The Road to AEP
The complete Medicare agent guide for preparing before AEP, executing during AEP, and retaining members after AEP through service, follow-up, education, and relationship building.
AEP Is Won Before AEP Starts
The best Medicare agents do not wait until October. They prepare early, organize their book, study plan changes, complete certifications, schedule reviews, protect compliance, and build a repeatable service process.
Get Ready to Sell
Complete licensing, AHIP, carrier certifications, appointments, product training, and portal access before the rush.
Organize Your Book
Segment clients, prospects, referrals, event leads, T65 leads, LIS/Medicaid opportunities, and retention-risk members.
Build a Follow-Up System
AEP production depends on consistent outreach, clean documentation, appointment tracking, and post-enrollment service.
Phase 1: Before AEP Starts
This is the preparation phase. Use this time to become certified, trained, organized, visible, and ready to help members make confident decisions.
Complete Your Foundation
Before you market, call, or schedule AEP reviews, make sure your core requirements are complete.
- Confirm resident and non-resident licenses are active.
- Complete AHIP or approved Medicare certification.
- Complete each carrier’s product certification.
- Confirm Ready to Sell status for each carrier and state.
- Verify portal access, writing numbers, and enrollment tools.
- Save all certification confirmations in one folder.
Clean and Segment Your Database
Your database is your AEP engine. Every contact should have a status, priority, and next action.
- Separate current clients, prospects, T65 leads, provider referrals, event leads, and inactive contacts.
- Confirm phone, email, address, preferred language, current plan, doctors, prescriptions, and pharmacy.
- Flag clients with complaints about dental, OTC, transportation, prescriptions, prior authorizations, providers, or customer service.
- Create priority groups: urgent review, standard review, retention risk, referral opportunity, and no-change check-in.
Build Your Marketing and Appointment Calendar
AEP is too short to improvise. Create your calendar before clients start receiving plan-change notices.
- Block weekly time for client reviews, new leads, follow-ups, and pending case work.
- Schedule provider office days, senior center visits, educational meetings, and community events.
- Prepare approved flyers, call scripts, emails, postcards, social posts, and reminder messages.
- Request marketing materials through Advantage Plus before the season gets busy.
Prepare for ANOC and Plan-Change Conversations
Clients may receive Annual Notice of Change information before AEP. This is one of your best reasons to contact them.
- Review plan changes in your top counties and ZIP codes.
- Study premiums, MOOP, copays, formularies, pharmacy changes, dental, vision, hearing, OTC, transportation, and extra benefits.
- Watch for provider network changes and plan terminations.
- Prepare a simple review message: “Your plan may be changing for January. Let’s review your doctors, prescriptions, and benefits before AEP gets busy.”
Final AEP Readiness Sprint
This is the final setup window before AEP applications begin.
- Confirm carrier portals, quote tools, enrollment links, and CRM access.
- Pre-book appointments for October 15 and after.
- Prepare Scope of Appointment process where required.
- Create your AEP tracking spreadsheet for leads, reviews, enrollments, pending cases, and follow-ups.
- Review compliance reminders and approved talking points.
Pre-AEP Master Checklist
This is the agent readiness checklist to complete before October 15.
- Complete AHIP.
- Complete carrier certifications.
- Confirm Ready to Sell status.
- Confirm license status.
- Confirm carrier appointments.
- Review top county plan changes.
- Review provider networks.
- Review drug formulary changes.
- Review pharmacy pricing differences.
- Review plan terminations.
- Review premium and MOOP changes.
- Review dental, vision, and hearing changes.
- Clean your CRM.
- Segment your book of business.
- Prepare appointment calendar.
- Prepare client review scripts.
- Prepare approved marketing materials.
- Prepare SOA process.
- Prepare follow-up templates.
- Prepare daily call goals.
- Prepare referral process.
- Attend Advantage Plus trainings.
- Confirm Agent Portal access.
- Know where to submit support requests.
Phase 2: During AEP
AEP runs October 15 through December 7. This is the execution phase: speed matters, but accuracy and compliance matter more.
The Perfect AEP Appointment Flow
- Confirm permission to speak and required disclosures.
- Confirm the client’s current coverage.
- Ask what changed this year.
- Verify doctors, specialists, hospitals, and clinics.
- Verify prescriptions, dosage, frequency, pharmacy, tiers, and restrictions.
- Compare total estimated annual cost, not just premium.
- Review dental, vision, hearing, OTC, transportation, fitness, and extra benefits.
- Explain trade-offs clearly.
- Submit the application accurately.
- Document the conversation and next steps.
Daily AEP Production Rhythm
- Morning: Review pending cases, carrier updates, and today’s appointments.
- Midday: Complete client reviews and enrollment consultations.
- Afternoon: Work new leads, referrals, missed calls, and callbacks.
- Evening: Document notes, confirm submissions, and prepare tomorrow’s call list.
- Weekly: Audit pending applications, missing items, and follow-up commitments.
What to Review With Every Client
This table helps agents avoid rushed plan reviews and create a better member experience.
| Review Area | Questions to Ask | Why It Matters |
|---|---|---|
| Doctors | Are your primary doctor, specialists, hospitals, and clinics still important to you? | Provider access is one of the biggest reasons clients become unhappy after January 1. |
| Prescriptions | What medications, dosage, frequency, and pharmacy do you use? | Drug tiers, formularies, deductibles, prior authorization, and pharmacy pricing can change yearly. |
| Budget | Are premiums, copays, dental costs, or drug costs becoming difficult? | Total annual cost matters more than monthly premium alone. |
| Benefits Used | Which benefits did you actually use last year? | Some clients value dental, OTC, vision, hearing, transportation, fitness, or flex benefits differently. |
| Health Changes | Any new diagnosis, surgery, specialist, treatment, therapy, or hospital stay? | Health changes may make last year’s plan less suitable. |
| Pharmacy | Do you use retail, preferred retail, mail order, or specialty pharmacy? | Pharmacy choice can change the client’s real prescription cost. |
| Travel | Do you travel, live part-time elsewhere, or need out-of-area flexibility? | Network type and travel rules can affect access to care. |
| Extra Help / Medicaid | Do you receive Medicaid, LIS, Extra Help, SSI, SNAP, or other assistance? | Eligibility may affect plan options, SEP opportunities, and affordability. |
Simple Scripts Agents Can Use
Use these as starting points and always adjust for compliance, carrier rules, and the client’s situation.
Current Client Review
ANOC Follow-Up
Post-Enrollment Follow-Up
Phase 3: After AEP — Service and Retention
The sale is not complete when the application is submitted. Retention starts immediately after enrollment.
December Follow-Up
- Confirm application received.
- Track pending or rejected applications.
- Confirm January 1 effective date.
- Remind client to watch for ID card and welcome materials.
- Confirm first premium or billing details if applicable.
January Service
- Confirm ID card received.
- Confirm PCP selection.
- Help with pharmacy issues.
- Help with member portal setup.
- Explain OTC, dental, transportation, vision, hearing, and extra benefits.
Year-Round Retention
- Schedule quarterly check-ins.
- Send birthday and annual review reminders.
- Educate clients on unused benefits.
- Ask for referrals after good service moments.
- Document all issues and resolutions.
Retention Calendar After AEP
Use this schedule to keep members engaged after January 1.
| Timeframe | Agent Action | Goal |
|---|---|---|
| December | Confirm application status, effective date, and next steps. | Prevent surprises before January 1. |
| January | Confirm ID card, PCP, pharmacy, and benefit access. | Help the member use the plan correctly. |
| February | Check for provider, prescription, billing, or access issues. | Fix early problems before frustration builds. |
| March | Review unresolved concerns before MA OEP ends. | Protect the client and reduce complaints. |
| Quarterly | Send benefit reminders, newsletters, and service check-ins. | Stay visible and strengthen trust. |
| Before Next AEP | Prepare annual review list and update client information. | Make next AEP easier and more productive. |
Advantage Plus Resources
Use these internal resources to prepare, submit requests, solve issues, and grow your business.
Agent Portal Login
Access your platform, quoting, enrollment, resources, and support tools.
AHIP 2027 Resources
Certification information, study resources, office hours, and AHIP support.
Carrier Directory
Find carrier information, contracting resources, and plan details.
Compliance Center
Review compliance expectations, reporting resources, and agent guidance.
Commission Support
Submit commission questions, missing commission requests, and payment issues.
Marketing Materials
Request approved flyers, campaign materials, and agent marketing support.
General Support Request
Submit questions or requests to the Advantage Plus Agent Support team.
Agent Store
Order branded items, supplies, apparel, and agent materials.
AEP Success Rules
Use these rules to protect the client, protect the agent, and create a better member experience.
Do This
- Stay compliant every time.
- Document every client interaction.
- Verify doctors using approved sources.
- Verify drugs, dosage, pharmacy, and estimated costs.
- Explain benefits clearly and honestly.
- Set expectations about ID cards and effective dates.
- Follow up after enrollment.
Avoid This
- Do not assume last year’s plan is still best.
- Do not rush provider or drug verification.
- Do not use unapproved marketing material.
- Do not overpromise benefits.
- Do not ignore service issues after the sale.
- Do not leave clients confused about next steps.
- Do not wait until December 7 to fix pending issues.
Ready for the Road to AEP?
Advantage Plus is here to help agents prepare, execute, service, and retain. Use the resources, attend trainings, stay organized, and treat every client review like a long-term relationship.