What are the Medicare marketing guidelines?
The Medicare Marketing Guidelines provide a list of items that “may fall under CMS’ definition of marketing materials.” While it is not a complete list of what could require CMS’ review, the list includes: While this may not directly affect you as a broker, marketing materials also include:
How does the Medicare Agency regulate the marketing of Medicare products?
The Medicare agency conducts only complaint-based oversight and he can market the products he represents as he sees fit, as long as he does so in a manner that would be considered ethical by a reasonable lay person. c. The state sets most requirements for marketing Medicare health plans, but each plan has different policies that he must adhere to.
What is exclusion from Medicare marketing materials?
Exclusion: These materials do not include websites that reference Medicare products, which carriers must submit to CMS for review. Individual carriers might have their own rules about approving broker-created marketing materials.
What do you need to know about Medicare Advantage Marketing appointments?
While making an appointment to discuss Medicare Advantage (MA) and Part D plans with a potential enrollee, you are asked to describe other types of insurance products that your client might wish to purchase. What additional types of insurance can you present during the MA and Part D marketing appointment?
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.
What is a scope of appointment form for Medicare?
The Medicare Scope of Appointment is a form which Medicare beneficiaries must complete to designate, prior to their appointment with an agent, exactly which items they wish to discuss. In other words, this form is how you tell your agent which insurance products he or she can present to you.
What is 1 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.
Who approves Medicare marketing materials?
CMSAll marketing materials need to be filed and approved by CMS. Agent created communications to members do not need CMS approval. Any agent created communication must follow the CMS Medicare Communications and Marketing Guidelines.
Which of the following is considered by CMS to be a sales and marketing event?
What Does CMS Consider a Sales Event or Appointment? An activity will be considered a sales event or appointment if it is designed to persuade potential enrollees to choose a specific plan (or set of plans), according to CMS.
Do you need a scope of appointment at a formal marketing event?
Beneficiaries attending a formal or informal sales event do not need to complete a Scope of Appointment. The scope of the marketing/presentation is implied in the event promotion.
How do you market a Medicare Advantage plan?
Medicare Advantage Marketing to current patientsTargeted mail and emails for patients 65+Reminders for current patients during open enrollment.Informational blogs and social media posts.Posters in your office.Referring patients to an informational page on your website with a lead capture.More items...
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 is considered unsolicited contact with a Medicare eligible consumer according to CMS regulations?
Unsolicited Contact: The Center for Medicare and Medicaid Services (CMS) states that agents cannot make direct unsolicited contact. This is anyone who has NOT given explicit permission to contact.
What are the three main ways in which Medicare sales occur?
There are three different types of Medicare products sold by agents and brokers: Medicare Supplement plans (Also called Medigap plans), Medicare Advantage plans and Medicare Part D Rx plans.
Which of the following is considered the best defense under the Medicare Integrity Program?
Which of the following is considered the best defense under the Medicare Integrity program? Having a strong compliance plan.
What are CMS guidelines for referrals?
In a CMS compliant situation, you would 1) ask for referrals without mentioning any benefit to the enrollee and then 2) present a thank-you gift for the referrals he or she has provided. Second, the gifts you provide must be of a nominal value.
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.
Do you need to approve marketing materials?
c. Only scripts and marketing practices must be approved by CMS, so you do not need to do anything further with your marketing materials, as long as you make them available to anyone who attends the marketing event
Does MA state licensure apply to marketing representatives?
a. State licensure laws are pre-empted and do not apply to marketing representatives marketing MA and Part D plans
Do you have to attend remedial training before taking Medicare test?
d. You will have to attend one of several remedial training events sponsored by the Medicare agency before being allowed to retake the test.
Do you have to take a Medicare Advantage test?
b. You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate score, although you will not have to take a test if you exclusively market employer/union group plans and the companies do not require testing.
Does Medicare have to comply with requests for information from state insurance departments investigating complaints about a marketing representative?
Medicare health plans must comply with requests for information from state insurance departments investigating complaints about a marketing representative. You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your state.
Do you need CMS approval for a material?
a. You do not need to get CMS approval of the materials, so long as the materials are not misleading or materially inaccurate.
Can you tell her she is wrong and that only agents employed by the plans are exempt from training and testing requirements?
a. You could tell her she is wrong and that only agents employed by the plans are exempt from training and testing requirements.
What is Medicare Savings Program?
Medicare Savings Program: help paying for the Medicare Part B premium and, in some cases, deductibles and coinsurance. Part D low-income subsidy: help paying for prescription drug coverage. The State Medicaid office will check eligibility for this and other programs such as the Medicare. Savings Program.
What is ABC in Medicare?
ABC is a long-term care facility provider. What steps may it take to inform residents of the Medicare options available to them?
How many options are there for Part D?
Part D enrollees have three options for paying their Part D premium.
What are the enrollment mechanisms?
enrollment mechanisms, including, but not limited to: Plan Sponsors must submit all materials, web pages, and images (e.g. screen shots) related to the electronic enrollment process for CMS approval.Individuals must be provided with all required pre-enrollment information (see module 4).The mechanism must comply with CMS' data security policies.
When must an individual be advised of the electronic enrollment process?
Each individual must be advised at the beginning of the electronic enrollment process that he or she is completing an enrollment request.
Is Part B deductible covered by Medicare?
Specifically, for individuals newly eligible. to Medicare, the Part B deductible cannot be covered. Therefore, Plans C and F will no longer be an option for newly eligible individuals starting January 1, 2020.
Does MA automatically enroll in the same plan?
automatically enrolled in an MA plan offered by the same organization .Individuals subject to deemed enrollment will be notified by CMS and the plan and given the opportunity to choose another option.
What are Medicare marketing guidelines?
The Medicare Marketing Guidelines provide a list of items that “may fall under CMS’ definition of marketing materials.”. While it is not a complete list of what could require CMS’ review, the list includes: General circulation brochures, direct mail, newspapers, magazines, television, radio, billboards, yellow pages, and the Internet.
What are the marketing materials for a broker?
Presentation materials, such as slides and charts. Promotional materials, such as brochures and leaflets. While this may not directly affect you as a broker, marketing materials also include: Membership communication materials. Communications to enrollees about plan changes and membership activities. Activities of a carrier’s employees, independent ...
What are business cards that don't include specific plan benefits?
Business cards that don’t include specific plan benefits. Materials that only mention the products you sell (like HMO, PPO, and PDP) Exclusion: These materials do not include websites that reference Medicare products, which carriers must submit to CMS for review.
Do you need to include a disclaimer when referring to a health insurance plan?
First, you may need to include disclaimers. If you mention a plan’s benefits, premium, or out-of-pocket costs, you may need to include one or more of the following disclaimers. “This information is not a complete description of benefits. Contact the plan for more information.”.
Can you publish a document after the review process is finished?
If you have included all of the necessary disclaimers and comments, the carrier will likely give you approval to publish or share the documents after the review process is finished. If the carrier or CMS have noticed errors, your materials will need to be changed and resubmitted.
What is Medicare Communications and Marketing?
Section 20 of the 2019 Medicare Communications and Marketing Guidelines clearly defines communications and marketing, which are determined both by the intent and content of the message. “Communications means activities and use of materials to provide information to current and prospective enrollees.”.
What are the Medicare marketing guidelines for 2019?
The Medicare Marketing Guidelines for 2019 have loosened the rules around unsolicited contact. Sections 30.6 and 40.2 allow brokers to initiate contact via email, conventional mail, and print media. This includes communication and marketing for sales and retention.
What is content in marketing?
Content – based on the exclusions in the definition of marketing and marketing materials and the type of information that would be intended to draw attention to a plan or influence a beneficiary’s enrollment decision, marketing activities and materials include: Information about benefits or benefits structure;
What is marketing in a plan?
Marketing, on the other hand, “includes activities and use of materials that are conducted by the Plan/Part D sponsor with the intent to draw a beneficiary’s attention to a MA plan or plans and to influence a beneficiary’s decision-making process when selecting a MA plan for enrollment or deciding to stay enrolled in a plan (that is, retention-based marketing). Additionally, marketing contains information about the plan’s benefit structure, cost sharing, and measuring or ranking standards.”
Can a call from informational to sales/telephonic enrollment be changed?
Any change in the nature of a call from information al to sales/telephonic enrollment must clearly inform the beneficiary regarding the change. This must be done with the full and active concurrence of the beneficiary, ideally with a yes/no question. Telephonic enrollment must also meet the requirements in CMS Eligibility and Enrollment Guidance (Chapter 2 of the Medicare Managed Care Manual and Chapter 3 of the Medicare Prescription Drug Benefit Manual).
Can a Medicare broker make an appointment at an educational event?
Section 50.1 of CMS’ Medicare Communication and Marketing Guidelines for 2019 now allow brokers to schedule future appointments during educational events. You may also hand out business cards and contact information to attendees. But brokers are still prohibited from distributing enrollment forms and any type of marketing materials at educational events.
Does CMS update Medicare marketing guidelines?
The Centers for Medicare and Medicaid Services (CMS) recently updated the 2018 Medicare Marketing Guidelines. But before you click through the lengthy PDF, let Excelsior give you a breakdown of the main changes that apply to you as a broker or agent. We’ll run through the guide— marking the updates in red —so that you know which changes you should implement now. Here are the highlights for brokers and agents:
Who is tasked with remaining compliant with the Centers for Medicare and Medicaid Services while marketing their services?
Insurance companies and agents are tasked with remaining compliant with the Centers for Medicare & Medicaid Services while marketing their services. It makes sense on the surface, but the details may need some clarifying.
Can you put Medicare on a business card?
Additionally, agents shouldn’t use the word “Medicare” on their business card in any fashion that suggests they represent Medicare, like putting the words “expert,” or “specialist” behind it.
Can an agent sell Medicare Advantage?
A: CMS states that only agents who are licensed, certified, or registered under state law are permitted to market an insurance company’s Medicare Advantage or prescription drug plans. Agents are also required to complete the insurance companies’ annual mandatory certification processes for the carriers they wish to represent. Only after an agent is trained and certified to understand the rules, regulations, and specific Medicare product details can a carrier confirm an agent’s ready-to-sell status.
How does CMS determine the category?
CMS determines the category that the material falls into by reviewing both the content and the intent of the piece. What does it say and what is your intention? Let’s look at an example from the MCMG:
What is marketing materials?
Marketing, however, is a subset of communications. These materials are often more specific and provide detailed information. The purpose of these materials is to draw a beneficiary’s attention to a certain plan and influence their decision. These pieces could potentially include information on the plan’s benefit structure, cost sharing, and measuring or ranking standards. Marketing materials are subject to CMS review.
When is Medicare Advantage Open Enrollment Period?
The Medicare Advantage Disenrollment Period (MADP) which would normally take place from January 1 through February 14 is being replaced with the Medicare Advantage Open Enrollment Period (OEP). The new OEP will occur between January 1 and March 31 annually beginning in 2019.
Is agent developed communication material a CMS material ID?
Please note that agent-developed communication materials that are not marketing are excluded from CMS’s material ID requirement.
Does Ritter Insurance use mass email?
While you are permitted to do this, Ritter Insurance Marketing does not recommend mass emailing unless you completely understand how to use your email marketing application.
Can you send marketing materials to a beneficiary?
You are allowed to send marketing materials and hold one-on-one meetings , but only at the request of the beneficiary.
Is the advertisement considered marketing or communications?
Would this be considered communications or marketing? Because the advertisement includes both the intent to draw the reader’s attention to the plan and mentions that $0 premiums are available, this would fall under the marketing category.