We are in the process of retroactively making some documents accessible. LEARN WHAT WE HAVE TO OFFER HERE. Chapter 3. Medicare Marketing Guidelines. EJ+QTEEJ+QtE mU|9"TavkY pUqF`%l]7 >m! "N E{8Q*~gc{;Cu6c8CVjm/i~e?]3t1. Full commission (directly from the carriers) and no minimum production needed to start. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423). lock The site is secure. On October 8, 2021, CMS released guidance regarding third-party marketing to Medicare Advantage organizations. endstream endobj 563 0 obj <>stream Federal government websites often end in .gov or .mil. Stay up to date with Medicare Marketing Guidelines by attending our Medicare Training Series live events! The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 2 0 obj Secure .gov websites use HTTPSA g9fT'MzhrUJ"%$%*%\3j=)#|l_G___|~u,u*52 ]G'co%:lO>mVXIWc#$P1+/24 Marketing Guidelines MCS Improving or Maintaining Mental Health MedPAC Medicare Payment Advisory contract year 2021 and 2022. endobj The most recent memo from CMS is available below through the link. They are educational events, sales events and individual appointments. incorporated into a contract. This section includes standardized outreach and educational material for Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and 1876 Cost Plans. The Guidelines are for use by Medicare Advantage Plans (MAs), Medicare Advantage Prescription Drug Plans (MA-PDs), Prescription Drug Plans (PDPs) and 1876 Cost Plans. In addition, we are also providing clarification to the existing guidance. On January 19, 2021, CMS issued a final rule entitled Medicare and Medicaid Programs; Contract Year 2022 Policy and Technical Changes to the Medicare Lets say that your ideal client likes to listen to carol singers during the holidays, as a content creator, you could potentially create your very own festive song that describes your business and all the services you provide (health insuranc. Are you contracted with Ambetter yet? The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. WebMarketing rules for Medicare plans People representing Medicare plans aren't allowed to: Ask for your personal information (like your Medicare, Social Security, bank account, or credit card numbers) over the phone unless its needed to verify membership, determine enrollment eligibility, or process an enrollment request. 36>=#n!9OB2J{k+ye|8exK2rTx6>#8g-o,.@L [ZGkhyGGGCZ[^;85M L`P83p2@A >(d'X(^`ocTcdPs`/;5Auscv|]B8Uj7g6````>nH "y g` c? During a sales event: Sales events are an attempt to steer someone into a specific plan. Your email address will not be published. endstream endobj startxref In the fall of 2017, CMS launched the Patients over Paperwork initiative. Free should also not be included in any description of part B premium, part B reduction plans or dual eligible status. Marketing Communications Guidelines while the proposed changes noted above are both welcome and necessary, CMS should reverse the significant changes to the guidelines that have weakened protections in recent years, and add new requirements; for example, as noted above, CMS should: Rescind rules weakening marketing v. educational 219 0 obj <>stream Washington, D.C. 20201 Starting January 1, 2023, Ambetter Value plan members can access providers in the below list for all medical needs. Sign up to get the latest information about your choice of CMS topics. Agility Insurance Services, LLC. 1 Most people who write articles haveRead more, Your email address will not be published. CMS considers communications and marketing to be two different things. However, the does need to have an opt out option in option to be compliant. <> The Department may not cite, use, or rely on any guidance that is not posted x]nI}7\E23w=DHgs3"(JY'%PNFfV{g>7vu}6ULTugO'w~O]}'??.9{O~U5{`nv.!UMZ1C(=kUUh1/_f^J|giqT_^.'Z_. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Access to all major carriers with the ability to compare plan benefits and prescription drug costs. X;/?~I(A@%EOMG1Rc9 5:E[0n8 They cannot include plan specific information and cannot be intended to steer someone towards a specific plan. Guidance for this document can be located at https://www.cms.gov/Medicare/Health-Plans/Managed Care Marketing/Final Part C Marketing Guidelines. You need a scope for any type of sales event. The federal regulation at 42 CFR 438.104 defines marketing as any communication, from an [Medicaid managed care plan] to a Medicaid beneficiary who is not enrolled in that entity, that can reasonably be interpreted as intended to influence the beneficiary to .gov We provide agents with their own compliant website through Connect4Medicare. WebCMS COVID-19 Reporting Requirements for Nursing Homes June 2021 [PDF 300 KB] CMS Press Release: CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 [PDF 400 KB] CDC and CMS Issue Joint Reminder on NHSN Reporting In addition, an email should not be intended to steer someone into a specific plan. You can decide how often to receive updates. WebAll MA communication and marketing regulations and guidance issued by CMS, as well as other applicable laws, continue to apply to materials and activities of participating sH2jy + a&@GJh& +%V,fpt!9'cfO+Ip|L2\1 Agents are still not able to make unsolicited contact to prospects for MA, MAPD or PDP by phone or in person in common areas. At that time, any new medical sales commissions due will be paid, starting from the first 2023 application. Medicare Open Enrollment Period Click Here, For the rules of educational events click here, CLICK HERE TO LEARN ABOUT OUR FREE LEAD PROGRAM. incorporated into a contract. 'j0"0",NG)1p8i{^h38R ur@msO;F$A$gOyOOr[{YxqyIJ. Overall, the holiday season seems to bring joy and family unity around the world. WebChapter 3 Medicare Marketing Guidelines For Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and 1876 Cost plans The guidelines allow organizations offering both Medicare Advantage and Prescription Drug Plans the ability to reference one document when developing marketing materials. including individuals with disabilities. or or Ambetter Value plans are available in: Broward, Clay, Duval, Hillsborough, Lake, Miami-Dade, Orange, Osceola, Palm Beach, Pasco and Seminole counties. In fact, two of the plans will beRead more, Medicare Leads Available At No Cost Note: Our blog: Medicare Leads Available At No Cost program has been changed. Model marketing materials include: the standardized Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) templates and instructions, ANOC/EOC Errata, and Provider Directory. As part of CMS implementation of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS has revised the Medicare Marketing Chapter to include the latest provisions in the current guidance. Director, Medicare Drug Benefit and C & D Data Group. American Progressive Medicare Contracting, Teladoc, Lasik Vision Correction, Discount Dental,Vision,Rx Sales Contract, Medicare Advantage vs Supplement Plans Sales, Free Medicare Lead Program (Turning 65/Med Supplement Leads), https://attendee.gotowebinar.com/recording/2899290519088332033, Report the event prior to conducting and advertising it, You can distribute and collect applications, Call attendees from the sales event if they provided permission to contact (Gave you a PTC card or flyer), You cannot offer meals. /0U4,P9L&009 =\.gi'Jo-=5I9)zwf?PGsr oom0\jd Z.F kD db3u2 lock 189 0 obj <>/Filter/FlateDecode/ID[<731268243A464E09A5CB70A201055789>]/Index[159 61]/Info 158 0 R/Length 118/Prev 733811/Root 160 0 R/Size 220/Type/XRef/W[1 2 1]>>stream Sales events, on the other hand, are designed to steer, or attempt to steer potential enrollees towards a limited set of plans. t18:14Xw8zxs View the model marketing materials in the Downloads section below. An official website of the United States government. Cigna just announced their 2023 ACA commission schedule! Medicare Marketing Guidelines For Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, Employer/Union-Sponsored Group Health Plans, Medicare-Medicaid Plans, and Section 1876 Cost Plans. Qu4 8q ]8!FaO6{dB>8ws#%=MK%E,E*e*!*O|?Q4RRRRSiRiS]O8kgn^0N.iP~3nOF"FD"yza4={ o?l)$Fq\xH*QDEl IU%QJ(D* Heres how you know. Medical commissions will be paid for up to four children on the plan. Simply sign another scope documenting those products and continue the appointment. %%EOF Agents are now able to make unsolicited contact with a prospects for MA, MAPD and PDP via email. website belongs to an official government organization in the United States. authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically Same day scopes of compliant. Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. You are able to start taking/submitting applications on October 15th. WHY WORK WITH US? WebThe Medicare Advantage (MA) and Part D Marketing and Communications (MCMG) provides the marketing and communications requirements for Medicare Advantage (MA) plans, Secure .gov websites use HTTPSA It should focus more on promoting your services and general information about Medicare. Each year CMS and states participating in the Financial Alignment Initiative (FAI) jointly update state-specific marketing guidance and model member materials required for use by Medicare-Medicaid Plans (MMPs) and Minnesota Senior Health Options (MSHO) Plans. To sign up for updates or to access your subscriber preferences, please enter your contact information below. CLICK HERE TO ACCESS MEDICARE MARKETING CMS MCMG MEMO. _n("<>E$mmZ4i57c]8~89jMJ0SL8,4B`i(e Any website CMS considered marketing must be submitted for review and approval through the Health Plan Management System (HPMS). Manages the alignment of MOAAs ) If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov. We have tried to list the more common questions and aspects of the guidelines below. We can expect to see Christmas decorations just about everywhere. U.S. Department of Health & Human Services Lastly, prospects can enroll through the site into any of the plans you are certified to offer. CMS replaced the models that were previously posted on this website to reflect the OMB approval number and expiration date. } This means that all marketing materials must be clear, and accurate, and not promote any plans inappropriately. Before sharing sensitive information, make sure youre on a federal government site. Schedule marketing appointments immediately after the meeting You cannotdo the following: Require anyone to sign on or provide contact information Hand out or take applications or other plan specific information- (This is a marketing event) Give away cash prizes Provide or take enrollment forms Discuss carrier specific information Provider Medicare Training & Marketing Guides | Health Net Skip to Main Content Healthnet.com uses cookies. An official website of the United States government SOAs are needed for every face to face meeting. What if a client would like to talk about additional or different products? Commissions will be paid on posted premiums applied to the agents or agencys clients eligible cases. For information on the Medicare Open Enrollment Period Click Here. Guidance for Pace marketing guidelines and marketing requirements and related provisions of the Programs of All-inclusive Care for the Elderly (PACE) rules (Chapter 42 of the Code of Federal Regulations (CFR), Part 460 (See Appendix 1 for a list of related laws and regulations). means youve safely connected to the .gov website. The .gov means its official. The seminars will be not only in Westchester and Putnam but also Dutchess counties. And dont get me started on the unofficial holiday song that was released back in 1994 (yes, we are talking about Mariah Careys single: All I want for Christmas is you). You can decide how often to receive updates. Among the salient points: Medicare Advantage Organizations are responsible for first tier, downstream or related entities (FDRs) adherence to all terms and conditions of the organizations contract with CMS Stay away from using any absolute statements on materials or during presentations. They are educational events, PTC forms can now be used for more than one enrollment period. In other words, if you are talking Medicare with someone get a scope. HXUJjz9"UQM`v$,VT,]Xh"N`%J5.rEJj`= #Ba.2EJjUHql.D`.^b1:eV=}oK/{7*v>GcxlLtttoN|,ty0wt6M[d1a.HqE2_4Emc"dRx9xz0}/h@c/4d"OM x>4iKnfqp)utAzcl(sZvtx^ https:// Sign up to get the latest information about your choice of CMS topics. The site is specific and codded to you the agent. Dental Insurance Commissions The dental commission structure pertains to business with effective dates of 1/1. 698 0 obj <>stream Cigna just announced their 2023 ACA commission schedule! Heres how you know. %PDF-1.7 % ) ( (You can offer meals at educational events), Avoid absolute statements This is the best Medicare Advantage plan, You must have a sign in sheet but cannot require anyone to sign in. Secure .gov websites use HTTPSA The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423). Click for updated Medicare Lead Program Free Medicare Lead Program (Turning 65/Med Supplement Leads) We have made some changes toRead more, How To Start Selling Medicare Insurance How To Start Selling Medicare Insurance: There are a number of articles on the web advising How To Start Selling Medicare Insurance. All Rights Reserved. lock 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare-Medicaid Plan (MMP) Marketing Information & Resources, List of Covered Drugs - English & Spanish, Provider and Pharmacy Directory - English & Spanish, Medicare-Medicaid Plan (MMP) Application & Annual Requirements, Medicare-Medicaid Plan (MMP) Reporting Requirements, Medicare-Medicaid Plan (MMP) Audit Programs, Medicare-Medicaid Plan (MMP) Encounter Data Reporting, Medicare-Medicaid Plan (MMP) Quality Withhold Methodology & Technical Notes, Medicare-Medicaid Plan (MMP) Chronic Care Improvement Programs & Quality Improvement Projects, CY 2023IllinoisMMP Model Materials Memo (PDF), CY 2023Illinois MMP Marketing Guidance (PDF), CY 2023 MassachusettsMMP Model Materials Memo (PDF), CY 2023Massachusetts MMP Marketing Guidance (PDF), CY 2023 Michigan MMP Model Materials Memo (PDF), CY 2023Michigan MMP Marketing Guidance (PDF), CY 2023Minnesota Plan Model Materials Memo (PDF), CY 2023Minnesota PlanMarketing Guidance (PDF), CY 2023 New York FIDA-IDD MMP Model Materials Memo (PDF), CY 2023New York FIDA-IDD MMP Marketing Guidance (PDF), CY 2023 Ohio MMP Model Materials Memo (PDF), CY 2023Ohio MMP Marketing Guidance (PDF), CY 2023 Rhode Island MMP Model Materials Memo (PDF), CY 2023Rhode Island MMP Marketing Guidance (PDF), CY 2023 South Carolina MMP Model Materials Memo (PDF), CY 2023South Carolina MMP Marketing Guidance (PDF), CY 2023 Texas MMP Model Materials Memo (PDF), CY 2023Texas MMP Marketing Guidance (PDF), Explanation of Benefits - Integrated & Drug-Only, Provider& Pharmacy Directory - English & Spanish, Annual Notice of Change - English & Spanish, Explanation of Benefits (EOB) - Drug Only & Integrated, Annual Notice of Change - English& Spanish, Explanation of Benefits (EOB) - Drug Only, Integrated Coverage Determination Notice (ICDN) Models, Provider & Pharmacy Directory - English & Spanish. on the guidance repository, except to establish historical facts. Medicare Marketing Guidelines Marketing Models, Standard Documents, and Educational Material This section includes standardized outreach and educational material Under the new CMS guidelines, agents selling Medicare Advantage plans can no longer use promotional materials that could mislead, confuse, or exaggerate the benefits of their plans. WebHealth Net Medicare providers can review training and marketing guidelines to ensure services and coverage determinations are accurate. Please contact, on American Progressive Medicare Contracting. Plans may now contact The .gov means its official. https:// An official website of the United States government. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription (SOA) The PTC is used to start contact with a prospect. Agents and brokers must record all calls (inbound and outbound calls) in their entirety, including calls to inform or educate clients about the event, as well as any post-event discussions. hbbd``b`>$ &$ .+ bX1 $"pH, $")s@Lz@`!3u>0 '` Download the Guidance Document Final Issued by: Centers for Medicare & Medicaid Services (CMS) Issue Date: January 01, 2020 HHS is committed to making its But how is this fact going to help you sell more health insurance? Better to have one every time to be safe. zCW`W- d%c@4F&4VXL`w dPO[ I)i61e$EI 2f=!z6"lqr endobj This post will outline two of the moreRead more, Medicare Advantage vs Supplement Plans Sales As you can see in this post, Medicare Advantage vs Supplement Plans Sales have a few differences. Share sensitive information only on official, secure websites. Medicare Marketing Guidelines 2021: Types of events and appointments Meetings and presentation fall under one of three categories. The Vice President of Communications oversees the organization's communications, editorial, media, design and advertising sales functions to produce a wide range of high-quality, accessible and compelling communication products and content for a diverse set of member and external audiences. The Centers for Medicare & Medicaid Services (CMS) received OMBs approval for the latest ANOC and EOC models through 12/31/21. The Medicare Marketing Guidelines 2021 are the same as the 2020 MCMG. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); With licensed sales professionals in both the investment and insurance fields, the experienced and knowledgeable team at Crowe & Associates can tend to your various needs. H\n@yL. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423). Sign up to get the latest information about your choice of CMS topics. stream The purpose of the SOA is to ensure you will not be discussing products with the client/prospect other than those chosen prior to the appointment. pgA +tKe.hT+mqOi^Ef(V: 09\O^]S`Uj0? 1 0 obj Toll Free Call Center: 1-877-696-6775. Crowe and Associates offers a free Medicare lead program. 0 2023 medical commissions for applications one to four will be paid $0 PMPM until the agent or agency reaches five medical applications. Please be advised eligible producers will be paid commission for existing medical policies scheduled to renew 1/1/2023 under this 2023 commission schedule. ( CMS requires all marketing websites to be submitted for review. https:// 5 Social Media Content Ideas for December, blue cross and blue shield of texas bonus program, Bright HealthCare Expands ACA in 42 New Markets, temporary special enrollment period unwinding, unitedhealthcare individual and family plans. Agility Agents have learned from us that incorporating trending themes into their online content strategy plan will help them achieve their marketing goals. lock % ( Web( 2) The material has been deemed approved; that is, CMS has not rendered a disposition for the material within 45 days (or 10 days if using CMS model or standardized marketing A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. XM! View the Part C EOB materials in the Downloads section below. Click Here, We do not offer every plan available in your area. For example, the same PTC can be used during AEP and OEP. 0 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare Communications and Marketing Guidelines 3-16-2022 (PDF), CY 2016 Medicare Marketing Guidelines (PDF), Medicare Marketing Guidelines 06.28.13 (ZIP), CY2018MedicareMarketingGuidelines_Final072017 (PDF), CY2019 Medicare Communications and Marketing Guidelines_Updated 090518 (PDF), Medicare Marketing Guidelines 06.17.14 Updated with Issue Date (ZIP), Medicare Communications & Marketing Guidelines Update Memo - 8-6-19 (PDF), Medicare Advantage Marketing Regulations - 422 Subpart V, Medicare Part D Marketing Regulations - 423 Subpart V. 200 Independence Avenue, S.W. endstream endobj startxref Sign up to get the latest information about your choice of CMS topics. The Guidelines are for use by Medicare Advantage Plans (MAs), Medicare Advantage Prescription Drug Plans (MA-PDs), Prescription Drug Plans (PDPs) and 1876 Cost Plans. CLICK HERE TO LEARN MORE ABOUT CONNECT4MEDICARE. DISCLAIMER: The contents of this database lack the force and effect of law, except as hb```b``c`e` B@1V @C This chapter contains revisions in most of the sections within the manual chapter, however, there are some sections that have not been revised, but are included in this instruction as well. WebMarketing Guidelines such that the MAO cannot comply with both, the MAO must comply with 2021, a communication plan and all draft communication(s) for that change, must be All other CMS requirements relating to the review of marketing materials under 42 C.F.R. The site is secure. ZbO KM~ View the Agent/Broker Training & Testing Guidelines in the Downloads section below. Washington, D.C. 20201 You can decide how often to receive updates. means youve safely connected to the .gov website. Official websites use .govA A federal government website managed by the If the materials are not generic in nature they will be considered marketing and require CMS review. %%EOF Only light snacks and refreshments. WebThe Medicare Communications and Marketing Guidelines (MCMG) is a set of rules that insurance companies selling plans must follow. Cano Health Medical Centers Centrum Medical Center Fox Medical Center IMC Health Medical Centers MedFlorida Medical Center UniVida Medical Center Community Medical Group is currently the main provider for the Ambetter Value Network. Ambetter plans to expand access to their value network in Florida. 1, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, Employer/Union-Sponsored Group CMS also has rules for when you are allowed to market products and the way you can do it. Issued by: Centers for Medicare & Medicaid Services (CMS). endobj Advancing is not available. U.S. Department of Health & Human Services 159 0 obj <> endobj They are even needed if the meeting did not result in a sale. But before creating any type of content, insurance agents must be able to identify the key traits that characterize their ideal audience. There is no longer a rule that the SOA needs to be submitted 48 hours prior to the sales appointment. Make sure to do the scope form prior to starting the meeting however. Medical Insurance Commissions Medical commissions apply to all metal and which has been designated by CMS as meeting the requirements of an MA SNP as i !q Pf`qH X$AQ e&ExLL^LLA+nLuI-t)P&|neJrX!q@?,@mA lock Heres how you know. The difference between the two is the material used and intent of the material. A Scope of Appointment form is used to document the types of plans you will be discussing with the client or prospect. An official website of the United States government Issued by: Centers for Medicare & Medicaid Services (CMS). Communication materials do not require CMS approval. part 422, subpart V, continue to apply. endstream endobj 160 0 obj <>>> endobj 161 0 obj <. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 13 0 R 16 0 R 17 0 R 21 0 R 22 0 R 28 0 R 30 0 R 33 0 R 34 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 44 0 R 45 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> hb```a``Zk @16, TX3 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Marketing Models, Standard Documents, and Educational Material, CY2018MedicareMarketingGuidelines_Final072017 (PDF), CY2019 Medicare Communications and Marketing Guidelines (PDF), Medicare Marketing Guidelines 06.17.14 Updated with Issue Date (ZIP), CY 2016 Medicare Marketing Guidelines (PDF), Medicare Marketing Guidelines 06.28.13 (ZIP). Communication pieces are more general and provide non specific information. 4 0 obj SUBJECT: Medicare Communications and Marketing Guidelines . <>/Metadata 3591 0 R/ViewerPreferences 3592 0 R>> Even for events held by phone only. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Current guidance and model member materials issued by CMS through the Health Plan Management System (HPMS) appear below. Download the Guidance Document Final endstream endobj 560 0 obj <>>>/Lang( E N - U S)/MarkInfo<>/Metadata 52 0 R/Names 583 0 R/Outlines 643 0 R/OutputIntents 557 0 R/PageLayout/OneColumn/PageMode/UseOutlines/Pages 554 0 R/StructTreeRoot 81 0 R/Type/Catalog/ViewerPreferences<>>> endobj 561 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 43/Tabs/S/Type/Page>> endobj 562 0 obj <>stream [M7XRM v:rY DXF4UbT+"J%p$