Medicare quoting and enrollment
MAPD, PDP, Medicare Supplement, and Special Needs Plans across 110+ carriers at general availability. Eligibility checked first, drugs and doctors priced for real, and the application signed before you leave the kitchen table.
Start with what the client can actually elect
Every wasted Medicare appointment starts the same way: a beautiful comparison of plans the client is not eligible to take. So the lookup happens before the quote, not after the objection.
- CMS eligibility and entitlement. Part A and Part B status and effective dates, confirmed against CMS rather than read off a card the client cannot find.
- Enrollment history. What they are in now, when it took effect, and how many elections they have already used this year.
- Low Income Subsidy and Medicaid status. Extra Help level feeds both eligibility and the drug math, which is what makes a D-SNP conversation honest.
- Only electable plans are presented. If the election period does not allow the change, the workflow says so on the way in.
Solved Enroll is in private beta. Medicare quoting is live with beta agencies ahead of the 2027 public rollout, and the carrier list grows with each cohort. Join the waitlist for the next one.
Election periods, surfaced in the workflow
You already know these rules. The platform applies them to the case in front of you, so the window and its effective date are attached to the quote instead of held in your head.
| AEP | The Annual Election Period, October 15 through December 7, for a January 1 effective date. Quotes run against next plan year data as soon as it loads, without disturbing the current year. |
|---|---|
| MA OEP | The Medicare Advantage Open Enrollment Period, January 1 through March 31, for clients already in an MA plan. One change, effective the first of the following month. |
| ICEP and Part D IEP | The initial windows around new Part B entitlement or turning 65, where the effective date depends on when the client enrolled in Part B. |
| Med Supp open enrollment | The six-month window that opens with the Part B effective date, plus the guaranteed issue situations, which decide whether health questions apply at all. |
| SEP triggers | A move out of the service area, a change in Medicaid or Extra Help status, a plan leaving the county, entering or leaving an institution, or losing employer coverage. The trigger is recorded on the case with the election it justifies. |
| 5-star SEP | The one-time switch into a 5-star plan available in the client's county, flagged when a qualifying plan exists. |
Why it matters on the case file. The election period and its trigger are stored with the enrollment, next to the Scope of Appointment and the disclosures. When a carrier asks six months later why a February change was allowed, the answer is on the record instead of in a memory. Election period rules are set by CMS and change from year to year; the platform tracks the current plan year rather than asking you to.
Shop by doctor and pharmacy, then price the drugs for real
Two questions decide most Medicare recommendations: can I keep my doctor, and what will my prescriptions cost. Both are answered from the names the client gives you, not from an average.
- The providers they name. Enter each doctor or facility by name or NPI and every plan in the comparison is verified against its network for those providers.
- The pharmacy they use. The corner pharmacy they have used for nineteen years is priced as preferred, standard, or out of network, next to the mail-order alternative.
- Network deltas on the compare. Which of the client's named providers each plan covers is shown side by side, so the trade-off is visible rather than discovered in March.
- Therapeutic alternatives. Where a generic or an equivalent changes the annual total materially, it is flagged as something to raise with the prescriber.
What the drug model computes
Formulary placement
Tier placement per plan, plus prior authorization, step therapy, and quantity limits on each drug. A tier 3 drug with step therapy is a different conversation than a tier 3 drug without it.
Every coverage phase
The deductible, initial coverage, and catastrophic phases priced across the plan year, so the client sees the January number and the annual number rather than one of them.
The actual pharmacy
Preferred, standard, and mail-order pricing at the pharmacies the client will really use, because the same plan can be the cheapest or the most expensive depending on where the prescription is filled.
Medicare product availability
Where each Medicare line stands in the private beta. Everything listed is in scope for the 2027 general availability release.
| Product | Stage | What the workflow covers |
|---|---|---|
| Medicare Advantage (MA and MAPD) | Live in beta | Quote, provider and pharmacy verification, drug cost modeling, side-by-side compare, and enrollment in the same session. |
| Prescription drug plans (PDP) | Live in beta | Standalone Part D with the full formulary model and pharmacy-level pricing, including mail order. |
| Medicare Supplement | Live in beta | Rate comparison by plan letter and rating class, with the carrier's health questions where underwriting applies. |
| Dual-eligible SNP (D-SNP) | In build | Medicaid level and Extra Help verification gating the plans that are presented, with the verification stored on the case. |
| Chronic-condition SNP (C-SNP) | In build | Qualifying condition capture against the carrier's condition list, and the attestation step the carrier requires. |
| Low Income Subsidy screening | In build | Extra Help level pulled into eligibility and priced into the drug model rather than estimated afterward. |
| Institutional SNP (I-SNP) | Planned | Scheduled after the D-SNP and C-SNP verification flows settle with beta agencies. |
| Cost plans and PFFS | Planned | Quoted where carriers still offer them. Low volume, so sequenced behind the core lines. |
Stage reflects the private beta build order across cohorts, not a delivery date. Carrier coverage reaches 110+ at general availability.
Medicare Supplement and Special Needs Plans
The two lines where the plan the client wants and the plan the client can get are most likely to differ.
Med Supp rates and underwriting
Rates compared by plan letter across the carriers you are appointed to write, with the rating class and any household discount applied so the number you quote is the number on the bill.
- Health questions asked only where the state and the carrier actually require them.
- Open enrollment and guaranteed issue situations flagged, because they decide whether underwriting applies at all.
- A Part D plan quoted alongside the supplement, since a Med Supp client still needs drug coverage.
SNPs and their extra steps
Special Needs Plans carry verification a standard MAPD does not. The flow collects it before the plan is presented, not after the application is rejected.
- D-SNP: Medicaid eligibility category and Extra Help level, matched to the plans that accept that level.
- C-SNP: the qualifying condition, recorded against the carrier's list with the attestation the carrier requires.
- Extra benefits that drive the recommendation, such as transportation, over the counter, and dental allowances, compared plan to plan.
Compare it with the client, then enroll in the same session
The comparison is built from the fields that came up in the conversation, so you can turn the screen around without editing anything out of it.
Client-facing compare
Two to four plans side by side on premium, maximum out of pocket, the named providers, annual drug cost, and the extras the client asked about. Internal fields stay off the screen.
PDF leave-behind
One click produces a summary of exactly what was compared, for the client's kitchen drawer and for your file. The version they were shown is the version stored.
Enrollment in the session
Carrier-approved forms pre-filled from the quote, signed by text, tablet, or email, with the Scope of Appointment and disclosures already timestamped on the record.
Dedicated Medicare quoting platforms such as Sunfire publish capability around MAPD, PDP, and Med Supp quoting with enrollment. Based on those publicly published materials, the difference we build for is the second and third sale on the same visit: the fact-find that qualified a final expense case is the record that quotes the MAPD plan and attaches dental. Comparisons describe the common shape of each category rather than any one product, and are based on publicly published materials. See the detailed comparisons
Where Medicare fits in the platform
AI Plan Recommender
Ranked plans with the network and drug factors behind each score.
ExploreEnrollment and e-signature
Scope of Appointment, disclosures, and carrier-approved signature.
ExploreAncillary attach
Dental, vision, hearing, and hospital indemnity on the same visit.
ExploreAgency and IMO
Hierarchies, dashboards, and onboarding for your downline.
ExploreSee the full platform, the quote-to-enroll workflow, pricing, the API reference, or the documentation.
FAQs
Questions about Medicare quoting
Which Medicare products can I quote and enroll?
Medicare Advantage (MA and MAPD), standalone Part D prescription drug plans, Medicare Supplement, and Special Needs Plans. At general availability the platform reaches 110+ Medicare carriers. During the private beta the live carrier and product list is smaller and grows with each cohort, prioritized by what beta agencies actually write.
Does Solved Enroll check eligibility before it shows plans?
Yes. Entitlement, current enrollment, and enrollment history are looked up before the quote, so the plans on screen are plans the client can actually elect. If someone is already in a Medicare Advantage plan and it is April, the workflow tells you that before you spend twenty minutes comparing plans they cannot switch to.
How does the drug cost modeling work?
The client's medication list is priced against each plan's formulary rather than estimated. That means tier placement, prior authorization, step therapy, and quantity limits per drug, priced across the deductible, initial coverage, and catastrophic phases, at the pharmacy the client actually uses, with preferred, standard, and mail-order pricing compared.
Can I verify that the client keeps their own doctor?
You enter the providers the client names, by name or NPI, and each plan in the comparison is checked against its network for those specific providers. Network deltas are shown on the comparison, so the answer to "can I keep Dr. Alvarez" is on the screen instead of in a phone call after the appointment.
How are Special Needs Plans handled?
Dual-eligible and chronic-condition SNPs run through the same guided flow, with their extra verification steps built in: Medicaid level and Extra Help status for a D-SNP, and the carrier's qualifying condition requirements for a C-SNP. The plan is not presented as an option until the verification the carrier requires has been collected.
Can the client sign in the same appointment?
Yes. Scope of Appointment is captured and timestamped before the sales conversation, the application is pre-filled from the quote, and the client signs by text, tablet, or email on carrier-approved forms. See enrollment and e-signature for how the submission and its audit trail are recorded.
Something else? Contact us
Bring a hard Medicare case. We will run it live.
A client with six medications, two specialists, and a pharmacy they will not leave is the case worth watching the platform handle.