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Medicare Marketing Guidelines for Medicare Advantage

Medicare and Medicare-related plans can seem complicated. Add in an insurance agent who may want to sell additional products or is recommending you change plans, and it can be hard to tell what's approved by Medicare and what's not. That's why the Centers for Medicare & Medicaid Services has put guidelines in place to control when and how Medicare Advantage plans are sold. Agents must comply with these guidelines or face serious consequences, including investigation by their state insurance department and possible loss of their license.

  1. Marketing Materials

    • All the materials used by a company, or plan sponsor, offering Medicare Advantage plans must be approved by Medicare. Any sales materials that are developed and used by agents and use plan-specific information must be approved by the plan sponsor. Generic, general materials don't need to be approved by the plan sponsor. If you're uncertain, it's best to submit materials for review to your plan sponsor. You should also be cautious about how you use Medicare's name in materials you create yourself; Medicare is restrictive in how its name can be used in order to protect consumers from fraud.

    Sales Appointments

    • Medicare prohibits cold calls or visits. You or your company can mail Medicare-approved sales materials, though. If you collect names from a marketing event, carefully document the date of the contact. You can contact your own clients and the clients of the company you represent. During a Medicare Advantage appointment, you can only discuss Medicare Advantage related materials -- no other products. You must have a "scope of appointment" form filled out for any Medicare Advantage appointments; there is a mandatory 48-hour waiting period between when the form is filled out and the actual sales appointment.

    Seminars and Public Events

    • At seminars and other public events where you provide plan-specific information, you can have promotional items available, but they have to be available to everyone, regardless of whether they enroll in your plan. You can't give away cash or cash equivalents like lottery tickets or gift cards. There is also a limit to the value of items you can give away; in 2010, it was $15. You also can't provide meals, but you can provide light refreshments, like fruit, cookies and juice. You can provide meals if your event is educational. Medicare strictly defines that as an event where you do not discuss plan specific information at any point. You can't conduct either type of event in a health care setting.

    Agent Education

    • All companies that offer Medicare Advantage plans must provide agent training annually. Medicare provides some training materials; there may be additional materials through your state or company. Medicare piloted a standardized educational program for insurance agents in 2009 in hopes of improving compliance with marketing guidelines.

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