Scope of Appointment

Confirmation Form

TrustInsure Aberdeen, NC
(910) 994-6464

The Centers for Medicare & Medicaid Services (CMS) requires agents to document the scope of a marketing appointment before any sales meeting, so the beneficiary understands what will be discussed. All information on this form is confidential and should be completed by the person with Medicare or their authorized representative.

There is no obligation to enroll in a plan. Attending this meeting will not affect your current or future Medicare enrollment status, and enrollment will not happen automatically.

Products to discuss

Check the product types you want the agent to discuss. The agent may only cover the products you select. Agents must be licensed, contracted, and certified where applicable for each product.

Medicare Advantage (Part C) and Cost Plans All-in-one plans that bundle Part A and Part B, often with prescription drug coverage and extras. Stand-alone Prescription Drug Plans (Part D) Drug coverage that pairs with Original Medicare or a Medicare Supplement. Medicare Supplement (Medigap) Plans Policies that help pay the out-of-pocket costs Original Medicare leaves behind. Dental, Vision, and Hearing Products Standalone coverage for routine dental, vision, and hearing needs. Hospital Indemnity Products Plans that pay a fixed cash benefit for covered hospital stays.

Beneficiary

Beneficiary name

Phone (optional)

Date

Address (optional)

Beneficiary signature

If signed by an authorized representative, complete the line below.

Representative name

Relationship to beneficiary

To be completed by the agent

Agent

Agent name

Agent phone

Plan(s) the agent represented during this meeting

Date appointment completed

Initial method of contact

Agent signature

Beneficiary was a walk-in? Yes No

If this form was signed at the time of the appointment, explain why it was not documented beforehand

This documentation is subject to CMS record-retention requirements. An SOA does not obligate the beneficiary to enroll and does not authorize the agent to discuss products not selected above.

TrustInsure is a licensed insurance agency and is not affiliated with any government agency. Medicare has neither reviewed nor endorsed this information.

Rules and reminders

The essentials

When you need one

Before any personal marketing or sales appointment to discuss Medicare Advantage or Part D plans. Secure it before you discuss specific plans.

What it captures

The specific plan type or types the beneficiary agrees to discuss. You may discuss only the types they selected.

How long it lasts

Valid for 12 months from the date it is signed.

Recordkeeping

Keep the completed SOA on file. You must be able to produce it.

Timing: the 48-hour rule is changing

Through September 30, 2026: the SOA must be documented at least 48 hours before the appointment, with limited exceptions such as a beneficiary-initiated walk-in or the final days of a valid enrollment period.

Starting October 1, 2026: the 48-hour advance requirement is removed. An SOA is still required before discussing plans, just without the wait. Do not adopt the new timing before October 1.

What keeps you clean

Discuss only the plan types on the SOA. To discuss a new type, collect a new SOA first.
Remember the SOA is not permission to contact. You still need prior permission to reach out.
Match the SOA to the appointment: right beneficiary, right date, right plan types.
Retain every SOA, including ones where no sale resulted.

Common mistakes

Drifting into a plan type the beneficiary did not agree to discuss.
Treating the SOA as consent to call or door-knock.
Collecting it after the appointment has already started.

Training aid, not legal advice. SOA rules are set by CMS and can be applied more strictly by your carrier or FMO. Confirm the current requirements and forms with your upline before relying on this. Last reviewed June 2026.