On May 10, 2023, the Centers for Medicare & Medicaid Services distributed a memo that more strictly defines “marketing” in regards to Medicare plans.
It’s vital you review these changes and update your business strategy if you work with potential Medicare Advantage, prescription drug, and Cost plan clients.
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Through complaints and reviews of recorded sales calls, CMS found that many beneficiaries inquire and enroll in Medicare plans upon hearing mention of widely available benefits, including, but not limited to, dental, vision, hearing, premium reduction, and cost savings. As a result, they’ve revised their definition of Medicare marketing to include “content that mentions any type of benefit covered by the plan and is intended to draw a beneficiary’s attention to plan or plans, influence a beneficiary’s decision-making process when selecting a plan, or influence a beneficiary’s decision to stay enrolled in a plan (that is, retention-based marketing).”
Marketing Includes the Mention of Any Benefits
Previously, MA and Part D sponsors or TPMOs could mention widely available benefits, such as dental, vision, and hearing benefits, in advertisements, and the ads would not be considered marketing. Starting July 10, 2023, promotional materials for MA, Part D, and Cost plans that mention any benefits will be considered marketing and will need to be filed with and reviewed by CMS, via HPMS, prior to usage.
Marketing Includes Retention Marketing
CMS has definitively stated that marketing includes retention marketing. In their 2024 Final Rule for MA and Part D, CMS softened the call recording requirement from last year to only include sales, marketing, and enrollment calls. Since retention marketing is now considered marketing, agents will need to record phone or remote conversations with clients that may influence them to stay enrolled in their current plan.
The Intent & Content of Marketing
When deciding if an advertisement falls under marketing, CMS considers both intent and content. The latest revisions to their definition of marketing pertain to the content component of the definition.
To review, the intent component of CMS’ marketing definition is “when any material or activity is intended to draw a beneficiary’s attention to plan or plans, influence a beneficiary’s decision-making process when selecting a plan, or influence a beneficiary’s decision to stay enrolled in a plan (that is, retention-based marketing).”
The content component of the definition is “when any material or activity includes or addresses plan benefits, benefits structure, premiums, or cost sharing; measuring or ranking standards; or rewards and incentives.”
How This Will Affect Agents
As of July 10, 2023, you will no longer be able to mention widely available benefits, including, but not limited to, dental, vision, hearing, premium reduction, and cost savings, in your MA, Part D, and Cost plan marketing unless the materials have been filed with and approved by CMS. You will also have to continue to record phone or remote conversations with clients that influence them to stay enrolled in their current MA, Part D, or Cost plan.
To help you stay compliant with this new rule, as well as the other CMS marketing rules from the 2024 Final Rule, MA & Part D Communications Requirements, and the Medicare Communications and Marketing Guidelines, we’ll be updating our marketing materials on ShopRitterIM and refiling them with CMS. We encourage you to use the latest materials we offer, as well as the latest materials your carriers offer, when marketing Medicare plans.
Our final advice: Market your services rather than the products. Don’t ever pitch yourself as offering cost savings or extra benefits, but instead, as offering a well-rounded portfolio, knowledge, experience, and trustworthiness.
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We understand the expanded definition of marketing for Medicare will present some challenges for our agents, plan sponsors, and other TPMOs, but please know we’re here to help answer your questions. For more information, please email our Compliance Officer at [email protected].