2019 has some big changes to the Medicare rules, including now calling them the Medicare Communications and Marketing Guidelines (as opposed to the Medicare Marketing Guidelines).

3 Major changes quick review:

  • You can now email market to unsolicited contacts
  • Open Enrollment Period is back but you cannot advertise it
  • Agents can set appointments and distribute business cards/contact info at educational events

Below are some key areas for agents to know going into AEP and beyond:

40.2 – Marketing Through Unsolicited Contacts

Plans/Part D Sponsors may make unsolicited direct contact with potential enrollees using the following methods:

  • Conventional mail and other print media (e.g., advertisements, direct mail)
  • Email provided all emails contain an opt-out function

Plans/Part D sponsors may not:

  • Use door-to-door solicitation, including leaving information such as a leaflet or flyer at a residence;
  • Approach potential enrollees in common areas (e.g., parking lots, hallways, lobbies, sidewalks, etc.); or
  • Use telephonic solicitation, including leaving electronic voicemail messages.

Note:

  • Agents/brokers who have a pre-scheduled appointment with a potential enrollee who is a “no-show” may leave information at that potential enrollee’s residence.
  • If a potential enrollee provides permission to be contacted, the contact must be event-specific, and may not be treated as open-ended permission for future contacts.

40.3 – Marketing Through Telephonic Contact

Plans/Part D sponsors and their agents/brokers may not make unsolicited telephone calls to prospective enrollees. However, they are permitted to contact their current enrollees to discuss plan business, but cannot market prior to October 1 under the pretense of plan business.

40.7 Prohibition of Open Enrollment Period Marketing

During the OEP, Plans/Part D Sponsors may not:

  • Send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP
  • Specifically, target beneficiaries who are in the OEP because they made a choice during Annual Enrollment Period (AEP) by purchase of mailing lists or other means of identification
  • Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales
  • Call or otherwise, contact former enrollees who have selected a new plan during the AEP

50.1Educational Events

May set up a future marketing appointment and distribute business cards and contact information for beneficiaries to initiate contact

110.2 – Permitted Agent Activities

Permitted activities include, but are not limited to:

  • Conducting sales presentations;
  • Holding one-on-one sales appointments with potential enrollees;
  • Providing business reply cards at educational events;
  • Creating and distributing communication materials. As outlined in section 90.1, broker-created communications do not require a material identification number;
  • Distributing marketing materials as long as CMS has accepted/approved those materials as submitted through the Plan(s)/Part D sponsor(s) with whom the broker contracts; and
  • Using CMS-created materials provided the materials are not modified in any way.

Download the full Medicare Communication and Marketing Guidelines:

https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/FinalPartCMarketingGuidelines.html

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