Voice AI for Medicare Advantage (Part C) Plans
Medicare Advantage integrates hospital, medical, and often prescription coverage into a single managed plan. With more than 30 million enrollees, MA plans compete intensely during the Annual Enrollment Period (AEP). Coverage Voice empowers carriers and agencies to scale outreach, onboarding, and retention through compliant AI voice automation.
Who's Eligible for Medicare Advantage Plans
Beneficiaries qualify if they:
Are enrolled in Medicare Parts A and B, and
Reside within the MA plan's service area, and
Do not have ESRD unless eligible under new CMS guidelines.
AI agents validate these requirements instantly during calls.
Measure What Drives Medicare Advantage Growth
Gain visibility into enrollments, conversions, costs, and ROI with AI-powered insights that drive Medicare Advantage growth.
Understand What Medicare Pays.
All Part A & B services
Prescription drugs (for MAPD plans)
Dental, vision, and hearing benefits
Preventive screenings and chronic care management
Fitness and wellness programs
Telehealth services
What Medicare Doesn't Include
Out-of-network services without plan approval
Experimental or non-medically necessary procedures
Long-term custodial care
Overseas healthcare services (unless emergency)
Who Benefits from Coverage Voice Medicare Voice AI
Medicare Agencies
Field Marketing Organizations (FMOs)
Call Centers for Medicare Outreach
Insurance Brokers
Managing General Agent (MGA)
How Coverage Voice Optimizes Medicare Advantage Operations
Eligibility & Needs Analysis
Voice AI gathers medication lists, preferred providers, and cost preferences to identify suitable plans.
Plan Comparison & Education
Explains premiums, copays, MOOP limits, and network options with full CMS-approved disclosures.
AEP Scalability
Between Oct 15 and Dec 7, handle thousands of calls simultaneously—no temporary staff needed.
Welcome & Onboarding Calls
Guide new members through PCP selection, wellness visit scheduling, and Health Risk Assessment (HRA) completion for RAF scoring.
Retention Outreach
Automated quarterly check-ins improve satisfaction and lower churn by up to 10%.
Star Ratings Support
Increases CAHPS scores and preventive care compliance through proactive outreach.
CMS & HIPAA Guardrails
CMS call recording, 10-year retention, encryption, and audit readiness are built in.
CMS-Compliant Voice AI Workflow
This guardrail-driven approach ensures every Medicare Advantage call meets CMS marketing guidelines, HIPAA safeguards, and SOC 2 data integrity requirements, eliminating offshore exposure and manual documentation errors. Coverage Voice follows a strict compliance sequence aligned with CMS and HIPAA standards to protect sensitive health and enrollment data.
Call Initiation
AI delivers CMS-required disclaimer within the first 60 seconds.
Consent Capture
Member voice confirmation logged with timestamp and agent ID.
Eligibility Verification
AI validates Part A/B enrollment and plan service area.
Health Risk Assessment (HRA)
Conversational completion of chronic condition and SDoH screening.
Audit Trail Generation
Transcript + metadata archived under 10-year retention protocol.
Data Encryption
All PHI secured using AES-256 encryption across U.S.-based servers.
Compliance Reporting
Auto-generated compliance summary available for CMS audits.
Frequently Asked Questions
Also called Part C, it's a private plan that bundles Parts A and B and often Part D plus extra benefits like dental, vision, and hearing.
Anyone enrolled in Medicare Parts A and B who lives in a plan's service area can join, usually during the Annual Enrollment Period (Oct 15–Dec 7).
MA plans are offered by private insurers, may have provider networks, and include extra benefits not found in Original Medicare.
Yes, most MAPD plans include Part D coverage for medications.
Every call includes mandatory disclaimers, CMS call recording, 10-year retention, and encrypted PHI storage, all within U.S. infrastructure.
Absolutely. Coverage Voice automates follow-ups for preventive visits, medication adherence, and satisfaction surveys, key drivers of CMS Star Scores.
Fast, Compliant, Future-Ready Enrollment.
Coverage Voice helps you scale instantly, ensure CMS compliance, and improve Star Ratings, all while reducing costs.