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MEDICARE BASICS

Transparency in Medicare Marketing

by Ken Williams

04 Oct 2023

As Medicare’s Annual Enrollment Period (AEP) approaches, consumers must be aware of the Medicare Marketing Guidelines to make informed decisions and protect themselves from deceptive or non-compliant marketing practices. This article aims to highlight the crucial aspects of these guidelines, shedding light on what Medicare agents can and cannot do during the AEP.

The Importance of Medicare Marketing Guidelines

The Centers for Medicare & Medicaid Services (CMS) has established the Medicare Marketing Guidelines to ensure the protection of Medicare beneficiaries. These guidelines are in place to create a level playing field, prevent misleading information, and protect the rights of beneficiaries.

What Medicare Agents CAN Do:

  • Provide Information: Agents can give out informational materials about Medicare Advantage, Prescription Drug Plans, or other Medicare-related products.
  • Schedule Appointments: If you express interest, an agent can schedule a future appointment.
  • Host Educational Events: Agents can hold educational events to inform beneficiaries about Medicare. However, these should not include any sales activities or be coercive in nature.
  • Provide Enrollment Forms: If you express interest, agents can provide enrollment forms.

 

What Medicare Agents CANNOT Do:

  • Conduct Unsolicited Contacts: Agents cannot contact you unless you’ve given them permission. This includes unsolicited emails, calls, or home visits.
  • Offer Gifts: Agents can’t offer you gifts to entice you to enroll in a particular plan. They can, however, offer gifts of nominal value (as defined by CMS) to potential enrollees regardless of whether they enroll.
  • Misrepresent Information: Agents cannot provide false or misleading information. They should not exaggerate potential benefits or make unsupported statements.
  • Conduct Sales at Educational Events: Agents cannot conduct sales activities, like distributing and accepting enrollment forms, at educational events.
  • Cross-sell non-health-related products: During a sales or marketing presentation, agents cannot try to sell you non-health-related products, such as life insurance or annuities.
  • Employ Pressure Tactics: They cannot exert pressure or use aggressive tactics to force you into making decisions. You should never feel rushed or pushed.

 

Protecting Yourself: Best Practices

  • Know Your Rights: Familiarize yourself with Medicare’s guidelines and understand what agents can and cannot do.
  • Stay Informed: Before making decisions, always ensure you have the right information. Refer to the official Medicare website or trusted sources for any clarifications.
  • Report Suspicious Behavior: If you believe an agent is not following the guidelines, report them to CMS or your local State Health Insurance Assistance Program (SHIP).
  • Seek Guidance: If in doubt, always seek advice. Ask Claire can assist if you’re unsure about any part of the enrollment process.
Claire's Perspective

CLAIRE’S PERSPECTIVE

Being informed is the key to protecting yourself during Medicare’s AEP. Familiarize yourself with the guidelines, remain vigilant, and report any suspicious behavior. After all, the primary goal is to ensure you get the best healthcare coverage suited for your needs without undue pressure or misleading tactics.

Sources:
  • Centers for Medicare & Medicaid Services. (Last Updated 2022). “Medicare Marketing Guidelines.” CMS.gov.
  • Medicare.gov – The official U.S. government site for Medicare.
  • State Health Insurance Assistance Programs (SHIPs). Find your local SHIP at shiptacenter.org.

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