Updates to the Medicare Marketing Guidelines

What Agents Need to Know

The Medicare Marketing Guidelines (MMG) have evolved significantly since 2019, transitioning into the Medicare Communications and Marketing Guidelines (MCMG). These updated guidelines are essential for insurance agents selling Medicare Advantage and Part D plans, as they outline how to communicate and market Medicare plans compliantly.

Here, we’ll break down the most relevant changes, from new distinctions between communications and marketing to updates on electronic communication policies.

"Staying compliant isn’t just about following the rules—it’s about building trust and ensuring clients get accurate information."

Key Changes to Medicare Communications & Marketing Guidelines

This summary focuses on important updates to help you stay compliant, protect your business, and build credibility with clients. While this is not an exhaustive list, it covers the most significant changes.

1. Communications vs. Marketing (Section 20)

The MCMG now differentiates between “Communications” and “Marketing”:

Communications: General information-sharing activities that don’t require CMS review. Examples include materials promoting Medicare Advantage (MA) plans in a non-specific way, such as content on Medicare plan awareness.

Marketing: A subset of communications with a clear intent to influence a client’s enrollment decision. Marketing materials include specifics on a plan’s benefits, cost-sharing details, and rankings. These materials must be reviewed by CMS.

"Marketing is all about intent—if the goal is to promote a specific plan, it’s considered marketing and must go through CMS approval."

2. Electronic Communication Policy (Section 30.6)

Electronic outreach policies have also seen changes:

Permitted: Sponsors may initiate contact via email, provided an opt-out option is available.
Prohibited: Unsolicited electronic messages, such as text messages and social media DMs, are not allowed.

This ensures clients have control over communication methods, enhancing transparency.

3. Unsolicited Contact Rules (Section 40.2)

Further clarifying electronic communication rules, Section 40.2:

Allows Unsolicited Emails: As long as they include an opt-out option, emails are permissible.
Bans Unsolicited Texts: Unsolicited text messaging remains prohibited.

"Email is now a powerful tool for connecting with potential clients—just ensure they have the option to opt out."

4. Personal/Individual Marketing Appointments (Section 50.3)

One key change for agents is the removal of restrictions on requesting referrals during one-on-one appointments. Agents can now ask for referrals directly during these meetings.

"Referrals are invaluable, and now agents can request them directly—opening up more growth potential within compliance boundaries."

5. Sales in Healthcare Settings (Section 60.4)

Section 60.4 clarifies rules for marketing activities in healthcare environments:

Allowed in Common Areas: Waiting rooms and other common areas are now approved for sales activities.

Communication Materials: Can be distributed throughout healthcare settings, increasing visibility while keeping activities compliant.

6. Material Identification (Section 90.1)

CMS has introduced a streamlined material identification process, helping agents easily determine which materials require submission for CMS review. This simplifies the documentation process, ensuring compliance without unnecessary red tape.

Conclusion: Staying Ahead in Compliance

The MCMG’s updates reflect an evolving landscape aimed at enhancing transparency, simplifying client interactions, and protecting the integrity of Medicare sales. For agents, staying informed on these updates ensures smooth, compliant operations and stronger client relationships.

"Compliance isn’t just a box to check—it’s a standard that elevates client trust and long-term success."

PSM Brokerage offers a range of pre-approved Medicare marketing materials and carrier-approved resources to keep you compliant. Our experienced team is here to help you navigate these updates and answer any questions. Compliance isn’t just about rules; it’s about serving clients with integrity and professionalism. Contact us today for support and assistance.