Confirm access and client context
Open the intended client in CRM, then the Medicare section. The product line and your access must be enabled by your organization. If the section is absent, ask an authorized administrator to review access.
Confirm the client and plan year before working. Keep health, prescription, and identification information in the private client record.
Review the Medicare Profile
Review the client's location, county, coverage dates, and applicable profile fields. Plan browsing requires the client's county. Correct incomplete location information before comparing plans.
Save edits and reopen the profile to confirm them. Do not reveal or copy a protected identifier unless it is needed for an authorized task.
Maintain doctors, pharmacies, and prescriptions
Open Doctors, Pharmacies & Prescriptions. Review the names and details with the client, update the relevant entries, and save. Check any preferred pharmacy selection.
Medication information is shared with the client's health information. Check the existing list before adding another entry for the same medication.
Browse Available Plans
- Confirm the plan year and client county.
- Open Available Plans.
- Use the available plan-type filters.
- Open a plan and review its coverage and displayed limitations.
- Select at least two plans and choose Compare to inspect them together.
An unavailable value or dash is not a confirmed zero. Plan data, estimates, and eligibility require review before a recommendation.
Check prescription results
Inspect each prescription's result and restrictions, including any prior authorization, step therapy, or quantity limit shown. Unknown means the medication could not be matched; it does not mean covered. Not on formulary is a separate result.
If plan data is missing or the medication is uncertain, resolve that uncertainty before relying on the comparison. An estimate is not a guaranteed out-of-pocket charge.
Save an option and verify it
Use Save to option for a plan you want retained with the client's choices. Reopen the numbered option and confirm the selected plan and year.
Saving or comparing an option does not submit enrollment. Complete enrollment through the appropriate authorized process and record its actual result separately.
For annual review and appointment documentation, see Use AEP Radar and Scope of Appointment.