10 Medicare Compliance Tips for 2022 AEP

Sep 23, 2022

Starting October 15, you have two months to sell Medicare Advantage and Supplement plans to Medicare eligibles during the 2022 Medicare Annual Enrollment Period (AEP).

How ready are you to build your pipeline of leads? Let’s revisit the basics with some things to leave out of your upcoming Medicare marketing and communications.

This post has been updated from 2019.

10 Medicare Compliance Tips for 2022 AEP

Medicare Marketing and Communications guidelines (MCMG) are there to help outline what’s acceptable and unacceptable when marketing your services and selling plans. Here are 10 things to never say in Medicare sales and marketing to remain CMS compliant:

  1. “Free premiums!” When it comes to Medicare sales, take “free” out of your vocabulary—because it’s never 100% accurate. $0 premiums and copays usually only pertain to specific areas and plans, and they are not free. It’s vital to never generalize a plan or use misleading language (such as, “this plan is the best”) that can confuse the beneficiary.
  2. “Is your spouse eligible for Medicare? Why don’t you give me their number so I can call them?” It’s okay to ask for referrals, but only for their names and mailing addresses. Instead, simply give out your business card and ask that they have their reference reach out to you at their convenience.
  3. “I post about the best plans on my Facebook page. You should follow me.” This would be considered pushy and misleading language.  All your social media posts, which advertise Medicare products, (like all other Medicare marketing communications) must be submitted to and approved for compliance—which helps ensure your advertising remains squeaky clean!
  4. “If you like this plan, you should hear about this life insurance plan.” An agent can’t cross-sell insurance products or sell non-health related products to their Medicare clients during the same appointment.
  5. “We’re offering gifts for new plan enrollees!” You can advertise rewards/incentives in your marketing materials, but you may never exchange anything for plan enrollment, or provide gifts selectively.
  6. “I’m endorsed by Medicare.” You can never claim to work for Medicare or be endorsed by Medicare/CMS, or the government in any way. This should always be made clear to the beneficiary.
  7. “Come to my sales event for a free meal.” Meals are permitted at educational events only. You can never offer meals during sales events. A light snack option is okay, however, it’s best to stick to one item like a muffin, or slice of pie,so items cannot be  combined and considered a meal.
  8. “You have to sign in at my event.” Sign-in sheets at events are never required. In fact, your sign-in sheet must clearly state that signing in is completely optional.
  9. “Let me get your contact info so you can come to my event.” You cannot require potential clients or people interested in your event to provide any contact information in order to attend.  The good news is that same-day scope of appointment forms are compliant in all cases since 2018.
  10. “While you’re waiting for your doctor, let me tell you about your Medicare options.” Insurance brokers can never conduct sales and marketing activities where beneficiaries receive their health care services including waiting rooms, exam rooms, treatment centers and pharmacies.

Medicare Compliance Tips For Insurance Agents

No agent wants to get dinged with a CMS complaint or carrier allegation (and trust us – the secret shoppers are watching!). In addition to knowing the Medicare Marketing and Communication guidelines, keep careful records of your contacts, record your calls as required, report required  events, and ensure the marketing used to promote your services is always compliant. Be transparent when selling. Use the most accurate data. And most importantly – always consider your client’s experience and needs above the sale.

Keep Medicare compliance top-of-mind by subscribing to our blog for agent resources, and following us on social (LinkedIn, Facebook, and Instagram) for more Medicare compliance tips as we continue through AEP.

In the meantime, you can always reach out to AGA for specific questions on Medicare compliance by filling in the form on this page:

Sep 23, 2022 | | 0 comments


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