Getting AEP-ready: your complete Medicare sales prep guide

We don’t have to tell you that the Annual Enrollment Periods (AEP) is the most important time of year for a health insurance agent. Running from October 15 to December 7, this seven-week window represents your biggest opportunity to help clients and grow your business. But you can’t just show up day one and start selling—it requires thorough preparation well before the first day arrives.

If you're already licensed and ready to dive into Medicare sales, here's your essential steps to fully prepare yourself for October 15.

Step 1: Get certified – It's not optional, it's essential

Before you can sell any Medicare products, you must complete annual certification training. Watch for the most current version to hit the web in early summer. This isn't just a regulatory requirement, it's your foundation for understanding the complex Medicare landscape and serving your clients effectively.

Your certification options

AHIP (America's Health Insurance Plans) is often a go-to for Medicare certification. Their comprehensive training covers Medicare Advantage, Part D prescription drugs, and supplements, ensuring you understand the intricate details of each product type, which is great for a first-timer.

NABIP (National Association of Benefits and Insurance Professionals) offers another pathway to certification, providing training designed for seasoned agents. This online course covers basic Medicare, Medicare Advantage, and fraud, waste, and abuse training. It also includes some continuing education (CE) credits and a logo to put in your email signature to broadcast your accomplishment.

Pinpoint Global has emerged as a popular alternative, offering streamlined certification processes that many agents find efficient and user-friendly.

Whichever you choose, cross-check the list of your partnered carriers with the list of carriers accepting that certification platform to save yourself time and money. Don’t wind up having to complete two separate trainings!

Action's got you covered with a reimbursement program

Here's some great news: Action's Medicare reimbursement program makes certification affordable. We provide up to $125 reimbursement for agents who certify through AHIP, and agents who choose Pinpoint Global or NABIP are eligible for 100% reimbursement.

Important deadline reminder: Each carrier will have their own deadline for certification. Don't wait until the last minute—start your certification process early to avoid any potential issues that could sideline you during AEP.

Step 2: Secure your carrier appointments

Certification is just the beginning. To legally sell Medicare products, you must be appointed with each carrier whose products you plan to offer. This appointment process involves:

• Completing carrier-specific training modules
• Passing product knowledge assessments
• Submitting required documentation and agreements
• Waiting for approval (which can take several weeks)

The consequences of selling without appointments

This cannot be overstated: never sell a product without being properly appointed with that carrier. The consequences are severe and can include:

• Immediate contract termination with the carrier
• Chargebacks on earned commissions
• Regulatory violations that could jeopardize your license
• Legal liability for operating outside your authority

Insurance carriers and regulatory bodies take unauthorized sales extremely seriously. What might seem like a shortcut to capture a quick sale can end your Medicare career permanently. If you find yourself eager to sell a carrier you are not appointed with, contact us and we can help.

Required documentation for appointments

The appointment process involves significant paperwork, and being prepared with all required documents will expedite your approval and make the process easier. Common requirements include:

Essential forms:

• Agent Agreement - Your primary contract with the carrier
• Commission Payment Forms - Specifies how you want to receive payments
• W-9 - Tax form required for commission payments
• Direct Deposit Form - Formal authorization for direct deposits

Professional documentation:

• Copies of your Errors and Omissions (E&O) insurance certificate - Proof of professional liability coverage
• Michigan Resident Producer's License - Your state insurance license
• NPN (National Producer Number) - Your unique agent identifier
• SSN or EIN (Social Security Number) (Employer Identification Number) - Required for tax and payment processing

Action Agent Portal resource: For Action carriers specifically, you can find detailed appointment processes and requirements in Ensurability within your agent portal. This resource will walk you through each carrier's specific requirements and help streamline your appointment process.

Plan your appointments like chess

Don't try to get appointed with every carrier in existence. You will never get through them all! Instead:

• Research which plans and carriers are most popular in your market
• Understand the gaps of those carrier plans and pick another that covers those gaps
• Choose a carrier with some supplemental options
• Focus on 3-5 carriers initially

Step 3: Understand performance expectations

Getting appointed is just the beginning of your relationship with carriers. Many insurance companies have minimum performance standards, and failing to meet them can result in appointment termination. Some carriers might also require you to use their information portals, so be prepared to pay a subscription fee for those services if need be.

Common reasons for appointment termination

Low sales activity: Carriers invest time and resources in training and supporting their agents. If you're book of business is a party of none, they may terminate your appointment to focus on more productive agents.

Zero new enrollments: Some carriers have minimum new enrollment requirements, whether monthly, quarterly, or annually. Consistently missing these targets puts your appointment at risk.

Quality issues: High complaint ratios, frequent policy cancellations, or compliance problems can trigger appointment reviews and potential termination.

Failure to follow CMS guidelines: If you want to play the game, you have to follow the rules. Nobody wants to play with someone who can't follow the rules, including carriers. 

Protecting your appointments

To maintain strong carrier relationships:

• Set realistic but ambitious sales goals
• Track and monitor your book of business regularly
• Communicate proactively with your carrier reps and field marketing organization (FMO)
• Focus on quality enrollments, not just quantity
• Stay current on product changes and updates

Your AEP success strategy

Preparing for AEP is like training for a marathon—the work you do beforehand determines your performance when it counts. By ensuring you're properly certified, appointed, and aware of performance expectations, you're setting yourself up for a successful AEP.

Remember, it isn't just about making sales—it's about helping Medicare beneficiaries find the right coverage for their needs. When you're properly prepared, you can focus on what matters most: doing what’s fair for the client.