Thank you for calling me back, Mr./Mrs./Ms. . This is Philip Roesel with Eon Health. Are you ready to continue onto the enrollment process?
Mr./Mrs./Ms. , which plan did you want to enroll in?” “Great! I’ll be happy to assist you with this enrollment.
We will now begin the enrollment. This enrollment is for the Eon Health . This plan
has a premium of $
, I have a brief statement required by Medicare. You are not
required to provide any health related information, unless it is used to determine enrollment eligibility. Our conversation during this call will be recorded, and this call will complete anenrollment request. Do you understand and agree?
Am I speaking to the individual who wants to enroll?
Thank you. Now we can proceed with the enrollment.
May I have your last name, first name, please?” “Do you have a middle initial?
May I have your date of birth?
May I have your home telephone number?
Eon Health may, from time to time, want to send recorded and electronic healthcare messages to you. Do you consent to receive recorded or electronic messages from Eon Health?
you may withdraw your permission at any time by calling the Member Service number located on the back of your ID card.
May I have your permanent residence address?
Is your mailing address different from your home address?
In order to complete this application, we need to verify the information listed on your Medicare card. Please get your red, white and blue Medicare card as we will need this information complete your enrollment
May I have your full name exactly as it appears on your Medicare card?
May I have your Medicare Claim number, please?”
“Please state your gender for the recording, please.
What is the hospital (Part A) effective date?”
“What is the medical (Part B) effective date?
Complete only if applying for one of the Dual Eligible Special Needs Plans.
Are you currently enrolled in your state Medicaid program? Please provide me your Medicaid number
ONLY IF Beneficiary does not have Medicaid number do you ask for SS#
“May I please have your Social Security number?
IF HMO – Please verify that your chosen Primary Care Physician is . The phone
number is .”
1. “Some individuals may have other coverage including other private insurance, TRICARE,
Federal employee health benefits coverage, VA benefits, or State pharmaceutical assistance
“Will you, on your own or through your spouse, have any health insurance or prescription drug
coverage other than Medicare?”
2. “Do you have End Stage Renal Disease (ESRD)?”
3. “Have you ever received a Medicare covered transplant?”
4. Are you a resident in a long-term care facility, such as a nursing home?
5. “Would you prefer us to send your information in a language other than English?
(Great, now I need to play a recording for you, it’s about a minute and 15 seconds long. The first part of the recording talks about a premium you would pay if you made more than $85k (if single), or more than $170k (if Married). The 2nd part of the recording talks about how to apply for extra help, which you already have. So even though this really doesn’t apply to you, I have to play the recording, so I’ll be back in just over a minute.)
FOR PPO, PLAY “EONPPOLIS” 1min 16 seconds
Eon Select (HMO) and Eon Silver (HMO SNP): If we determine that you owe a late enrollment penalty (or if you currently have a late enrollment penalty), we need to know how you would prefer to pay it. You can pay by mail with a check or money order. You can also choose to pay your premium by automatic deduction from your Social Security or Railroad Retirement Board (RRB) benefit check each month, or you can pay by check each month. If you don’t select a payment option, you will get a bill each month for any premiums owed. If you are assessed a Part D-Income related Monthly Adjustment Amount, you will be notified by the Social Security Administration. You will be responsible for paying this extra amount in addition to your plan premium. You will either have the amount withheld from your Social Security benefit check or be billed directly by Medicare or the RRB. DO NOT pay Eon Health the Part D-IRMAA.
Eon Choice (PPO), and Eon Gold (PPO SNP): You can pay your monthly plan premium (including any late enrollment penalty that you currently have or may owe)] by mail with a check or money order. You can also choose to pay your premium by automatic deduction from your Social Security or Railroad Retirement Board (RRB) benefit check each month. If you are assessed a Part D-Income Related Monthly Adjustment Amount, you will be notified by the Social Security Administration. You will be responsible for paying this extra amount in addition to your plan premium. You will either have the amount withheld from your Social Security benefit check or be billed directly by Medicare or RRB. DO NOT pay Eon Health the Part D-IRMAA.
Read the following statement to all
People with limited incomes may qualify for extra help to pay for their prescription drug costs. If eligible, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this extra help, contact your local Social Security office, or call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. You can also apply for extra help online at www.socialsecurity.gov/prescriptionhelp.
If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare will pay all or part of your plan premium. If Medicare pays only a portion of this premium, we will bill you for the amount that Medicare doesn’t cover.
If you don’t select a payment option, you will get a bill each month
“Please select a premium payment option:”
(And again, this plan doesn’t have a premium, so we’ll just choose to get a bill, but they won’t waste a stamp mailing you a bill since there is no premium)
I get monthly benefits from:
Agent must read the disclaimer below if automatic
The Social Security/RRB deduction may take two or more months to begin after Social Security or RRB approves the deduction. In most cases, if Social Security or RRB accepts your request for automatic deduction, the first deduction from your Social Security or RRB benefit check will include all premiums due from your enrollment effective date up to the point withholding begins. If Social Security or RRB does not approve your request for automatic deduction, we will send you a paper bill for your monthly premiums
(I know you said earlier that you don’t have any insurance from where you retired from, but now I have to play a 30 second recording about that)
PLAY “EON UNION” 31 seconds
Read to ALL:
If you currently have health coverage from an employer or union, joining an Eon Health MAPD plan could affect your employer or union health benefits. If you have health coverage from an employer or union, joining an Eon Health MAPD plan may change how your current coverage works. Read the communications your employer or union sends you. If you have questions, visit their website, or contact the office listed in their communications. If there is no information on whom to contact, your benefits administrator or the office that answers questions about your coverage can help. Do you have any questions about the information that I just read to you ?
Typically, you may enroll in a Medicare Advantage plan only during the annual enrollment period from October 15 through December 7 of each year. There are exceptions that may allow you to enroll in a Medicare Advantage plan outside of this period.”
“By choosing an election period, you certify to the best of your knowledge that you are eligible for an Enrollment Period. If we later determine that this information is incorrect, you may be disenrolled.”
Please read the following statements carefully and check the box if the statement applies to you.
By checking any of the following boxes you are certifying that, to the best of your knowledge,
you are eligible for an Enrollment Period. If we later determine that this information is incorrect, you may be disenrolled.
PICK CORRECT SEP FOR RECORDING
By completing this enrollment application, are agreeing to the following statements.”
Your signature on this application means you agree to the following:
(so now I will play a recording thats about 2 and a half minutes long, and will cover 5 statements, and we’ll almost be done)
TRANSFER TO “EON DISCLAIMER” 2min 35 seconds
1. Eon Health is a Medicare Advantage plan and has a contract with the Federal government. I will need to keep my Parts A and B. I can be in only one Medicare Advantage plan at a time and I understand that my enrollment in this plan will automatically end my enrollment in another Medicare health plan or prescription drug plan. It is my responsibility to inform you of any prescription drug coverage that I have or may get in the future. I understand that if I do not have Medicare prescription drug coverage, or creditable prescription drug coverage (as good as Medicare’s), I may have to pay a late enrollment penalty if I enroll in Medicare prescription drug coverage in the future. Enrollment in this plan is generally for the entire year. Once I enroll, I may leave this plan or make changes only at certain times of the year when an enrollment period is available (Example: November 15 – December 31 of every year), or under certain special circumstances.
2. Eon Health serves a specific service area. If I move out of the area that Eon Health serves, I need to notify the plan so I can disenroll and find a new plan in my new area. Once I am a member of Eon Health, I have the right to appeal plan decisions about payment or services if I disagree. I will read the Evidence of Coverage document from Eon Health when I receive it to know which rules I must follow in order to receive coverage with this Medicare Advantage plan. I understand that Medicare beneficiaries are generally not covered under Medicare while out of the country except for limited coverage near the U.S. border.
3. Non-PPO plan only: I understand that beginning on the date coverage begins, I must get all of my health care from Eon Health in-network, with the exception of emergency or urgently needed services or out-of-area dialysis services.
PPO plan only: I understand that beginning on the date coverage begins, using services in-network can cost less than using services out-of-network, with the exception of emergency or urgently needed services or out-of-area dialysis services. If medically necessary, Eon Health provides reimbursement for all covered benefits, even if received out of network. Services authorized by and other services contained in my Evidence of Coverage document (also known as a member contract or subscriber agreement) will be covered. Without authorization, NEITHER MEDICARE NOR EON HEALTH WILL PAY FOR THE SERVICES.
4. I understand that if I am receiving assistance from a sales agent, broker, or other individual employed by or contracted with Eon Health he/she may be compensated based on my enrollment in the plan.
5. Release of Information: By joining this Medicare health plan, I acknowledge that the Medicare health plan will release my information to Medicare and other plans as is necessary for treatment, payment and health care operations. I also acknowledge that the plan will release my information [MA-PD plans insert: including my prescription drug event data] to Medicare, who may release it for research and other purposes which follow all applicable Federal statutes and regulations. The information on this enrollment form is correct to the best of my knowledge. I understand that if I intentionally provide false information on this form, I will be disenrolled from the plan.
“Do you understand and agree to these statements?”
“Your proposed effective date will be .”
Read for DSNP plans only.
“You must have both Medicare and Medicaid in order to be eligible for . If you lose your eligibility, you will be dis-enrolled after 90 days. Once you are a member, you will want to show both your Eon Health card and your Medicaid card when visiting a provider or the pharmacy.”
Read for all plans:
“Please do not use your Eon Health card for medical or prescription coverage until after your effective date. You will receive a Verification Letter and a Welcome Call or Welcome Letter.”
“You will receive a confirmation letter. You may use the confirmation letter as proof of your coverage until you receive your ID card.”
Read if beneficiary is currently on supplement or Medicare Advantage plan.
“Do not dis-enroll from your current plan until you receive your confirmation letter from Eon Health.”
Read to all callers:
o “If you have any questions, you may call Member Services at 1-888-906-3889; if from October 1 – February 14, seven days a week, from 8:00am – 8:00pm and if from February 15 – September 30, Monday through Friday, 8:00am – 8:00pm (you may leave a voicemail Saturday, Sunday and Federal Holidays). If applicable, TTY users should call 711.”
Submit application and provide Confirmation Code to enrollee. (just create a confirmation code. I use the first 3 of the SSN, and the last 4 of the medicare number in reverse, doesn’t matter what you use.
“I want to welcome you to Eon Health and thank you for allowing me to assist you with a plan today. Have a great day!”