CMS Guidelines Are Changing–Here’s What Agents Need to Know
For Medicare insurance agents, marketing is about more than generating new business. Your goal is also to connect seniors with the plan best suited to meet their health needs. And since communicating clear, factual information is essential, the Centers for Medicaid & Medicare Services (CMS) periodically publishes new marketing guidelines.
The guidelines for 2024 are soon to be released, and while they’re still being finalized, now is the time to start familiarizing yourself with the updates. Preparing for the changes now means you’ll be ready to start making potential adjustments for your clients and know how to accurately answer their questions.
As always, the latest CMS guidelines for marketing are designed to protect beneficiaries and weed out bad actors in the Medicare insurance space. Staying current with your knowledge of the guidelines protects your reputation as a caring, professional Medicare agent.
Oversight of communications
Third-party marketing organizations (TPMOs) require oversight. Soon, materials advertising a single carrier will need to be submitted directly to the Health Plan Management System (HPMS) by that carrier. Materials advertising multiple carriers should be submitted to HPMS by the TPMO.
Additionally, there are some changes to the guidelines around Scope of Appointments.
Previous guidelines required you to record all calls with clients and prospective clients. The updated set of rules has more specific requirements for call recording. Moving forward, you’ll need to record
- marketing calls,
- sales calls, and
- enrollment calls.
If you take calls via video conferencing software, only the audio portion needs to be recorded.
Medicare and CMS logo
The latest guidelines prohibit marketers from using the logo, name, and products of Medicare and CMS to mislead individuals seeking coverage. This means you have to clarify that your marketing materials aren’t actually coming from Medicare or the federal government.
If you want to use an image of the Medicare card in your marketing materials, you’ll need authorization from CMS. Details on how this approval process will work are pending.
So what exactly should you avoid? Essentially, your marketing materials can’t look like they’re direct correspondences from Medicare or the federal government. Include information about yourself on the materials, and don’t use the word “Medicare” in your name.
Use of disclaimers
There are also new required disclaimers for TPMOs, and the right one for you depends on whether you sell some or all carriers in your service area.
The new disclaimer for those TPMOs who do not sell all carriers in a service area is as follows:
We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
The new disclaimer for those TPMOs who do sell all carriers in a service area is as follows:
Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.
No unsubstantiated statements
Your marketing materials for Medicare need to have data backing up any claims you make. If you’re advertising a plan as being the highest-ranked you need to show a survey indicating those rankings. The documentation and data do have to be from the previous year and can appear in footnotes.
Restrict advertising to your service area
The latest guidelines also instruct your agency to direct your marketing efforts to prospective clients in your actual service area. Don’t advertise benefits in places where clients can’t access them!
The exception to this is if you are advertising through media (such as a newspaper) whose area of distribution is wider than your service area. Your marketing materials should also present the full range of possible benefits, not just the highest amount.
Keeping up with CMS Guidelines
Staying within the guidelines of CMS is crucial—but keeping up with the latest updates can be overwhelming. We’re here to help. For questions about the new Medicare marketing and communications guidelines, contact Financial Grade today.
image credit: shutterstock/Bapi Ray
