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Medicare educational events are to teach people about Medicare, not to sell them a plan. Here's what you need to know:

Goal: Teach people about Medicare (Original Medicare, Advantage Plans, Part D) and how to sign up. No selling specific plans.

Talk about:

  • What Medicare is and what it covers.
  • Who can get Medicare.
  • When you can sign up.
  • Where to find more information.to record face-to-face meetings for marketing and sales.

Rules:

  • Teach, Don’t Sell: Don’t give out marketing materials or sign people up at the event.
  • Generic Information Only: You can give general Medicare brochures, business cards, and contact information for later appointments.
  • Answer Questions: Answer questions about Medicare options but don’t push any specific plans.
  • Public Place: Events must be in public places, not in homes or one-on-one.
  • Advertise As Learning: Tell people it’s an educational event.

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Medicare sales events are meetings to help people learn about Medicare Advantage plans and enrolling them. There are two main types:

  • Formal Sales Events: These have presentations by agents or representatives from specific insurance companies. They explain the plans, including benefits, costs (premium and out-of-pocket expenses), and eligibility requirements.
  • Informal Sales Events: Representatives are at booths or tables to answer questions and give information about different Medicare Advantage plans. They can’t talk about specific plans unless someone asks.

Both types of events are meant to:

  • Teach People: They help people learn about Medicare Advantage plans and how they are different from Original Medicare.
  • Compare Plans: People can look at different plans to see which one is best for them.
  • Enroll in a Plan: People can sign up for a plan right at the event with help from agents.

Rules:

  • Teach People: They help people learn about Medicare Advantage plans and how they are different from Original Medicare.
  • Plan-Specific Materials: You can give out marketing materials for the plans you represent.
  • Enrollment on the Spot: You can take applications for Medicare plans during the event.
  • Limited Refreshments: You can offer light refreshments, but not full meals.
  • Marketing the Event: Tell people it’s a sales event. You need to get approval from the insurance companies you want to represent.
  • Contact Info: You can collect applications and contact information for enrollment purposes.

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What is TriCare for Life (TFL)?

TriCare is a healthcare program of the US Department of Defense for active and retired uniformed service members and their families.

Learn more about TriCare.

How does it work with Original Medicare?

If you’re eligible for TriCare and have Medicare Part A and Part B, TriCare for Life provides wraparound coverage which pays your out-of-pocket costs in Original Medicare for TriCare covered services. Medicare and TriCare coordinate benefits which eliminates the need for you to file claims.

How does it work with a Medicare Advantage plan?

If you enroll in a Medicare Advantage plan, you’ll have to pay copayments at the time of service. TriCare for Life can reimburse you for copayments you paid for TriCare covered services, when you file a paper claim.

Beware: Many Advantage plans provide automatic drug coverage, also known as Part D. TFL members probably won't want another drug plan. Because Tricare always pays last, you may find yourself filing manual claims to Express Scripts to exercise your Tricare drug coverage. Plus, you will lose Tricare home delivery by having another drug plan.

Finding a Provider

You may get health care services from Medicare participating and Medicare non-participating providers, as well as from providers who have opted out of Medicare. If TriCare for Life (TFL) is the primary payer, you must visit TriCare authorized providers and facilities. You’ll have significant out-of-pocket expenses when you get care from opt-out providers, or when seeing a U.S. Department of Veterans Affairs (VA) provider for health care not related to a service-connected injury or illness. Costs vary according to the type of provider you see (for example, opt-out or VA).

Source: https://www.military.com/benefits/tricare/what-tricare-life-enrollees-should-know-about-medicare-advantage-plans.html

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