AI Voice Agent for Medicare Agencies and FMOs
Every Medicare caller answered in seconds, nights and weekends included, and handed warm to your licensed agents. All year, and hardest from October 15, our AI voice agent picks up every inbound call, says it is an AI, collects the basics, and screens callers against your plans and your counties. Your licensed agents take the plan conversation.
What is an AI voice agent for a Medicare agency?
An AI voice agent for a Medicare agency answers your inbound calls by voice, in seconds, 24/7. It says it is an AI, takes the caller's name, location and current coverage, screens them against your plans and counties, and warm-transfers qualified callers to your licensed agents. It does not give plan advice and does not enroll anyone.
Coverage through every enrollment period
Medicare phones follow the enrollment calendar. The agent answers the same way in the first week of AEP as on a quiet afternoon in July, so no caller reaches voicemail when your floor is full.
| Period | When | What the agent does |
|---|---|---|
| Annual Enrollment Period (AEP) | October 15 to December 7 each year. | Answers every call in seconds through the peak, nights and weekends included, screens by ZIP code, county and current coverage, and warm-transfers qualified callers. |
| Medicare Advantage Open Enrollment Period (OEP) | January 1 to March 31, for people already in a Medicare Advantage plan. | Confirms the caller is in a Medicare Advantage plan today and gets them to a licensed agent who can talk through a change. |
| Special Enrollment Periods (SEP) | All year, after life events such as a move, a loss of coverage, Medicaid or Extra Help. | Asks the screening questions your script sets for the event, then transfers. Your licensed agent confirms eligibility. |
| Turning 65 (Initial Enrollment Period) | Seven months: the three months before the month a person turns 65, that month, and the three months after. | Takes the basics from callers new to Medicare and books or transfers them to a licensed agent. |
Health insurance shoppers run on a different calendar. For the Marketplace season, see ACA open enrollment call answering, and for every other line, AI receptionist for insurance agents.
Sources
- Medicare.gov, "Joining a health or drug plan," and 42 CFR 422.62. Checked October 14, 2026.
- Turning 65 (Initial Enrollment Period): 42 CFR 407.14. Checked October 14, 2026.
What the agent does on every call
Says it is an AI
Every caller hears that they are speaking with an AI, with the same disclosure given the same way on every call.
Collects the basics
In any of twenty languages and regional variants, detected automatically, it takes the caller's name, where they live and what coverage they have now, so your agent starts the conversation already knowing who is on the line.
Screens before it transfers
Callers are checked against your plans and the counties you are contracted for. Qualified callers are warm-transferred live to your licensed agents.
Your licensed agents take the plan conversation
Plans, benefits and eligibility are for your licensed agents, and the agent hands every qualified caller to them ready to talk.
Every caller gets an answer, and outside your agents' hours the agent books the callback. After the call, the same agent can follow up on WhatsApp with callers who opt in, as your agency's own assistant. See every channel.
Twenty languages with automatic detection
We detect the caller's language and answer in it. No menu, no "press 2 for Spanish", no transfer to a different desk. Twenty languages and regional variants, detected automatically from the first word, so a beneficiary who is more at home in Korean or Vietnamese gets the same answer as everyone else.
English, Spanish (Spain and Mexico), Portuguese (Brazil and Portugal), French, German, Italian, Russian, Turkish, Arabic (Egypt, Saudi Arabia and the UAE), Hindi, Bengali, Chinese (Simplified), Japanese, Korean, Indonesian and Vietnamese.
Warm transfer to your licensed agents
When a caller is qualified and agrees to speak with a licensed agent, the AI voice agent places a warm transfer to your team while the caller is still on the line. The caller is connected with the details already gathered, so nobody repeats themselves, and the details are written to a summary in your team's inbox or CRM. Outside your hours, it books the callback.
Need people on the phones too? Nearshore live call center agents from our partner call center take Medicare calls in English and Spanish and transfer the same way. See final expense call center outsourcing.
Hear it for yourself
The fastest way to judge an AI voice agent is to talk to one. Leave your name and number and the agent calls you for a live, two-way conversation, with the AI and recording notice up front. It is the same agent we build for agencies. Talk to a live AI voice agent.
Check the calls your licensed agents take
Our call QA platform scores every recorded call, or a set you choose, against a checklist written from your script and the CMS rules your agency follows, with the line from the call behind every mark. Medicare call monitoring for agencies. For a scorecard built around the TPMO disclaimer, the recording notice and scope of appointment, see call QA for Medicare call centers.
CMS sets recording rules for Medicare sales calls. Read Medicare call recording requirements, and for call flows built for the CMS rules, the Medicare and ACA call center script guide.
Built for the CMS marketing rules
We write the agent's script, disclosures and transfer rules with you, against the CMS marketing rules your agency follows, with TCPA consent built in, and every callback and follow-up checked against federal and state Do Not Call lists and your consent records, under our compliance standards.
Calls run on HIPAA-compliant, ISO 27001 certified voice infrastructure, with a business associate agreement available.
Three ways we help
AI voice agents for Medicare
Every call answered in seconds, 24/7, by an AI that says so, then screened and handed to your people.
Nearshore live call center agents
When you need people as well, our nearshore live agents take the calls and warm-transfer qualified callers to your team.
Call reviews
Our call QA platform scores the recorded calls your licensed agents and the live agents take, against a checklist written from your script and the CMS rules you follow.
Answer, screen and transfer. We answer your inbound calls, with AI voice agents around the clock and our nearshore live agents during the hours you set. Every caller is screened against your qualifying questions, and qualified callers are warm-transferred to your team. Calls are recorded where your program needs it, and our call QA platform can score them against a checklist written from your script.
Medicare AI voice agent questions
What is an AI voice agent for a Medicare agency?
It is software that answers your Medicare calls by voice, in seconds, 24/7. It says it is an AI, collects the caller's basics, screens them against your plans and counties, and warm-transfers qualified callers to your licensed agents. It never gives plan advice or enrolls anyone; your licensed agents do that.
Does the AI voice agent give plan advice?
No. Plans, benefits, costs and eligibility are conversations for your licensed agents. The AI voice agent answers the call, collects the basics and screens the caller, then hands them to a licensed agent. If a caller asks about a plan, it tells them a licensed agent will answer and moves to the transfer.
Does the agent tell callers it is an AI?
Yes. Every caller hears that they are speaking with an AI, at the start of the call, with the same disclosure given the same way every time. We write the disclosure and the rest of the script with you, against the CMS marketing rules your agency follows, before the first call.
Which languages does the Medicare AI voice agent speak?
Twenty languages and regional variants, including English, Spanish, Chinese, Korean, Vietnamese, Arabic and Hindi. We detect the caller's language and answer in it, with no menu and no transfer to a different desk. A beneficiary who is more at home in Russian or Bengali gets the same fast answer, the same screening and the same warm transfer as everyone else.
How do transfers to my licensed agents work?
Once a caller is screened and agrees to speak with a licensed agent, the AI voice agent places a warm transfer to your team. The caller is connected with the details already gathered, so nobody repeats themselves, and the details are written to a summary in your team's inbox or CRM. Outside your hours, it books the callback.
Does it record calls, and what does CMS require?
Recording, and the recording notice your script sets, are agreed with you during scoping. Under CMS rules, Medicare Advantage plans must require, by contract, that third-party marketing organizations record all marketing and sales calls in their entirety and keep them at least six years, the first three as audio (42 CFR 422.2274(g)(2)(ii)). Keeping recordings for that period sits with your agency or plan. This is not legal advice; your compliance team approves your setup.
Ready for the rest of AEP?
Each AI agent is priced as a one-time setup fee plus a monthly fee, quoted once we have scoped the work with you. Or score the recorded calls your licensed agents take on our call QA platform.