Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealth- care's rules, policies, and procedures?: Mailing a marketing brochure to the consumer via postal mail. 11.
What is unsolicited contact with Medicare?
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.
Can a Medicare agent contact potential enrollees via email?
Due to a change reflected in the 2019 Medicare Communications and Marketing Guidelines (MCMG) and now updated in CFR 42, agents are permitted to make unsolicited direct contact with potential enrollees via email. However, the email must have an opt-out option in order to remain compliant.
What does the doctor ask the consumer at each appointment?
At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older and calls the referred individual. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures?
What are the rules for Medicare solicitors in the UK?
1 Do Not engage in door-to-door solicitations. 2 Do Not engage in telephone solicitations, including voice mails or text messages. 3 Do Not approach and solicit Medicare Beneficiaries in common/ public areas. 4 Do Not call expired Permission to Contact lists.
What is unsolicited contact in Medicare?
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.
In which of the following situations can telephonic contact be made with a Medicare eligible consumer quizlet?
In which of the following situations can telephonic contact be made with a Medicare eligible consumer? When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
Which of the following must you not do when marketing UnitedHealthcare Medicare?
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.
When can telephone contact with a Medicare eligible consumer be made?
When does Permission to Contact for Medicare Advantage and/or Prescription Drug Plans expire? Once contact is made or 9 months from the date the consumer provided permission (e.g. consumer signature date on BRC) or 90 days if on federal do not call list, whichever comes first.
Which of the following must a consumer have to be eligible to enroll in UnitedHealthcare SCO?
UnitedHealthcare Senior Care Options (UnitedHealthcare SCO) is available to people who are 65 and older. You must be entitled to Medicare Part A and enrolled in Medicare Part B and MassHealth Standard to enroll in our Medicare Advantage Special Needs Plan. You also need to live in the service area.
Which of the following makes it generally inappropriate to enroll members of the PACE program into a SCO plan?
Which of the following makes it generally inappropriate to enroll members of the PACE program into a SCO plan? They are very frail and moving to SCO would disenroll them from their PACE plan and change their care approach.
Which of the individuals below would not likely have the authority to enroll a consumer in a Medicare Advantage plan?
Which of the individuals below would not likely have the authority to enroll a consumer in a Medicare Advantage Plan? The consumer's spouse, who is neither a Power of Attorney or legal guardian.
What is an informal marketing sales event?
Informal marketing/sales events are conducted with a less structured presentation or in a less formal environment. They typically utilize a table, kiosk or a recreational vehicle (RV) that is manned by a plan sponsor representative who can discuss the merits of the plan's products.
When must a marketing sales event be reported to UnitedHealthcare?
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 contact permission guidelines?
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 the permission to contact form?
The Medicare Permission to contact form (goes by acronym PTC) is different than a scope of appointment. A PTC form allows you to contact the prospect via phone or in person. Cold calling prospects for Medicare Advantage and Medicare part D plans is a violation of CMS rules.
Can you enroll in Medicare on an outbound call?
Medicare beneficiaries may request to enroll in a plan over the phone when they make a call to you or during an outbound call from you.
What is CMS marketing?
CMS differentiates between two types of marketing materials; Those intended as Generic communication content and those intended for marketing specific plans by the Insurance Provider. It is important to understand the difference between the two.
Do you state which types of coverage options you can offer?
Do state which types of coverage options you can offer (i.e. MAPD, PDP, but not specific carrier plans) Do include any applicable disclaimers, such as “Not connected with or endorsed by the United State Government". The Do’s and Don’ts for Plan Specific Materials. Plan specific marketing materials can be used IF they have been approved by CMS.
Do all email communications include opt out?
However, all email communication must include the option to Opt-out. If you have a website, including rich information and content to attract online shoppers can help build your email list when they sign up for more information. Do use print media: This includes newspaper or magazine ads to market and generate leads.
Can you use plan specific materials if they have been approved by CMS?
Most Medicare Insurance Carriers will have pre-approved, plan specific materials you can access after you are contracted to sell with them. Do Not use any plan specific materials that have not been approved by CMS.
Can you advertise Medicare?
As a Medicare agent, you probably already know how many rules and regulations accompany Medicare, and marketing Medicare is no exception. Be sure you know what you can and cannot do to promote your services and the plans you’re are selling to stay compliant.
Is Medicare a business?
Marketing is essential for any business, and Medicare is no exception. Successful marketing can make your Medicare business flourish. With approximately 11,000 Medicare eligible people aging into Medicare EACH DAY, you should be marketing and letting current and future Medicare recipients know you can help them make informed decisions and sign up for a plan.
Can an agent hold a sales event immediately following an educational event?
Agents are now permitted to schedule and hold a sales event immediately following an educational event. The attendees must be made aware of a change from educational event to marketing event and given the opportunity to leave prior to the event beginning.
Can agents improvise their presentation?
Additionally, agents are allowed to improvise their delivery of the presentation and content they’d like to cover before accepting an application at a sales appointment. Now only “talking points” need to be submitted to CMS by the carriers, allowing agents the freedom to conduct a more interactive sales presentation.
Do emails have to be opt out?
However, the email must have an opt-out option in order to remain compliant. Additionally, the content of any unsolicited email cannot intend to steer a recipient into choosing or retaining a plan. A compliant email would promote your services rather than any specific plans.
Can an agent contact potential clients via email?
Due to a change reflected in the 2019 Medicare Communications and Marketing Guidelines (MCMG) and now updated in CFR 42, agents are permitted to make unsolicited direct contact with potential enrollees via email. However, the email must have an opt-out option in order to remain compliant. Additionally, the content of any unsolicited email cannot intend to steer a recipient into choosing or retaining a plan. A compliant email would promote your services rather than any specific plans.
Can I Use Direct Mail or Print Advertisements to Market Medicare Plans to Potential Enrollees?
Yes. The limits on direct contact to unsolicited Medicare prospects do not include conventional mail or other print media.
Can I Market Medicare Plans Door to Door?
Only in certain situations. You can leave information, such as leaflets or fliers, at a residence only if that contact was a no-show for a prescheduled one-on-one appointment.
Can I Make Cold Call Solicitations in the Lobbies or Other Common Areas of Facilities?
No. You cannot approach unsolicited enrollees in any common areas, including parking lots, hallways, lobbies, sidewalks, etc.
Can I Call or Text Potential Enrollees?
No. You may not use telephone calls, voicemail, or text messages to market Medicare plans to unsolicited enrollees.
What If a Potential Enrollee Calls Me First?
If a potential Medicare enrollee gives you permission to contact them, your response must be limited to their specific inquiry (think: Scope of Appointment) and not treated as open-ended permission for any future contact.
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.
Important Medicare Guidelines Update
Permission to Contact
- Every interaction with a potential client has a starting point. Due to a change reflected in the 2019 MCMG and now in the Medicare Advantage & Part D Communication Requirements, agents are permitted to make unsolicited direct contact with potential enrollees via email. However, the email must have an opt-out option in order to remain compliant. Add...
Scope of Appointment
- Scope of Appointment means just what it says. It’s a form outlining exactly what you’ll be presenting to a client during a meeting. The SOA ensures that potential enrollees will not be pitched plans other than those they originally requested. In 2018, the Centers for Medicare and Medicaid Services (CMS) removed the requirement for SOAs to be recorded 48 hours in advanc…
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. In the CMS MA & Part D Communication Requirements, CMS differentiates between materials that are considered “non-…
Events & Appointments
- The types of presentations you host throughout the year typically fall under one of three categories; educational events, sales events, and individual appointments. Educational events must be advertised as such and be designed to inform Medicare beneficiaries about the parts of Medicare in general. When holding an educational event, you: MAY: 1. Distribute educational ma…
Secret Shoppers
- Staying compliant should be a year-long objective for every agent. Annual Enrollment is the culmination of revised CMS Medicare Advantage & Part D Communication Requirements, new 2022 plans, and all kinds of potential enrollees, some of which could be secret shoppers. CMS secret shoppers measure quality of service and compliance with Medicare regulations as a way …
Websites
- Consumer-facing websites that promote a specific carrier or a group of carriers’ Medicare Advantage or Part D products must be submitted to CMS for approval. This is typically accomplished through the carriers. You may refer to the specific carrier’s policy regarding website review. CMS has increasingly cracked down on websites in recent years, so it’s important to be s…