Insurance companies and agents are tasked with remaining compliant with the Centers for Medicare & Medicaid Services (CMS) while marketing their services. It makes sense on the surface, but the details may need some clarifying.
You may be brainstorming the best Medicare Advantage marketing ideas, but when getting creative with materials, agents still have to be mindful of how they’re representing themselves as it pertains to the Medicare Advantage & Part D Communication Requirements and CMS Medicare marketing guidelines.
Over the last several years, CMS has introduced and refined new rules, including defining agents and brokers as third-party marketing organizations (TPMOs). As a TPMO, you need to follow certain rules, like adding disclaimers to your materials.
We’ve put together a few common compliance questions and answers to help you navigate CMS’ marketing requirements for agents.
Q: First, what’s required of agents before engaging in Medicare marketing or sales?
A: CMS states that only agents who are licensed, certified, or registered under state law are permitted to market an insurance company’s Medicare Advantage or prescription drug plans. Agents are also required to complete the insurance companies’ annual mandatory certification processes for the carriers they wish to represent. Only after an agent is trained and certified to understand the rules, regulations, and specific Medicare product details can a carrier confirm an agent’s ready-to-sell status.
Medicare Advantage Organizations, Part D Sponsors, agents and other third-party marketing organizations (TPMOs) must submit materials that market any Medicare Advantage, Part D, or Cost plan benefits, including, but not limited to, widely available benefits such as dental, vision, and hearing, premium reduction, and cost savings, to CMS for approval before use.
Q: What’s required of an agent to become certified?
A: For each carrier an agent plans to market, the agent must complete that company’s annual certification process. It’s important to check with each company’s specific requirements, as processes may vary. Each company may also have a different notification method to inform an agent that they’re ready-to-sell, so checking on their specified system for confirmation is best. Ritter’s Certification Center can help to navigate some of these companies’ requirements.
Q: How can I easily record calls with my Medicare clients?
A: You can record calls by using Integrity’s call recording solution in MedicareCENTER, an easy and no-cost answer to securely recording, storing, and downloading both outbound and inbound calls. Read our post, FAQs About the Medicare Call Recording Requirements, to learn more details about using this solution.
Q: How do I keep my marketing materials compliant with the TPMO requirements?
A: Agents must add the TPMO disclaimer when communicating with a beneficiary through email, online chat, or other electronic means of communication, to their website, in any marketing materials (including print materials and TV ads), and within the first minute of sales call. The disclaimer must be specific to the beneficiary’s service area.
If marketing fewer than all plans within a service area, use:
“We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”
If marketing all plans within a service area, use:
“Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.”
You must also provide the disclaimer when communicating electronically with a beneficiary through email, online chat, or other means of communication.
See additional disclaimers you may need on your marketing materials
Q: On my website, can I reference a Medicare Advantage plan’s marketing materials and the trademarks of the companies I represent?
A: Agents cannot reference specific prescription drug plans or Medicare Advantage marketing on materials or use an insurance company’s trademark on their site. When a plan-specific or company-specific reference is used regarding a Medicare plan, it’s considered that company’s marketing material. It’s like forging a signature or fabricating a quote. If it wasn’t approved or provided by the company, it’s not OK to use it.
If an agent wants to reference any Medicare Advantage plan information or the insurance company logo on their website, the agent must work with the specific insurance company to obtain their prior approval and properly file with CMS if necessary.
Q: Can I reference Medicare Advantage or prescription drug plan info on direct mail marketing material?
A: No, for the same reasons specified in the answer to the previous question. Any time a plan-specific reference is made on marketing materials, it’s considered that company’s materials. CMS does allow brand promotion, but not specific product references, and prior approval of using the carrier’s logo or name is required. It is possible, though, to use a specific company’s pre-approved marketing materials.
Note that generic direct mail materials, without any plan or company-specific information, do not require prior approval, provided all other marketing guidelines are met and such material does not meet the definition of “marketing material.”
Q: When should I avoid using “Medicare” on my marketing materials?
A: According to Section 1140 of the Social Security Act, it’s forbidden to use the words or symbols including “Medicare,” “Centers for Medicare & Medicaid Services,” “Department of Health and Human Services,” or “Health & Human Services” in a way that would indicate the approval, endorsement, or authorization of Medicare or any other government agency. Never represent your business as one that is “from Medicare” or working “for Medicare.” Do not use the CMS logo.
Avoid using the word “Medicare” in a manner that suggests Medicare employs you. This includes terms like “Medicare Expert,” “Medicare Specialist,” or “Medicare Agent” on your business card. It’s important to be clear about your role and not mislead clients into thinking you’re affiliated with the federal government. Using these terms can create confusion and misrepresentation.
Instead, accurately describe your services without implying a direct connection to Medicare. Opt for a more generic title like “Licensed Health Insurance Agent” on your business card and consider adding a tagline that helps describe your services further. For example: “Over 65? Let’s find the best coverage for you.”
In addition to your marketing materials, CMS prohibits the use of “Medicare” in your business name, logo, or website URL if used in a misleading way — one that would cause potential enrollees or beneficiaries confusion over whether you’re affiliated with Medicare.
Q: Can I market certain plans as the “best”?
A: No, CMS prohibits the use of superlatives in most marketing unless you can back it up with factual data that supports the usage and meets CMS requirements.
Q: Do I have to tailor my marketing materials for certain service areas?
A: Yes, CMS prohibits marketing of benefits where they aren’t available unless it’s unavoidable due to the nature of the marketing. An example of an unavoidable situation is a TV ad picked up by an adjacent market. Remember this rule especially when marketing 5-star plans, Special Needs Plans (SNPs), and Part B giveback benefits. It is best to coordinate with the carriers that offer these plans in the service areas as such materials will require carrier prior approval and submission to CMS before they can be used.
Q: Do I have to include carriers’ names on my marketing for their plans?
A: Yes, if marketing plan-specific benefits in print ads, agents must include the names of the Medicare Advantage Organization (MAO) or Part D sponsors in 12-pt font. The names cannot be in a disclaimer. For radio or other advertisements that are voice-based only, the names must be read at the same speed as the phone number.
This rule applies to marketing and communication material content and will require HPMS submission and carrier opt-in, if applicable.
Q: Can I promote general savings a client could receive on a plan?
A: No, agents cannot market generalized savings when the actual savings are specific to the individual. Keep this rule in mind when marketing Dual Eligible Special Needs Plans (D-SNPs) and when working with third parties for lead generation.
Q: Where can I get compliant marketing materials?
A: Many carriers and field marketing organizations offer compliant marketing materials for agents.
Check out ShopRitterIM.com for CMS-approved business reply cards, Medicare educational event materials, promotional tchotchkes, and more! (Agents must register with Ritter and have at least one active contract through Ritter to purchase marketing materials on ShopRitterIM.com. Orders will be rejected if both requirements are not met. Newly registered agents must speak with their sales specialist to unlock Contract Now in the Platform.)
If you use PlanEnroll, Integrity’s consumer-facing enrollment platform, and become a PlanEnroll Network Agent, then you have access to a variety of marketing materials to use with clients, including direct mail, email, landing pages, and social media. These materials are customized with your contact information and boost traffic to your Personal Agent Website.
After signing up for MedicareCENTER and accessing PlanEnroll, follow these steps to become a PlanEnroll Network Agent:
- Complete the simple PlanEnroll training at Trainings.PlanEnroll.com.
- Log in to MedicareCENTER and visit your Account page to find your Personal Agent Website link to use in marketing.
- Log in to LeadCENTER and create a PlanEnroll Realtime Lead Campaign.
- Click the I’m Available switch in MedicareCENTER to receive realtime calls or data leads.
Marketing compliantly can seem challenging, but it is always better for your clients and your business to follow rules and regulations in place and we strive to make it easy!
To learn more about keeping your marketing materials and practices compliant, please see the Medicare Advantage & Part D Communication Requirements and our Do’s and Don’ts of Medicare Compliance. Don’t forget, you can always reach out to us with any questions!
Editor’s Note: This post has been updated to include regulations from CMS’ 2025 Final Rule.
Not affiliated with or endorsed by Medicare or any government agency.
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