Examples of marketing activities include: ▪ Providing a presentation on health plan benefits to Medicare beneficiaries where the intent is to steer them toward a plan or set of plans; ▪ Participating in an event where health plan brochures and a summary of benefits are distributed; ▪ Meeting with a Medicare beneficiary to review the Annual Notice of Change and encourage him or her to remain enrolled in his or her current Medicare plan; ▪ Passing out plan specific benefit information and agent business cards at a health fair; and ▪ Accepting enrollment forms and performing enrollment at marketing/sales events.
What are the Medicare marketing guidelines for sponsors?
The Centers for Medicare and Medicaid Services provide strict Medicare marketing guidelines for plan sponsors and providers. For example: Events promoting a particular plan must be properly labeled as sales/marketing events rather than educational events.
Do you have a goal for Medicare Advantage Marketing?
You can’t get to your destination without following a map, and you can’t be successful in Medicare Advantage marketing without a goal. Before you start any marketing plan, write down your goals. Then, you can use the materials at your disposal to help you reach them.
How do I market my Medicare Advantage plans?
The best way to market Medicare Advantage plans is to utilize marketing materials, including: We’ve developed some generic materials you can use to spread awareness and put yourself out there as an agent who offers Medicare Advantage plans. You can also dig into your agent portals and check out the available materials.
Can I participate in marketing activities in a healthcare facility?
You can participate in marketing activities in common areas only. Common areas are generally any space that’s not dedicated to the facilitation of healthcare service, such as a: What Areas in a Healthcare Facility Am I Prohibited from Conducting Marketing Activities?
What are the Medicare marketing guidelines?
Can Medicare Advantage and Prescription Drug Plans use one document?
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What marketing practices are allowed by Medicare Advantage companies?
You can't knowingly market to MA or Part D enrollees during the OEP (January 1-March 31). You can, however, market to age-ins (people turning 65). Educational events must be explicitly advertised as educational – no marketing or sales activities are allowed.
What must all Medicare Advantage sponsors have in place to meet CMS guidelines?
Medicare Advantage Plans Must Follow CMS Guidelines In the United States, according to federal law, Part C providers must provide their beneficiaries with all services and supplies that Original Medicare Parts A and B cover. They must also provide any additional benefits proclaimed in their Part C policy.
What is one CMS marketing rule that impacts how Medicare insurance plans market to consumers?
Marketing Rules CMS also regulates marketing and plan presentations, including when you're allowed to market, and how you market. Agents must wait until October 1 to begin marketing next year's plans to potential beneficiaries and cannot enroll members until October 15.
Which of the following areas is the marketing of Medicare health plans prohibited?
Participating in any marketing activity—such as distributing and accepting enrollment applications, conducting sales presentations, and soliciting beneficiaries—is not allowed in areas where individuals receive or wait to receive healthcare service. These areas include: Exam rooms.
What is a Medicare Advantage sponsor?
CMS uses the term “plan sponsor” to describe an organization that has an approved, active contract with the federal government to offer Medicare Advantage plans, prescription drug plans, and 1876 cost plans. A plan sponsor can be an employer, a union, or a health insurance carrier.
What is considered marketing material by CMS?
CMS Model Marketing Materials Model marketing materials include: the standardized Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) templates and instructions, ANOC/EOC Errata, and Provider Directory.
How do you market Medicare on Facebook?
Use these tips to make sure you're taking advantage of Facebook in the best way to market to the Medicare-eligible community.Post the content they want. ... Post frequently. ... Promote your posts. ... Run an ad. ... Follow these compliance tips.
What are the marketing guidelines?
What Are Content Marketing Guidelines? Content Marketing Guidelines are a set of instructions indicating tone, voice, length, style and topics on how your brand should communicate to your target audience.
What are some of the unique rules for marketing and selling Medicare plans?
Medicare has rules for how plans can contact you in different situations: By mail, radio, and print advertisements: Plans are allowed to market themselves by any of these means. They cannot, in these advertisements or in any other marketing situation, suggest that they are endorsed or preferred by Medicare.
Which of the following must you not do when marketing UnitedHealthcare Medicare Advantage?
As an agent, you must not do which of the following when marketing UnitedHealthcare Medicare Advantage plans to consumers? Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval.
What actions are prohibited during marketing sales events?
Cannot send unsolicited text messages and leave voicemail messages. May call or visit beneficiaries who attended a marketing/sales event prior permission is given and documented. Cannot approach beneficiaries in common areas (i.e. parking lots, hallways, lobbies, sidewalks).
Where is marketing in a healthcare setting acceptable?
Common areas where marketing activities are allowed include areas such as hospital or nursing home cafeterias, community or recreational rooms, and conference rooms.
Chapter 3 Medicare Marketing Guidelines
Chapter 3 – Medicare Marketing Guidelines For Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and 1876 Cost Plans Table of Contents
Medicare Communications and Marketing Guidelines (MCMG)
6 20 – Communications and Marketing Definitions 42 CFR §§ 422.2260, 423.2260 Communications means activities and use of materials to provide information to current and prospective enrollees. This means that all activities and materials aimed at prospective and
Medicare Marketing Guidelines 2021 - Crowe & Associates
Medicare Marketing Guidelines 2021 reviews the rules agents need to know when selling/soliciting Medicare plans and educational events.
Medicare Marketing DOs & DON’Ts Agent Summary CY2020 CMS Medicare ...
DO DON’T Educational Events MCMG Section: 50.1 Enrollee-Only Educational Events • Enrollee/Member • MUST be advertised as “educational” • enrollee towardMUST be only educational & comply w/CMS’ educational requirements • MUST be free of materials w/plan-specific/benefit info, including premiums and copayments data • MAY schedule marketing appointment & distribute business ...
What are HIPAA’s new rules for marketing? - AAPC Knowledge Center
I want to create a Refer-a-Friend program, for my dental practice, that will be managed by a third party marketing agency. The third party needs only my patient names and address to do an on-going e-mail campaign, no PHI will be given to the third party — just name and e-mail address.
What are the Medicare marketing guidelines?
The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423).
Can Medicare Advantage and Prescription Drug Plans use one document?
The guidelines allow organizations offering both Medicare Advantage and Prescription Drug Plans the ability to reference one document when developing marketing materials.
What is Medicare marketing guidelines?
The Medicare Marketing Guidelines (MMG) implement the Centers for Medicare & Medicaid Services’ (CMS) marketing requirements and related provisions of the Medicare Advantage (MA, MA-PD ) (also referred to as Plan), Medicare Prescription Drug Plan (PDP) (also referred to as Part D Sponsor), and except where otherwise specified, Section 1876 cost plans (also referred to as Plan) rules, (i.e., Title 42 of the Code of Federal Regulations, Parts 422, 423, and 417). These requirements also apply to Medicare-Medicaid Plans (MMPs), except as modified or clarified in state-specific marketing guidance for each state’s demonstration. State-specific guidance is considered an addendum to the MMG. State-specific marketing guidance for MMPs will be posted to http://www.cms.gov/Medicare-
What is an educational event for Medicare?
Educational events are designed to inform Medicare beneficiaries about Medicare Advantage, Prescription Drug or other Medicare programs and do not include marketing (i.e., the event sponsor does not steer, or attempt to steer, potential enrollees toward a specific plan or limited number of plans).
What is a Part D sponsor?
Plans/Part D Sponsors must ensure that materials developed by a third-party providing information on a subset of plan choices that lists, compares, or names available plans, must prominently display the following disclaimer on all materials:
How long does it take to review marketing materials in HPMS?
Based on the material type, and as indicated by HPMS, marketing materials submitted in HPMS for prospective review will have a review timeframe of 10 or 45 days. The marketing review time period begins on the date a material is submitted in HPMS.
What is a Part D call center?
Part D Sponsors must operate a toll-free pharmacy technical help call center or make available call support to respond to inquiries from pharmacies and providers regarding the beneficiary’s Medicare prescription drug benefit; inquiries may pertain to operational areas such as claims processing, benefit coverage, claims submission, and claims payment. This requirement can be accommodated through the use of on-call staff pharmacists or by contracting with the organization’s PBM during non-business hours as long as the individual answering the call is able to address the call at that time. The call center must operate or be available during usual business hours, which CMS interprets to mean during the entire period in which the Part D Sponsor’s network pharmacies in its plans’ service areas are open (e.g., Part D Sponsors whose pharmacy networks include twenty-four (24) hour pharmacies must operate their pharmacy technical help call centers twenty-four (24) hours a day as well).
What is a third party marketing organization?
Third-party marketing organizations are entities such as a Field Marketing Organization (FMO), General Agent (GA), or similar type of organization that has been retained to sell or promote a Plan’s/Part D Sponsor’s Medicare products on the Plan’s/Part D Sponsor’s behalf either directly or through sales agents or a combination of both.
What is a script in Medicare?
Informational scripts are designed to respond to beneficiary questions and requests and provide objective information about a plan or the Medicare program. Sales and enrollment scripts are intended to steer a beneficiary towards a plan or limited number of plans, or to enroll a beneficiary into a plan.
What is marketing in CMS?
Marketing refers to using materials to draw someone’s attention to a specific plan and then influence them to select it. Any marketing materials that have a carrier’s name on them or refer to a particular plan must be approved by CMS.
Can you connect with other businesses?
You can also connect with other businesses in your area and develop a referral stream. For example, you might connect with a financial advisor – she would refer her Medicare clients to you for their health and life insurance, and you would direct your clients to her for retirement planning.
Can you market to age ins?
You can, however, market to age-ins (people turning 65). Educational events must be explicitly advertised as educational – no marketing or sales activities are allowed. Marketing and sales events are designed to steer potential enrollees toward a plan or set of plans.
Can you market to MA enrollees?
You cannot market to potential MA enrollees in the following ways: Approaching someone in a common area (parking lot, hallway, etc.)
Can you get Medicare Advantage without a goal?
You can’t get to your destination without following a map, and you can’t be successful in Medicare Advantage marketing without a goal. Before you start any marketing plan, write down your goals. Then, you can use the materials at your disposal to help you reach them.
What is included in an I-SNP brochure?
Brochures may include eligibility requirements and benefits of an I-SNP. In addition, brochures may include a reply card or your telephone number for a resident or responsible party to request more information or a meeting.
What are providers facilities?
Provider facilities include hospitals, pharmacies, and long-term care residences such as nursing homes and assisted-living facilities. For long-term care facilities, there are special requirements when it comes to who marketing materials can be distributed to.
What are common areas in healthcare?
You can participate in marketing activities in common areas only. Common areas are generally any space that’s not dedicated to the facilitation of healthcare service , such as a: Cafeteria. Conference room. Recreational room.
Can you participate in marketing activities in healthcare?
Participating in any marketing activity—such as distributing and accepting enrollment applications, conducting sales presentations, and soliciting beneficiaries—is not allowed in areas where individuals receive or wait to receive healthcare service. These areas include:
Can I provide a brochure for I-SNP?
The facility staff must distribute brochures only to residents who meet the eligibility requirements for enrollment. Brochures may include eligibility requirements and benefits of an I-SNP. In addition, brochures may include a reply card or your telephone number for a resident or responsible party to request more information or a meeting.
Is Medicare confusing?
After all, Medicare can be confusing for most consumers, particularly for first-timers. See how we helped Piedmont Community Health Plan target a highly coveted Medicare audience – New-to-Medicare prospects who will soon age-in to their benefits.
Is Medicare age in anymore?
Medicare marketing professionals know, it’s not just “age-in” anymore. Older adults are retiring later, which can make targeting valuable New-to-Medicare consumers increasingly challenging. Media Logic has a proven set of year-round strategies and tactics for attracting and closing New-to-Medicare leads that can be customized around your market, your opportunities and your brand. See some examples of New-to-Medicare marketing campaigns that we’ve worked on for our clients. For more insights, you can also download our tip sheet on “A New Approach for New-to-Medicare.”
What questions do brokers ask?
Often, brokers are asked questions about topics ranging from house-cleaning services to assisted living facilities. Brokers may respond with suggestions —such as names of people and facilities—of where the beneficiary can go to receive more information regarding their question.
Is a health insurance broker a neutral entity?
Referring beneficiaries to their local state health insurance assistance program (SHIP) office is advised, as it is a neutral, state-run entity. However, brokers may not give endorsements or recommendations.
What is CMS review?
CMS reviews against all MMG content requirements, which, in general, are intended to prevent plan sponsors from making statements that are inaccurate, misleading or misrepresent the plan, or the benefits and services covered by the plan . Beneficiary Protection / Content Requirements include:
What is marketing material?
Marketing materials are communication materials (any format) targeted to Medicare beneficiaries that promote or mention plan sponsor names, brand names, plan names, logos, plan benefits, coverage or features of any of plans.
What are the Medicare marketing guidelines?
The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423).
Can Medicare Advantage and Prescription Drug Plans use one document?
The guidelines allow organizations offering both Medicare Advantage and Prescription Drug Plans the ability to reference one document when developing marketing materials.