SEPTEMBER 2023 RELEASES
September 2023 Releases
AI Agents Make AEP Easy for your Medicare Call Center
When it comes to prepping for the Medicare Annual Enrollment Period (AEP), you know the drill.
You staff up your Medicare call center, start training, and hope to be ready before the volume hits. The floodgates open, and you do your best to not let anyone fall through the cracks.
Just getting through the season afloat can feel like a win for any Medicare call center.
At Regal, we believe there’s a strategic conflict with that approach. Why? You’re betting on short-term hires to drive long-term trust. Your spending is defensive. It’s a survival play.
What you might not realize is that AI agents can handle a huge portion of the AEP load.
Imagine being able to guarantee clear, steady, compliant outreach, without spinning up a whole new team each fall.
That’s what companies like HPOne are doing right now. They’re managing the same seasonal waves. They’re not sacrificing quality (they’re improving it, tbh). Their systems can flex on demand, and are easy to repeat each year.
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Here, we’re going to show you all of the ways you can use AI agents for medicare—whether it’s for AEP, engaging medicare advantage leads or selling medicare insurance year-round, or offering general support.
We want to help you avoid the hiring spikes, while staying compliant and within budget.
How AI Agents Make AEP and 24/7 Comms Easy for your Medicare Call Center
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1. Lifecycle Screening
If you’ve ever found yourself asking…
- Why are we wasting agents’ time on unqualified leads?
- How do we keep up with screening during AEP without hiring 50 more reps?
The typical medicare call center issue: Too many leads. Too little signal. Contact centers get buried qualifying cold or non-compliant inquiries.
What AI Agents can do: Screen inbound and outbound leads, collecting eligibility and intent data to separate the signal from the noise.
How they do it:
- Ask eligibility questions like age, location, and plan type in natural language
- Pull in and update customer data from your CRM or enrollment systems
- Use real-time logic to route qualified leads to licensed brokers
- Instantly disposition and log outcomes for compliance and analytics
Regal AI Agents consistently drive qualified transfer rates on par with Medicare teams’ best human agents.
2. Appointment Scheduling
If you’ve ever found yourself asking…
- Why are my agents spending so much time booking appointments?
- Can we reduce no-shows without adding headcount?
The typical medicare call center issue: Scheduling eats up the time your agents should be spending with qualified leads. You want to drive better attendance, but can’t hire any more agents.
What AI Agents can do: Book, confirm, and reschedule appointments automatically, across voice and SMS.
How they do it:
- Offer available time slots via phone or SMS in natural language
- Integrate with calendar and scheduling tools to avoid conflicts
- Send confirmation texts and pre-appointment reminders
- Automatically handle rescheduling or cancellations
Automated scheduling reduces no-shows, while letting your licensed agents focus on selling and servicing—driving more conversations with qualified leads, and more conversions from those conversations.
3. Medicare Onboarding
If you’ve ever found yourself asking…
- How can we better engage members in their first 30 days?
- Can we move onboarding engagements to voice, SMS, and email without overloading agents?
The typical medicare call center issue: Most onboarding experiences are nonexistent—leaving customers confused and unengaged. You had to dump so much resource into AEP that there’s a natural dropoff during onboarding.
What AI Agents can do: Engage every new enrollee immediately, walk them through onboarding, and make sure they know what to do next and how to do it.
How they do it:
- Trigger personalized welcome calls, texts, or emails post-enrollment
- Confirm contact information and communication preferences
- Guide members through benefits education or portal setup
- Flag complex needs or gaps to human agents
AI-led onboarding improves engagement and first-month activation, which drives retention, lowers churn, and reduces follow-up volume down the line.
4. AEP Support
If you’ve ever found yourself asking…
- How do we prepare for another AEP surge without blowing our budget?
- Why are hold times still this long during peak season?
The typical medicare call center issue: Every year, AEP can overwhelm your medicare call center. Hold times balloon. Agent morale can be volatile. Too many leads fall through the cracks because your comms are inconsistent at-best.
What AI Agents can do: Handle major spikes in communications (both inbound and outbound), without diverting from quality, 24/7.
AI Agents can be carefully (and easily) prompted to drive conversations towards the outcomes you need (qualification, scheduling, general support, etc.). You can do this at any scale, as well.
How they do it:
- Handle up to 100% of inbound call volume
- Instantly triage and qualify leads, even during high-traffic hours, 24/7
- Leave personalized voicemails and SMS on outbound
- Transfer hot leads directly to licensed brokers in real time
During AEP, Regal AI Agents have eliminated hold times entirely while maintaining a 94% CSAT and matching top human agents with a 40% qualified transfer rate.
5. Medicare Billing and Payment
If you’ve ever found yourself asking…
- How can we minimize the time agents spend on chasing billing issues?
- How do we reduce late payments and missed reminders?
The typical medicare call center issue: Billing calls clog the queue. Payment reminders fall through the cracks. Your agents are leaving other qualified leads on hold. Everyone loses.
What AI Agents can do: Answer billing questions, handle payment reminders, and collect payment info securely.
How they do it:
- Look up and explain balances or payment due dates in real time
- Send proactive payment reminders via SMS, voice, or email
- Walk customers through making a payment or updating info
- Escalate payment disputes or errors to the right human team
By automating billing-related calls, companies see faster collections, fewer past-due accounts, and significantly reduced support overhead.
AI Agents: Your Medicare Advantage
Selling medicare insurance at scale and meeting AEP demands is hard to do with humans alone in 2025. Especially as your competitors implement more and more AI.
By adopting AI now, you can get ahead of seasonal spikes and make automated outreach your advantage.
With Regal AI Agents, you can:
- Qualify leads instantly
- Automate scheduling
- Onboard every customer
- Crush AEP without chaos
- Offload billing calls
Implementation and prompting is typically easier than you think. And the best part? Each year, as AEP rolls around, all you have to do is turn your agents on and rest assured knowing the quality of your outreach will remain consistent and personalized.
Want to see how Regal can streamline your Medicare call center with AI-powered agents? Give our AI Agent a call today.
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