When Does Permission to Contact (PTC) Expire
Purpose of Permission to Contact
Before we explore the question of “When Does Permission to Contact Expire,” it’s important to understand what it is and who it covers. When contacting current or future Medicare beneficiaries, brokers must stay on their toes. The Centers for Medicare & Medicaid Services (CMS) have published the Medicare Communications and Marketing Guidelines (MCMG) which governs the kind of language brokers and agents can use in informational and marketing materials. In addition, you must be very careful about when and how you contact beneficiaries.
On the nose, the guidelines set forth by CMS may seem rather strict. However, these rules were set in place because a few agents used unethical tactics to get people to sign up for prescription drug plans, along with other products. Some people reported feeling intimidated into agreeing to sign up for a specific plan, even though their doctors weren’t on it. Often the agent had a financial incentive for certain plans. Other beneficiaries were signed up for life insurance or other products without their knowledge. Ultimately, extensive guidelines were issued to protect seniors from misinformation, pressure tactics, and fraud.
What Does it Cover?
Specifically, the Medicare Permission to Contact (PTC) rule outlines when it is okay to contact a current or potential Medicare beneficiary, the specific products they are giving you permission to contact them for, how you can approach them, and when you can contact them.
How to Compliantly Receive Permission to Contact
According to MCMG Guidelines, agents must have permission before they can make marketing calls. Cold calling, canvassing door to door, and other activities are strictly forbidden.
How does an agent get that permission? Well, one way is for potential clients to fill out a Business Reply Card (BRC). Another way is for the beneficiary to email a Plan or Part D Sponsor and request a return call. Beneficiaries can also ask a customer service representative to have an agent contact them. It is vital that the beneficiary initiate the contact.
On the BRC, phone call, or email, the consumer will indicate what program they want information about. A client should indicate whether they want information on Medicare Supplements, Medicare Advantage, or both.
Once a beneficiary gives permission for an agent to contact them, the agent still has to be careful. The permission only covers a very small window of service. Specifically, beneficiaries can only be contacted by the entity they’ve requested contact from, and the agent can only discuss the products indicated on their BRC.
When Does the Medicare Permission to Contact Expire?
Now to answer the all-important question: “When does permission to contact expire?”. Well, it depends on what the scope of the appointment is for as indicated by the beneficiary.
For Medicare Advantage (MA) or Prescription Drug Plans (PDP), PTC expires 9 months after the date the request is received.
However, the PTC for Medicare Supplement products is 90 days.
It is important to note that the PTC must be renewed if it expires, even when ongoing contact is intended. In addition, the method of communication will be dictated by the beneficiary, (i.e. direct mail, phone call, email).
What About My Current Clients?
An agent may contact a client without PTC if one of these criteria are met and the burden of proof can be met:
- Current, active contract with another product (i.e. life insurance)
- Ongoing, active business relationship
- Agent of Record (AOR) for the beneficiary’s plan they are currently enrolled in.
Set Yourself Apart with PTC Compliance
Rather than thinking of the Permission to Contact as a silly and annoying rule, agents and brokers can present it so that they seem more trustworthy to potential clients. People get tons of unsolicited calls with pushy agents. Dozens of mailers arrive, some with very deceptive wording or images. When agents emphasize they want to make sure the beneficiary is only presented with information that is valued and desired, they set themselves apart.
If you would like to be better supported in compliance, find out more about our Agent Programs.