uncertain — that damages trust faster than a longer hold.
Thank you for holding. Based on what you shared with me, I found a plan that is a strong fit. It is [Plan Name], [Plan Number], with a premium of [$]. Let me walk you through it.
"Strong fit" is the right register — assured, not pushy. Land on the premium and pause briefly before walking through.
Walk through in this order
- Summary of Benefitsfocused on the specific benefits the client asked about
- Medication cost breakdownconfirm each medication and what they will pay
- Doctor network confirmationconfirm each doctor they named
All right [Client Name], let me recap what we found for you today.
Use real dollar amounts. Specific numbers build trust. Vague recaps lose sales.
Cover each of the following in the recap
We verified that [doctor names] are in network for this plan.
We also found [specialty or name] who is in network, which is great.
We verified that your prescriptions are covered by this plan.
We found you a plan that includes [list benefits with dollar amounts].
[Client Name], since we found a plan that fits your needs, go ahead and grab your Medicare card and we can move to the final step.
This is the soft close. The Medicare card request signals enrollment. If they hesitate here, address it before reading the verbatim.
[Client Name], are you calling to enroll in [Carrier], [Plan Name], [Plan Number] with a premium of [$] and an effective date of [date] over the phone today?
Silence is your friend. Let the client respond. Filling the pause is the most common close-killer on this script.
Do not end the call with a half-finished application. Confirmation, expectations, and the platform update all happen before goodbye.
Complete the enrollment application before ending the call. Do not end the call with enrollment incomplete unless the client requests it.
Half-finished apps are the largest source of dropped enrollments. Stay on the phone until it is submitted.
I want to congratulate you [Client Name] and thank you for taking the time to review your coverage today. You made a great decision. In the next 14 to 20 business days you will receive your policy documents and new insurance card in the mail. Please remember to notify your doctors and pharmacy of the plan change before your effective date.
The 14–20 day window prevents anxious "where is my card" calls. Doctors + pharmacy reminder prevents continuity-of-care issues.
Before ending the call, confirm all of the following
- Application submitted and confirmation number obtained
- Effective date stated clearly to the client
- Client instructed to notify doctors and pharmacy
- Client knows when to expect their new ID card in the mail
- Pipeline stage updated to Enrolled in the TIG platform immediately after the call
- Call note logged: carrier, plan name, plan number, effective date, and confirmation number