Medicare leads only pay when they effectuate. We build the media engine on projected lifetime value per enrollment: campaigns on Google, Meta, and Bing that optimize toward effectuated enrollments and net portfolio economics, not cost per lead.
Medicare Advantage, Medicare Supplement, Turning 65, and dual-eligible D-SNP programs. Value lands at effectuation, seasonality runs on AEP, and compliance runs on TPMO and CMS marketing rules.
ACA marketplace, subsidy-driven, commission economics with churn haircuts, and TPMO rules of its own. That program lives on our health insurance lead generation page. Insuring vehicles instead of people: see auto insurance leads, or for term and final expense, life insurance leads.
A submitted application is not revenue. Between submission and effectuation, 15 to 30 percent of Medicare applications fall out, and the first capitation payment does not clear until the policy effectuates, January 1 for AEP business. Any program measured on cost per lead or even cost per submitted application is optimizing toward a number that reliably overstates results.
Rapid disenrollment inside 90 days triggers a 100 percent commission clawback, and those clawbacks land months outside any ad platform attribution window. Passing them back as conversion drops would starve the algorithm. We solve it differently.
Projected LTV from day one. Historical portfolio monthly churn computes an expected lifetime value for every cohort. That projected value passes to the bidding algorithms at the moment of enrollment, so front-end media optimizes against net projected portfolio economics, with fallout and clawback risk already priced in.
MA and Supplement are different books. Medicare Advantage pays recurring capitation; Supplement pays commission on premium. Cohort values are computed separately so budget flows to whichever book compounds faster.
Every campaign feeds a two-stage conversion hierarchy through our offline conversion pipeline. The micro event is a qualified call with a licensed agent. The primary event is a submitted enrollment, valued at its projected lifetime value, never at a flat lead price.
Because value passes at enrollment with churn already priced in, Smart Bidding learns which ZIP codes, ages, and plan intents produce members who stay, not just seniors who fill in forms. Hashed first-party enrollment data flows back through enhanced conversions for leads to keep match rates high.
A call that reaches a licensed agent and clears the qualification threshold. High volume, fast feedback, keeps the algorithm learning between enrollment events.
Submitted enrollment, valued per cohort from historical churn. D-SNP, MA, and Supplement each carry their own value curve.
Dual-eligible members carry significantly higher capitation rates because of medical complexity, and D-SNP programs convert year round through Special Enrollment Periods instead of living and dying by AEP. A verified D-SNP enrollment commands a 20 to 40 percent premium over standard Medicare Advantage, and buyers want the volume.
The premium only holds if the enrollment is real. Verification runs before value passes to bidding, not after the carrier bounces it.
Unverifiable dual status, meaning no state Medicaid ID or subsidy tier confirmation. County and network mismatches, where no active D-SNP contract covers the ZIP code. And documented plan-swappers whose churn history destroys projected lifetime value.
AEP absorbs 60 to 70 percent of the annual budget because intent surges between October 15 and December 7. The rest of the year is not silence, it is a different market: smaller, cheaper, and strictly limited to Turning 65, Initial Enrollment, and qualifying Special Enrollment Periods such as relocation, loss of employer coverage, and subsidy changes.
The mechanic: a year-round LTV to CAC ratio. We bid to a target ratio of projected lifetime value against acquisition cost, and adjust the target as market volume moves. Off peak we accept a lower ratio and a higher acquisition cost when it captures share or keeps licensed agents fully booked, because idle agent capacity is its own cost.
Every ad and landing page carries the required TPMO disclaimer, avoids official Medicare language, agency logos, and deceptive card imagery, and captures TCPA consent on every form using industry-standard consent verification with visual playback tokens. Anyone auditing a lead can replay exactly what the consumer saw and agreed to. Plan questions belong with official Medicare resources, and our creative never pretends otherwise.
We refuse misleading cash-back and Medicare check hooks that promise flat cash allowances. They inflate fallout, generate carrier complaints, and poison the cohort data the whole system runs on.
Where our scope ends. LGG delivers a fully compliant inbound form or live call. Downstream obligations, including TCPA handling after the transfer, Scope of Appointment collection, 48-month call recording retention, and agent scripting, sit with the enrollment operation. That boundary holds whether you are building the program in-house or buying the infrastructure.
Campaigns are geo-fenced to states where your agents hold active licenses, and budget dynamically weights toward licensed states with deeper agent headcount and carrier footprint. We never pay for a click that cannot become a serviceable enrollment.
Inbound calls and transfers route through real-time ping-post routing that checks agent licensing before transfer, so calls never dead-end against an agent who cannot legally take them. Every call is scored and fed back to bidding through our call tracking architecture.
Lead vendors can only optimize what they can see: form fills and call duration. They cannot see effectuation, projected lifetime value, clawbacks, or your net portfolio economics, so their machine optimizes toward volume that looks good in a spreadsheet and falls out before the first capitation payment clears.
An owned program feeds enrollment truth back into the media engine. Every cohort makes the bidding smarter, and the asset compounds on your books, not a vendor’s.
Same lead sold to multiple call centers, optimized to the form fill, priced flat regardless of plan type, county, or churn risk. The vendor keeps the data.
Exclusive volume, valued per cohort at projected LTV, verified for dual status and network fit, geo-fenced to licensed states. The data asset is yours. Start on the lead generation pillar to see the full architecture.
Cost per lead is the wrong lens. A submitted Medicare application carries 15 to 30 percent fallout before effectuation, so cheap leads that never effectuate are expensive. We price media against projected lifetime value per enrollment, computed from historical portfolio churn, and optimize toward net portfolio economics rather than raw lead counts.
Dual-eligible enrollments carry significantly higher capitation rates and convert year round through Special Enrollment Periods, not just during AEP. A verified D-SNP enrollment typically commands a 20 to 40 percent premium over standard Medicare Advantage. We verify dual status before an enrollment counts, and we exclude ZIP codes without an active D-SNP network contract.
AEP takes 60 to 70 percent of the annual budget because intent surges from October 15 to December 7. Outside the window we keep campaigns live against a lifetime value to acquisition cost ratio, accepting a higher acquisition cost when it keeps licensed agents productive, and we target strictly Turning 65, Initial Enrollment, and qualifying Special Enrollment Period segments.
Every ad and landing page carries the required TPMO disclaimer, avoids official Medicare language and imagery, and captures consent using industry-standard consent verification with visual playback tokens. Our scope ends at a fully compliant inbound form or live call. Downstream obligations such as Scope of Appointment collection, 48-month call recording retention, and agent scripting sit with the enrollment operation.
We refuse misleading cash-back and Medicare check hooks that promise flat cash allowances, because they inflate fallout and carrier complaints. We also refuse to bid on unverifiable dual status, on counties with no active plan network, and on segments with a documented history of rapid plan switching.
Lead vendors can only optimize toward form fills and call duration, because that is all they can see. An owned program optimizes toward effectuated enrollments and projected lifetime value. If you already have licensed agents and enrollment infrastructure, building the media engine on your own data compounds; buying shared leads rents someone else's.
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