Selling to seniors means working with Medicare, Medicare Supplement (Medigap) policies, Medicare Advantage and Part D, Medicaid / long-term care, and stand-alone long-term care (LTC) insurance—an area with strong consumer protections because buyers are often vulnerable. This guide reviews the national fundamentals and then focuses on Tennessee specifics: Medigap regulation and free-look rights, TennCare and long-term care, SHIP counseling, and the replacement and suitability rules that protect older Tennessee consumers.

The federal base: Medicare Parts A/B/C/D

Medicare is the federal program for people 65+ (and certain younger people with disabilities or ESRD):

• Part A — hospital/inpatient, skilled nursing (limited), hospice; usually premium-free for those with enough work credits.
• Part B — physician/outpatient services, preventive care, durable medical equipment; carries a monthly premium.
• Part C (Medicare Advantage) — private plans that bundle Parts A and B (often with drug coverage) as an alternative to Original Medicare.
• Part D — prescription drug coverage sold by private insurers.

Eligibility is generally at age 65, or earlier with 24 months of Social Security disability (or immediately for ESRD/ALS).

Medicare Supplement (Medigap)

Medigap policies are sold by private insurers to fill Original Medicare's gaps—deductibles, coinsurance, and copays. They are federally standardized into lettered plans (A through N), so a "Plan G" offers the same core benefits from any company; insurers compete on price and service.

• The Medigap Open Enrollment Period is a 6-month window that begins when the applicant is age 65 or older AND enrolled in Part B. During it, coverage is guaranteed issue—no health-based decline or surcharge.
• After that window, insurers may use medical underwriting unless a separate guaranteed-issue right applies (for example, when a Medicare Advantage plan exits the area).

Medicare Advantage and Part D

• Medicare Advantage (Part C) replaces how you receive A and B through a private HMO/PPO network, often adding extras (dental, vision, drug coverage). It is not a supplement—you cannot pair Medigap with an Advantage plan.
• Part D drug plans carry their own enrollment periods and a late-enrollment penalty for those who delay without other creditable coverage.

A core distinction: Medigap supplements Original Medicare; Medicare Advantage replaces how you get it.

Tennessee Medigap regulation: free look, replacement, suitability

Tennessee regulates Medigap sales closely through the Tennessee Department of Commerce & Insurance:

• Free look — Medicare Supplement (and LTC) policies carry a free-look window during which the buyer may return the policy for a full refund; for seniors this is commonly cited as 30 days—verify the current figure.
• Replacement — when a sale replaces an existing Medigap or LTC policy, the producer must deliver a replacement notice, compare benefits, and ensure the change genuinely benefits the client.
• Anti-duplication — selling a second Medigap policy to someone who already has one, or coverage that duplicates Medicare, is a prohibited unfair practice.
• Suitability and disclosures — producers must deliver the "Guide to Health Insurance for People with Medicare" and an Outline of Coverage, and avoid twisting (misrepresentation to induce a switch).

Medicaid (TennCare) and long-term care

Medicaid in Tennessee is the TennCare program (administered by the Division of TennCare)—the income- and asset-based program that, unlike Medicare, does pay for extended custodial long-term care for those who qualify financially. Tennessee delivers long-term services and supports largely through a managed-care program commonly known as CHOICES—verify current program details:

• Applicants must meet income and asset limits; many seniors must spend down assets to become eligible.
• A look-back period (commonly cited as 5 years—verify) reviews asset transfers to discourage giving away assets to qualify.
• A community spouse is protected from full impoverishment through spousal asset/income allowances.

Medicare, by contrast, largely does not cover long-term custodial care—the gap the LTC insurance market exists to fill. Long-term care (LTC) insurance covers nursing-home, assisted-living, and home care, and benefits are commonly triggered by the inability to perform a set number of activities of daily living (ADLs) such as bathing, dressing, or eating (or by cognitive impairment).

Long-term care insurance and the Tennessee Partnership

Tennessee follows the NAIC LTC model protections and offers a Partnership program:

• Inflation protection and nonforfeiture benefits must generally be offered.
• LTC policies generally cannot require prior hospitalization as a condition for benefits.
• Producer LTC training and suitability review are required before selling LTC (with ongoing training—verify hours).
• The Tennessee Long-Term Care Partnership links qualified private LTC policies to Medicaid asset protection: dollars paid by a qualifying Partnership policy let the insured shield an equal amount of assets if they later need TennCare long-term care.

Tennessee SHIP and senior counseling

Tennessee operates a State Health Insurance Assistance Program (SHIP)—free, unbiased Medicare counseling for seniors choosing among Medicare, Medigap, Advantage, and Part D options. Agents should know SHIP exists as a non-sales resource and may refer clients to it.

Key Tennessee numbers to memorize

Common exam traps

• Confusing Medigap with Medicare Advantage. Medigap supplements Original Medicare; Advantage (Part C) replaces how you get A/B—and you cannot hold both.
• Miscounting open enrollment. It is 6 months and requires both age 65 and Part B.
• Using a 10-day free look for seniors. Tennessee senior policies commonly use 30 days—verify.
• Selling duplicate coverage. A second Medigap policy is a prohibited practice.
• Assuming Medicare pays for long-term custodial care. It largely does not—TennCare or LTC insurance fills that gap.
• Confusing Medicare with Medicaid. Medicare is federal, age-based; TennCare (Medicaid) is income/asset-based and central to Partnership asset protection.
• Asserting exact look-back or free-look figures. Treat them as statutory and verify.

Quick recap

Senior sales center on Medicare (Parts A/B/C/D), Medigap (federally standardized A–N), and long-term care. The headline protection is the 6-month Medigap open enrollment beginning at age 65 with Part B, which grants guaranteed issue. Tennessee adds a senior free look (commonly 30 days), strict replacement and anti-duplication rules, and a suitability/twisting prohibition. TennCare (Tennessee Medicaid) covers custodial long-term care for those who qualify after a spend-down and look-back, while stand-alone LTC insurance is triggered by ADL loss, must offer inflation protection and nonforfeiture, and connects to the Tennessee Long-Term Care Partnership for Medicaid asset protection. Tennessee SHIP offers free counseling. Remember "Medigap supplements, Advantage replaces," the 6-month window, and the 30-day senior free look—and verify any specific figure.