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 can an insurance agent help you review Medicare Advantage plans?
An agent can help you review which plans are available in your area and help you compare the costs, benefits, network providers and other important details of each plan. Call today to speak with a licensed insurance agent who can help you review Medicare Advantage plans and to find the best coverage for your needs.
Can I distribute materials with the Medicare Prescription Drug Benefit program Mark?
The license agreement is effective for a single contract year and plans must renew annually to continue using the mark. Unless otherwise approved, no individuals, organizations, and/or commercial firms may distribute materials bearing the Medicare Prescription Drug Benefit Program Mark.
Are your agents ready to sell Medicare products?
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. Q: What’s required of an agent to become certified? A: For each carrier an agent plans to market, the agent must complete that company’s annual certification process.
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.
What agency provides oversight for Medicare Advantage products?
The Centers for Medicare & Medicaid Services (CMS) is the agency within the Department of Health and Human Services (HHS) responsible for overseeing the Medicare Advantage (MA) program—Medicare's private plan alternative.
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.
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.
Who is the primary regulator for Medicare Advantage?
The private health plans are known as Medicare Advantage plans and are regulated and reimbursed by the federal government.
Who is responsible for the oversight of the facilities?
California state governmentCalifornia state government is responsible for the regulation and oversight of health care facilities through multiple agencies, departments, boards, bureaus, and commissions.
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...
Does CMS regulate Medicare Advantage plans?
The Centers for Medicare & Medicaid Services (CMS) released a regulation that clarifies the payment of compensation to agents and brokers who enroll beneficiaries in Medicare Advantage and Prescription Drug Plans. Copies of the new regulations and related documents can be downloaded from below.
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.
When marketing United Healthcare Medicare Advantage plans to consumers which of the following must an agent do?
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 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 are 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. Let's go into why you need to make this document, even if you're a smaller business, and how to go about doing it.
What is Medicare Advantage?
To prevent Medica re Advantage plans from providing misleading or even fraudulent information about a plan’s costs or benefits, the Center for Medicare and Medicaid Services (CMS) has published a set of regulations those marketing Medicare Advantage plans must follow. The regulations define what constitutes marketing activities and then define rules for various activities. Among the topics covered:
How much does a 1 star increase in Medicare Advantage mean?
An analysis by Navigant, for example, found that for plans with a 3 star or less rating, just a 1-star increase could lead to an 8 to 12 percent increase in enrollment. As a result, your organization must create a plan to optimize star ratings.
How loyal are seniors to Medicare?
According to a McKinsey survey, seniors are extremely loyal. The survey found 81% of Medicare customers 75 or older said they renewed their plans without shopping for a new one. 76% of 71 to 74-year-olds and 70% of 65 to 69-year-olds reported the same. For marketers selling Medicare Advantage plans, that loyalty can lead to the lifetime value ...
When is Medicare open enrollment?
The Medicare Advantage Open Enrollment period occurs from Jan. 1 to March 31 each year. Individuals enrolled in a Medicare Advantage Plan can switch to a different Medicare Advantage plan or original Medicare once in this period. These dates matter because they give timelines when your marketing will have the most impact.
What are the general communication requirements around anti-discrimination?
Among the topics covered: General communication requirements around anti-discrimination, referring to plans by standardized names, hours of operation requirements, prohibited terminology and statements, product endorsements and testimonials, and more.
Is Medicare Advantage a competitive market?
Entering the Medicare Advantage market can be a costly undertaking. Failing to create a realistic strategic plan and product roadmap in what is usually a competitive market anchored by the largest health insurers in the US may lead to less than favorable results.
Does Medicare Advantage have a lifetime value?
For marketers selling Medicare Advantage plans, that loyalty can lead to the lifetime value of Medicare Advantage members outpacing individual or group plan members. As a result, marketing Medicare Advantage plans can generate significant ROI for insurers. Here are some tips when marketing Medicare Advantage plans:
When do you have to review Medicare Advantage plans?
Review other Medicare Advantage plans during Open Enrollment. If you are enrolled in a Medicare Advantage plan and you wish try a different plan, you will have several weeks to review additional plans and enroll in a new plan during the Open Enrollment Period, also called the Annual Election Period.
What to consider when shopping for Medicare Advantage?
There are several things you may want to consider when shopping for a Medicare Advantage plan (Medicare Part C), such as plan cost, coverage and availability. You can get some help as you compare Medicare Advantage plans by using plan ratings and insurance company reviews.
What happens if a Medicare plan receives fewer than three stars?
If a plan receives fewer than three stars for three consecutive years, Medicare determines it to be a low-performing plan and reserves the right to remove it from its coverage. Current members of the plan will be notified and given a Special Enrollment Period to enroll in another Medicare plan.
What can an agent do for Medicare?
An agent can help you review which plans are available in your area and help you compare the costs, benefits, network providers and other important details of each plan. Call today to speak with a licensed insurance agent who can help you review Medicare Advantage plans and to find the best coverage for your needs.
Does Medicare Advantage have coinsurance?
Medicare Advantage plans may offer a variety of benefits that are not covered by Original Medicare , and these additional benefits can differ from one plan to the next.
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 use Medicare on a Social Security 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.
What is CMS marketing?
CMS defines “communications” and “marketing” in the CMS Medicare Communications and Marketing Guidelines. Agents need to be aware of the differences between the two terms. All 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 ...
What do Medicare agents do?
Agents create and use a variety of materials to advertise that they sell Medicare products such as Medicare Advantage and Part D products. These include, but are not limited to, letters, postcards, posters, brochures, scripts, radio and television ads, billboards, banners, signs, yellow page ads, church bulletin ads, ...
Do insurance agents need to have a business page?
Most carriers require that the agent set up a business page on social media rather than use their personal page. Agents CAN list the name and address of their business and indicate the type of products offered (e.g., Medicare Advantage, Prescription Drug Plans, Medicare Supplement insurance plans, etc.) offered.
Can you use your name on Medicare Advantage?
Note: Medicare Advantage and Prescription Drug Plan carriers may allow the use of their logo or name in certain circumstances such as on websites, but agents must get carrier approval first.
Can agents post on social media?
Agents should not post or link to any plan sponsor, carrier brand/logo or plan or product names, or any branded marketing materials via social media sites because this would be considered marketing and require filing with CMS. There are a few other limitations to keep in mind regarding unsolicited contact:
Do you need carrier approval for a listing?
If you are listing carrier names or logos, you need carrier approval, and response time is often long and tough to get. Identify yourself as an insurance agent or independent insurance agent. Do not give the impression that you are connected, endorsed or accredited by the state or federal government.
Do insurance agents have to be compliant with CMS?
Agents still have to be otherwise compliant with CMS rules. (Examples of this would be to clearly identify to the Medicare member that you are a licensed insurance agent/broker, and include the recommended disclaimer: “Not connected with or endorsed by the United States government or the federal Medicare program.”).
