10 Medicare Compliance Tips for 2019 AEP

Oct 21, 2019

Starting October 15, you have two months to sell Medicare Advantage and Supplement plans to eligible baby boomers during the 2020 Medicare Annual Election Period (AEP).

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

This post has been updated from 2016.

10 Medicare Compliance Tips for 2020 AEP

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 (section 30.7, page 6). $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 (Section 40.3, page 9). Instead, simply give out your business card.
  3. “I post about the best plans on my Facebook page. You should follow me.”This would be considered pushy and misleading language. Per section 70.3 (see page 20), all your social media posts (like all other Medicare marketing communications) must be submitted to and approved by HPMS—which helps ensure your online brand 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 at an appointment.
  5. “We’re offering gifts for new plan enrollees!”You can market rewards/incentives in your marketing materials, but you may never exchange anything for plan enrollment, or provide gifts selectively. See the guidelines under section 40.8 (starting on page 12) for more details. Get a good understanding on what nominal gifts are under section 40.4 on page 10.
  6. “I’m endorsed by Medicare.”You can never claim to work for Medicare or be endorsed by Medicare/CMS in any way. This should be made clear to the beneficiary. Refer to section 30.7 on page 6.
  7. “Come to my sales event for a free meal.”Meals are permitted at educational events only. You can never offer meals during your sales events. One or two light snack options are okay, so long as they can’t be combined to create a meal. See section 40.5 on page 10 for more on meals.
  8. “You have to sign in at my event.”Sign-ins at events are never required. In fact, your sign-in sheet must clearly that sign-ins are completely optional (See section 50.2 on page 13).
  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. This is also mentioned on page 13 of MMG.
  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). See section 60.4 (starting on 16) for more on how to properly conduct Medicare sales and marketing activities.

Medicare Compliance Tips

No agent wants to get dinged with a CMS complaint or allegation.

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

Don’t forget your two best tools on Medicare compliance:

2019 Medicare Marketing Guidelines

2020 Medicare Marketing memo (these are the changes to know for this year; remember—CMS is not providing an updated MMG document this year)

Contact Us

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

Oct 21, 2019 | | 0 comments

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