Medicare Marketing and Enrollment Compliance
What to know
CMS marketing rules exist to protect beneficiaries from confusion and high-pressure sales. Agents must be licensed and appointed, complete required training (including AHIP and product-specific training), and follow rules on unsolicited contact. Prohibited: door-to-door sales, unsolicited emails, approaching beneficiaries in parking lots or common areas, and cross-selling non-health products during a Medicare sales presentation. Required: clear disclosure that the agent represents a plan, permission before contacting, and written consent for certain communications. The Scope of Appointment (SOA) must be documented before a personal marketing appointment and must be specific to the products discussed. Enrollment applications require the beneficiary's signature and date, and agents must not enroll someone without their knowledge. The Annual Enrollment Period is October 15–December 7 for January 1 coverage; the MA Open Enrollment Period is January 1–March 31.
Traps
Questions test whether a specific action is permitted. Calling a beneficiary who attended a seminar is not automatically allowed-you need permission. Discussing a different product than the SOA allows is a violation. Do not confuse marketing rules with enrollment deadlines. Educational events cannot be used to collect enrollment information or conduct sales.
Rule of thumb
If the contact is unsolicited, in person without an appointment, or outside the SOA, assume it is prohibited.