Insurance Regulatory Insights

Medicare AEP 2025 is only 20 days away!

Today, we are sharing some helpful tips to keep your marketing compliant during AEP.

When creating marketing material or planning a campaign for Medicare Advantage or Part D, remember:

Marketing Content

• Marketing or communication material mentioning any benefits available to a Medicare beneficiary, including dental, vision, or hearing, must be submitted to HPMS through a carrier or TPMO

• Benefits cannot be marketed in a service area where not available, except if benefits are advertised in local media where distribution across plan service areas is unavoidable

• Clearly indicate you are not affiliated with or endorsed by the Federal Medicare program or government

• Include the names of the Medicare Advantage organization(s) or Part D sponsor(s) whose plan, benefits, or costs are being represented

• Cannot describe potential savings an enrollee could experience by enrolling in a Medicare Advantage or Part D plan when compared to an uninsured beneficiary

• Websites and social media are governed by the same marketing rules as print material

Beneficiary Contact/Sales

• Unsolicited contact allowed: direct mail, print advertisements, email

• Unsolicited contact not allowed: cold-calling, text messages, door-to-door solicitation, solicitation in common areas

• Get express consent (permission to call/contact) before contacting beneficiaries

• Scope of Appointments must be obtained 48 hours prior to a marketing appointment and must list all products to be discussed

• Cannot offer gifts to beneficiaries unless they are of nominal value

• Record all marketing and enrollment calls (TPMOs)

Source: Medicare Communications and Marketing Guidelines (MCMG)

Telos Actuarial’s team of experienced regulatory compliance professionals are ready to help YOU stay informed of legislative and regulatory changes.

Contact us to learn more!