For FMO Partners

Your agents get the
best leads
in Medicare.

Patient Coverage Connect delivers clinically sourced, pre-qualified Medicare referrals to agents in your network — complete with the patient's medications, diagnoses, current plan, and the specific coverage question that triggered the referral. Agents join the PCC marketplace directly; FMO or CRM integration is available when you want it. The highest-quality lead channel in the market.

9:41
●●● WiFi 🔋
PCC
Patient Coverage Connect now
New Clinical Referral
Medicare coverage question identified at Summit Primary Care — Nashville. Patient briefed and waiting.
Clinical Referral Brief AOR Match
Robert T. Hollis
DOB: 03/14/1952 · Chattanooga, TN · (423) 555-0182
Coverage Question
Formulary change — Eliquis Tier 4
Clinical Brief
Current plan: Humana Gold Plus H1036
Apixaban (Eliquis) 5mg moved to Tier 4 — now $180/fill vs. $4
3 active medications · Allopurinol · Levothyroxine
Income indicators present — may qualify for Extra Help
Permission given · Timestamp: 9:38 AM today
2 more referrals this morning +2
What your agents receive
A complete clinical brief delivered before they make contact — in whatever system they use
$0
Revenue generated from the clinical referral channel today
$50–100
What agents pay for a Medicare internet lead — cold contact, no clinical context. Source: leadgen-economy.com, Jan 2026 AEP/OEP guide ($60–100 during AEP for qualified MA leads)
$40
PCC lead fee — clinical context, documented consent, patient expecting contact
20+
Coverage gap types detected from a patient's clinical record
How It Works

The referral your agents
have always wanted.

A Medicare advisor receives a referral that includes the patient's name, contact information, current plan, medications, relevant diagnoses, and the specific coverage question that triggered the referral — where available in the patient's clinical record. Before they make a single call. The patient has given permission, documented with a timestamp.

1

Platform identifies a coverage gap

Automatically from the patient's clinical record — before the appointment, or when staff submits a referral. The system finds what the patient doesn't know yet: a formulary change, a C-SNP they qualify for, a plan that's terminating, an approaching eligibility date.

2

Patient gives permission. Referral is built.

The patient gives permission, documented with a timestamp. The clinical record is parsed automatically — medications, diagnoses, current coverage, income indicators where available. Built in seconds, no manual data entry.

3

AOR check routes to your agent

PCC matches agent of record in its own agent database by default — or through your CRM when that integration is in place. If an enrolled agent of record has availability set, the referral routes to them at full price. If not, it routes to the next available agent. Every patient's first referral carries the full lead fee.

4

Agent arrives knowing. Patient gets helped.

No cold calling. No discovery. No wasted appointments. The agent already knows the patient's situation before making contact. The advisor relationship begins from a position of expertise and trust — established by the provider who arranged it.

What makes this different from every other lead source

Internet leads are bought, recycled, and cold. Patient Coverage Connect leads come from inside a clinical encounter — the highest-trust setting in healthcare.

The patient has already identified a coverage need in front of a provider they trust, with permission documented. Your agent arrives not as a salesperson but as a solution the provider arranged.

  • Permission documented with timestamp — compliant from the start
  • Clinical brief eliminates discovery — agent goes straight to solutions
  • Medications, diagnoses, current plan, and income indicators where available in the clinical record
  • Advisor relationship starts with clinical credibility
  • Covers physician offices and pharmacies
  • All Medicare product types — MA, PDP, supplement, social programs that seed future leads
Lead Quality

The lead source that was always there.
Now captured.

Premium pricing reflects clinical sourcing, pre-qualification, and conversion advantage no other channel can match. These are not the cheapest leads. They are the best ones.

And the timing favors early partners. In 2026, health systems and MA plans parting ways forced more than 3.7 million enrollees to choose new coverage — many of them eligible to move immediately under a Special Enrollment Period rather than waiting for fall. That is a large, time-sensitive pool of clinically sourced referrals flowing to whichever agent network is already connected when the patient asks.

Internet / Digital Leads

Standard market lead
❌

Generated by consumer search or advertising — often recycled across multiple agents

❌

No clinical context — agent arrives without knowing the patient's situation

❌

Consent implicit — not documented at a trusted clinical moment

❌

Cold contact — patient may not remember requesting information

Lowest conversion

Patient Coverage Connect

Clinical referral — highest quality
✓

Sourced inside a clinical encounter — physician or pharmacist

✓

Clinical brief — medications, diagnoses, current plan, coverage question where available in the record

✓

Permission documented with timestamp at point of care

✓

Patient is expecting contact — the provider arranged it

✓

All Medicare product types — no referral type restrictions

Highest conversion

Direct Mail / TV Leads

Traditional lead generation
❌

Mass market — not pre-qualified for specific coverage needs

❌

No clinical context — discovery conversation required

❌

Response lag — patient interest may have passed

❌

High volume, low specificity — difficult to prioritize

Average conversion
Pricing Model

Every first referral. Full price.
Every follow-up. No charge.

Patient Coverage Connect uses a first-contact premium model with a $0 ongoing relationship fee — giving agents a powerful incentive to build their book through the platform and use it as their compliance and communication layer for every patient interaction.

First Contact — Every Patient

Every patient's first referral through Patient Coverage Connect carries a premium lead fee — regardless of any prior agent relationship. The AOR check identifies the patient's existing advisor and asks whether they're enrolled in the lead program with availability set. If yes, routes to them at full price. If not, routes to the next available advisor.

FMOs may co-op or sponsor lead costs as an agent retention and recruitment tool.

Premium Per lead — same price for all first contacts

Ongoing — Same Patient

Once an agent has received and paid for a patient's first lead, all future referrals for that patient route back to them at no charge — for as long as the AOR relationship remains active and uninterrupted in their CRM. The referral routes to the active agent of record at the moment of referral, as identified by the CRM.

Agents can tell their book of record to hit Request Review in their patient portal each year. Every client who does sends the agent their latest clinical information as a free, fully briefed lead — an entire book re-engaged annually at no cost.

$0 All subsequent leads while AOR is active and uninterrupted
What the patient sees
Your advisor — one tap to re-engage
9:41
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Coverage Overview
Humana Gold Plus H1036 / Medicare Advantage HMO
✓ Information from Humana. Prices may vary.
Robert T. Hollis
H10360041882
⚠️
Formulary change. Eliquis moved to Tier 4. Now $180/fill vs. $8. Annual cost increase ~$2,064. No therapeutic equivalent.
💊Prescription Drug Coverage (Part D)
Levothyroxine 200mcg
Thyroid · 30-day supply
$8/fill
Tier 1
Apixaban (Eliquis) 5mg
Blood thinner · AFib
$180/fill
Tier 4 ↑
Allopurinol 300mg
Gout · 30-day supply
$8/fill
Tier 1
ℹ️
You may qualify for Extra Help with prescription costs. Ask your advisor.
Your Medicare Advisor
Jenny Woods
Jenny Woods
Rural Health Advisors
👨‍⚕️ Your Care Team Coverage
The patient sees their advisor's name and a Request Review button directly in their coverage portal — one tap re-engages the relationship at no cost to the agent
For Your Agents

Minor certification. Major leads.

Agents access Patient Coverage Connect referrals through a brief online certification. This is a quality standard that protects the integrity of the clinical referral channel and the providers who use it. Providers need to know their patients are being connected to advisors who meet a standard.

What agents need to participate

  • Active Medicare license in good standing
  • Register directly on PCC — no FMO affiliation required. Agents who work through an affiliated FMO can operate that way instead; either path is first-class
  • Brief online certification — The Clinical Referral, Provider and Professional Standards, The Non-Partisan Standard, and Platform Mechanics
  • Enrollment in the lead program with availability set in their PCC agent profile — or their FMO platform, whichever they use. Referrals route only to agents who can accept leads
  • That's it. No lengthy credentialing. No in-person requirement.

What agents receive

  • Access to the highest-quality lead channel in Medicare distribution
  • Complete clinical brief with every referral — medications, diagnoses, current plan, income indicators where available in the clinical record
  • Referrals sourced from physician offices and pharmacies
  • All Medicare product types — MA, PDP, supplement, Extra Help, social programs that seed future leads
  • AOR recognition through PCC's own system or their existing CRM, whichever applies — referrals route back to them for patients already in their active book
  • $0 ongoing leads for every patient in their active book — pay once for the first referral, no charge for follow-ups while AOR is active and uninterrupted
  • Annual free re-engagement of their entire book via the patient portal Request Review button
Provider & Advisor Onboarding

Relationship-driven
onboarding. Real standards.

Patient Coverage Connect onboards clinical partners through a direct, relationship-led process — physician offices, pharmacies, and community health settings where Medicare patients already receive care.

Provider staff learn the referral workflow in a short orientation. Advisors complete a certification curriculum developed with the Rural Health Association's Medicare Education program — the quality credential that tells providers their patients are connected to advisors who meet a standard, not just a checkbox.

The approach is built on community health relationships and a clear vetting bar for advisors. Reach grows with each provider and certified agent brought online.

Growing
Provider footprint expands as clinical partners complete onboarding
20 min
Provider staff orientation — BAA, workflow training. Done.
All
Clinical settings — physician offices, pharmacies, community health centers
Ongoing
Referral potential at each onboarded site — every Medicare encounter can surface a coverage gap
FMO Onboarding

Three steps. Then your agents
start receiving referrals.

1

Agents join the marketplace

Your agents register directly on Patient Coverage Connect — no CRM integration required to start receiving referrals. FMO or CRM platform integration is available if and when you want lead delivery and AOR lookup through your own systems.

2

Agent certification

You notify your agent network about the Patient Coverage Connect clinical referral channel. Agents complete the brief online certification and set their availability in their PCC agent profile — or in your FMO platform, whichever they use. No in-person requirement.

3

Referrals start flowing

As providers come online, referrals route to certified agents. AOR matching uses PCC's agent database by default, or your CRM when that integration is in place — either path works. Every patient in an agent's active book becomes a $0 follow-up lead for as long as the AOR relationship is active and uninterrupted.