" Hello, this is Alex calling on behalf of the Health Insurance
Marketplace. How are you doing today?"
(If the customer responds positively)
"That’s great to hear. I’ll keep this brief to respect your time."
2. Purpose of the Call:
"The reason for my call is to inform you that you may qualify for
additional benefits under the Marketplace, including potential
subsidies that could reduce your healthcare costs. May I ask, how
old are you?" (Eligibility requires age 18-64)
"Additionally, could you confirm whether or not you currently have
Medicare or Medicaid?" (Eligibility requires a ‘No’ answer for those
under 65)
3. Rebuttals to Common Responses:
If the customer says they already have a plan:
"I completely understand that you already have a plan through the
Marketplace. However, there may be additional benefits, such as
assistance with food, transportation, and medication costs, that you
could qualify for. I have a licensed agent available who can review
your options in detail and help you maximize your benefits. May I
confirm your age and zip code to proceed?"
If the customer asks, ‘What benefits are these?’ or says, ‘I’m not
interested’:
"The benefits I’m referring to include state-subsidized health plans,
which could reduce your premiums to as low as $0 in certain cases.
I’d be happy to check if you qualify by confirming just a few details
like your age and zip code."
If the customer asks for specific names of the benefits:
"The Marketplace offers a variety of supplemental benefits,
including assistance with food, transportation, and medication. Our
licensed agents are well-equipped to explain each benefit available
to you and guide you through the process. To get started, could you
confirm your age?"
4. Key Questions to Confirm Eligibility:
"Could I please confirm your first and last name?"
"May I have your zip code for verification?"
"Just to confirm, you do not currently have Medicare or Medicaid,
correct?"
"And do you currently have insurance through an employer?"
5. Additional Verification Steps:
If the customer confirms they have insurance through the
Marketplace:
"Thank you. Did you enroll in the Marketplace within the last 30
days, or has it been longer than that?"
Transition to Licensed Agent:
"I have a licensed specialist who will review your information and
discuss the benefits you may qualify for.
Please hold the line for a moment."