What are the marketing guidelines for Medicare Advantage?
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).
How does the CMS check in on your agent?
Keep in mind the CMS uses secret shoppers to check in on their agents. Calls made to a Medicare beneficiary that attended a marketing/sales or educational activity or was sent a marketing item through the mail, even if the Medicare beneficiary requested the item.
What counts as a Medicare marketing call?
Calls made to a Medicare beneficiary that attended a marketing/sales or educational activity or was sent a marketing item through the mail, even if the Medicare beneficiary requested the item. Calling a medicare beneficiary whose contact information was obtained through a purchased lead list or by referral.
What is Medicare permission to contact?
What Is Medicare Permission To Contact? Permission to contact is a rule that exists in order to protect existing or new medicare beneficiaries from medicare agents that use unethical marketing tactics.
What entity regulates Medicare marketing?
The Centers for Medicare & Medicaid Services (CMS) began regulating MA marketing two months later, just in time for 2009 enrollment. A decade later, CMS quietly loosened (PDF) some of those restrictions just in time for 2019 open enrollment.
Who approves Medicare marketing materials?
CMSWhat is considered branded marketing material for Medicare? Branded material, by MMG definition, is any marketing material that contains a carrier and/or product information (e.g., plan name, plan costs/benefit information). CMS must approve these pieces.
What is CMS marketing rule?
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.
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).
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.
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.
What is Medicare compliance?
The Medicare Compliance Program is specifically designed to prevent, detect, and correct noncompliance as well as fraud, waste, and abuse.
What are marketing materials in Medicare?
Marketing materials are any materials developed and or distributed by entities covered by the Medicare Marketing Guidelines (MMG) and are targeted to Medicare beneficiaries.
Which of the following must you not do when marketing United Healthcare Medicare Advantage or prescription drug plans to consumers?
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.
Can you sell Medicare door to door?
MA/PD PLANS May not market to beneficiaries door to door, including leaving materials at a beneficiary's doorstep. May call a beneficiary they enrolled in a plan to discuss plan business, as well as discuss the availability of other plan options/types within the same parent organization.
When must a marketing sales event be reported to United Healthcare?
It needs to be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to the date of the event.
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 Permission To Contact?
Permission to contact is a rule that exists in order to protect existing or new medicare beneficiaries from medicare agents that use unethical marketing tactics. Such unethical tactics have previously made beneficiaries feel as if they were obligated to go with a specific plan all though they did not like the plan.
What is Medicare call?
Calls made to a Medicare beneficiary that attended a marketing/sales or educational activity or was sent a marketing item through the mail, even if the Medicare beneficiary requested the item. Calling a medicare beneficiary whose contact information was obtained through a purchased lead list or by referral.
What does a Medicare referred beneficiary need to do?
A referred Medicare beneficiary needs to contact the agent directly. Calls based on referrals. Handing out materials or leaving materials in or under front doors or on car windows. Approaching individuals in common areas such as parking lots, sidewalks, hallways, or lobbies.
What is Medicare educational event?
Medicare Educational Events. Medicare educational events are meant to inform prospective clients about medicare and its programs. During these events, all information must be generic. Otherwise, the event will be considered a marketing or sales event.
How long does Medicare contact last?
For Medicare Advantage or prescription drug plans, permission to contact expires after 9 months. Medicare supplement product lines have a 90-day expiration date. Permission to contact MUST be established again after it expires even if ongoing contact is intended.
Do you need a scope to sign a Medicare beneficiary?
Even if there is someone representing the medicare beneficiary a scope must be signed. The form is not required at educational events. If a prospective beneficiary walks into an agent’s office and requests information a form must be signed. The form is only required for sales or marketing purposes.
Do Medicare beneficiaries have to specify what type of plan they are interested in before they speak with an agent?
Medicare beneficiaries must specify what plan types they are interested in before they speak with an agent. There are a few plan types that the beneficiary can check.
What is Medicare Part C and Part D?
The Centers for Medicare & Medicaid Services (CMS) have guidelines for marketing Medicare Part C and Part D insurance that protect beneficiaries from manipulative and deceptive sales and enrollment tactics. Plan sponsors and their representatives, including agents and brokers, must follow strict guidelines when they wish to market to beneficiaries.
Can marketing be conducted under the guise of education?
A fundamental principle is that marketing cannot be conducted under the guise of education. Report potential Medicare marketing violations and/or enrollment fraud, errors, or abuse if: You receive an unsolicited phone call from a company you have no prior relationship with.
How to keep clients in touch with agents?
Carve out time for retention efforts. Keep in touch with your clients throughout the year by sending information they can use, as well as birthday cards and other gestures to show that you appreciate them.
How to get referrals for your business?
Make yourself worthy of referrals by providing excellent service and putting the needs of your clients first. Also make it easy for your happy clients to refer you. One way to do this is to keep extra business cards on hand and give them to clients to hand out to their friends and family.
Can a plan that is perfect for one client be wrong for another client?
A plan that’s perfect for one client might be totally wrong for another client. Let’s say you’ve found a plan that offers lots of extra benefits, like meal delivery and adult day care coverage. A client who needs these benefits might love this plan, but someone who doesn’t need these benefits probably won’t want to pay for them. You also need to consider differences in plan networks and prescription formularies. Read this article to see why successful Medicare agents develop a multi-carrier portfolio.
Can you break CMS rules to get referrals?
Don’t break CMS rules to get referrals.
Is direct mail good for Medicare?
Your marketing campaigns should also include digital tools. Direct mail remains a great option for Medicare marketing, but many seniors are online, so don ’t underestimate the importance of an active social media feed and an easy-to -navigate website.
Can Medicare be sent through mail?
For instance, companies can market their plans through direct mail, radio, television, and print advertisements. Plans can also send emails, but they must provide an opt-out option in the email for people who do not wish to receive them. Agents can also visit your home if you invite them for a marketing appointment.
Can Medicare be used in their name?
Plans can use Medicare in their names as long as it follows the plan name (for example, the Acme Medicare plan) and the usage does not suggest that Medicare endorses that particular plan above other Medicare plans
Where Can I Get More Medicare Marketing Guidance?
Our resource center is available 24/7 to give you the help you need with Medicare guidelines, sales advice, and more to keep your business on track. To learn more about the Excelsior team and how we can help you, contact us.
What Are All of the Medicare Anti-Discrimination Categories?
According to CMS rules (MMG, Section 30.1 ), brokers may not discriminate based on race, ethnicity, national origin, religion, sex, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability, or geographic location.
Are Brokers Allowed to Target Seniors?
No. Brokers are not allowed to suggest that certain plans are available to “seniors” rather than all Medicare beneficiaries.