Medicare Marketing Guidelines 2022

The Centers for Medicare and Medicaid Services releases updates to the current Medicare Communications and Marketing Guidelines (MCMG) via a memo.

MCMG was renamed to Medicare Advantage and Medicare Part D Communication Requirements. Some of the important parts of the guidelines/requirements are highlighted in this article.

Permission To Contact vs. Scope of Appointment

– The permission to call/contact – PTC – is used to start contact with a prospect. There are various methods to obtain the PTC in order to initiate conversations with prospects: through flyers, business reply cards, PTC from online leads or vendors.

Now Medicare agents are able to make unsolicited contact via email with a prospect for MA, MAPD and PDP plans, however the opt-out option should be sent in that email in order to be compliant. The email should not steer the prospect into a specific plan.

Agents are still not able to make unsolicited contact to prospects for MA, MAPD or PDP by phone or in-person in common areas.

– A Scope of Appointment form is used to document the types of plans you will be discussing with the prospect. SOA ensures that an agent will not be discussing products with the prospects other than those chosen prior to the appointment. Agents should make sure to complete the scope of appointment prior to starting the meeting.

SOAs are required to be completed for every face-to-face, over the phone, and virtual meetings with the clients even if the meeting did not result in a sale. If a client wants to talk about additional and different Medicare plans during the meetings, the agent should get another scope of appointment documenting those additional plans and can continue the appointment.

Types of Events and Appointments

There are three categories of events that agent’s meetings and presentations fall under: educational events, sales events and individual appointments.

Educational event provides a general information about the Medicare program.

Sales events steer or have an attempt to steer potential enrollees towards a limited set of plans. Agents can show plan specific details, benefits and premiums during the sales event.

Agents should follow the dos of sales events:

  • Use only approved sales materials
  • Report the event before conducting and advertising it
  • Follow cancellation procedure rules
  • Allowed to distribute and collect applications
  • Call attendees from the sales event if they provided a PTC (card or flyer)

Agents should avoid the don’ts of sales events:

  • Only light snacks and refreshments can be offered, agents cannot offer meals (at educational events)
  • Avoid absolute statements “this is the best Medicare Advantage plan”
  • Only promote health-based products
  • You must have a sign-in sheet but cannot require anyone to sign in

All marketing websites should be submitted for review according to CMS requirements. In most cases website content reviews are done through the carriers.

Communications vs. Marketing

Based on the CMS MCMG definitions the concepts of ‘communication’ and ‘marketing’ are two different things based on the material used and intent of the material. Communication materials do not require CMS approval, as they do not include plan specific information, but just a more general info, cannot be intended to steer someone towards a specific plan.

Materials can be considered as marketing and require a CMS review if they are not generic in nature. Agents should avoid using any absolute statements on materials or during presentations.

Agents should stay away from using the word ‘free’ when talking about $0 premium Medicare plans, describing part B premium, part B reduction plans or dual eligible plans.

 

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