X;/?~I(A@%EOMG1Rc9 5:E[0n8 Provider Medicare Training & Marketing Guides | Health Net Skip to Main Content Healthnet.com uses cookies. 200 Independence Avenue, S.W. Lastly, prospects can enroll through the site into any of the plans you are certified to offer. They are educational events, 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. They are even needed if the meeting did not result in a sale. Issued by: Centers for Medicare & Medicaid Services (CMS). You also need a scope for phone meetings and virtual meetings. Access to all major carriers with the ability to compare plan benefits and prescription drug costs. Washington, D.C. 20201 Medicare Communications and Marketing Guidelines pgA +tKe.hT+mqOi^Ef(V: 09\O^]S`Uj0? Chapter 3. Medicare Marketing Guidelines. 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. All Rights Reserved. Medicaid managed care plans contract with the state Medicaid agency. Starting January 1, 2023, Ambetter Value plan members can access providers in the below list for all medical needs. CMS Updates 2020 Guidelines for Medicare & Medicaid Marketing .gov Toll Free Call Center: 1-877-696-6775. Overall, the holiday season seems to bring joy and family unity around the world. Medical Insurance Commissions Medical commissions apply to all metal CMS replaced the models that were previously posted on this website to reflect the OMB approval number and expiration date. 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. How Agents Influence Medicare Beneficiaries Plan Choices Share sensitive information only on official, secure websites. Heres how you know. SUBJECT: Medicare Communications and Marketing Guidelines . .gov (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. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. View the Agent/Broker Training & Testing Guidelines in the Downloads section below. The new marketing material module has enhanced functionality and will provide tools to Plans to facilitate tracking its marketing materials. This means that all marketing materials must be clear, and accurate, and not promote any plans inappropriately. 0 WebThe Medicare Communications and Marketing Guidelines (MCMG) is a set of rules that insurance companies selling plans must follow. While plans may deplete existing hard copy stock, they should add the approval number and expiration date to the online versions and newly produced hard copies by January 1, 2020. The key focus of being of patients over the CMS requirements on the healthcare industry. LEARN WHAT WE HAVE TO OFFER HERE. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription CMS A federal government website managed by the incorporated into a contract. DISCLAIMER: The contents of this database lack the force and effect of law, except as %PDF-1.7 % DEPARTMENT OF HEALTH & HUMAN SERVICES 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Marketing Models, Standard Documents, and Educational Material, Agent/Broker Dos and Don'ts - Translated (CY 2023) (ZIP), CY2023 Model Materials - Reissued 12-15-2022 (ZIP), CY2023_Part C_Translated_DSNP_Model_Materials_-_Chinese_and_Spanish (ZIP), Agent/Broker Dos and Don'ts - 9-2022 (PDF), CY_2023_Part C_Translated Model_Materials_Chinese (ZIP), CY_2023_Part C_Translated_Model_Materials_Spanish (ZIP), CY2023 Agent Broker Training Testing Guidelines - Updated 08-03-2022 (DOCX), Agent/Broker Dos & Don'ts - Translated (ZIP), Agent/Broker Dos & Don'ts - 9-2021_ (PDF), CY_2022_Part_C_Translated_Model_Materials_Spanish (ZIP), CY_2022_Part_C_Translated_Model_Materials_Chinese (ZIP), CY 2022 Agent-Broker Training and Testing Guidelines_revised 7-6-2021 (PDF), 2021_Part_C_Translated_Model_Materials_Spanish (ZIP), 2021_Part_C_Translated_Model_Materials_Chinese (ZIP), CY_2021_ MA_and_Section_1876_Cost_Plan_Provider_Directory_Model_7-08-2020 (PDF), 2021_Agent_Broker_Training_Guidelines_Revised (DOCX), 2020 Translated Part C Model Materials_Spanish 2 (ZIP), 2020 Translated Provider Directory Models (ZIP), 2020 Agent Broker Training Testing Guidelines (PDF), 2019 Model Materials Updated 12-13-18 (ZIP), 2019 Model Materials - Translations (ZIP), 2019 Translated Model Materials_Part C EOC_SPA (ZIP), 2019 Translated Model Materials EOC Chinese (ZIP), 2019 Agent Broker Training Guidelines_Revised 08.20.18 (PDF), 2018 Model Materials - Translations (ZIP), 2017 Model Materials - Translations (ZIP), 2015 Model Materials - Translations (ZIP). ) A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Medicare Marketing Guidelines Marketing Models, Standard Documents, and Educational Material This section includes standardized outreach and educational material endstream endobj startxref 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. HHS is committed to making its websites and documents accessible to the widest possible audience, For starters, you must wait until October 1 to market, talk about or review the new plans for the coming year for AEP. 1 0 obj Medicare and which has been designated by CMS as meeting the requirements of an MA SNP as Same day scopes of compliant. Full commission (directly from the carriers) and no minimum production needed to start. Medicare Advantage plans are offered by private insurance companies. An official website of the United States government Heres how you know. Medicare WebThe Medicare Advantage (MA) and Part D Marketing and Communications (MCMG) provides the marketing and communications requirements for Medicare Advantage (MA) plans, In addition, an email should not be intended to steer someone into a specific plan. An official website of the United States government. OK Find a Provider It should focus more on promoting your services and general information about Medicare. a new appointment will need to be made. 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. Sign up to get the latest information about your choice of CMS topics. Sales events, on the other hand, are designed to steer, or attempt to steer potential enrollees towards a limited set of plans. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Simply sign another scope documenting those products and continue the appointment. H\n@yL. 2023 medical commissions for applications one to four will be paid $0 PMPM until the agent or agency reaches five medical applications. website belongs to an official government organization in the United States. Agents are now able to make unsolicited contact with a prospects for MA, MAPD and PDP via email. 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. Cigna just announced their 2023 ACA commission schedule! 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. Federal government websites often end in .gov or .mil. Because these plansRead more, Free Medicare Lead Program (Turning 65/Med Supplement Leads) NOTE: We have updated our lead program. Prospects and clients can compare plans (Advantage, supplement and part D), check on benefits, check doctors and Medications. Federal government websites often end in .gov or .mil. hb```b``c`e` B@1V @C A Scope of Appointment form is used to document the types of plans you will be discussing with the client or prospect. In 2021, Medicare beneficiaries will have, on average, 33 Medicare Advantage plans and another 30 stand-alone Part D prescription drug plans available in their market. Agility Insurance Services, LLC. 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. website belongs to an official government organization in the United States. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. This FAQ walks through both permitted and Marketing Guidelines MCS Improving or Maintaining Mental Health MedPAC Medicare Payment Advisory contract year 2021 and 2022. Meetings and presentation fall under one of three categories. ) Medicare Advantage Marketing: Understanding CMS Guideline 159 0 obj <> endobj 1 View the model marketing materials in the Downloads section below. lock Share sensitive information only on official, secure websites. 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 <> %%EOF endobj Managed Care Chapter 3 - Marketing Guidelines 9002 Federal Register /Vol. 85, No. 32/Tuesday, February 18, You can decide how often to receive updates. Reviews are done through the carriers in most cases. PTC can be obtained through flyers, business reply cards, PTC forms online leads (Likes or shares on social media platforms are not valid) from vendors and other methods that prospects use to initiate contact. 219 0 obj <>stream Secure .gov websites use HTTPSA 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^ Official websites use .govA CMS 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. Medicare Marketing Guidelines | CMS The SOA is used to document the type of products you will be discussing once you have a meeting. The .gov means its official. Chapter 3. Medicare Marketing Guidelines | Guidance Better to have one every time to be safe. Sponsors still are falling behind in their postmarket reporting, according to the FDAs yearly update on progress of postmarketing requirements/commitments. <>/Metadata 3591 0 R/ViewerPreferences 3592 0 R>> Hosting a Compliant Medicare Educational hb```a``Zk @16, TX3 The most recent memo from CMS is available below through the link. This works for health type products only however. This revision replaces Chapter 3, Medicare Marketing Guidelines for Medicare Advantage, Medicare Prescription Drug Plans, Prescription Drug Plans and 1876 Cost plans with a new revised Chapter 3. Crowe and Associates offers a free Medicare lead program. Issued by: Centers for Medicare & Medicaid Services (CMS). PTC forms can now be used for more than one enrollment period. ZbO KM~ In the fall of 2017, CMS launched the Patients over Paperwork initiative. Chapter 3 Medicare Marketing Guidelines - HHS.gov 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 By: Michelle M. Saavedra The most wonderful time of the year is here! Before sharing sensitive information, make sure youre on a federal government site. WebMedicare Marketing Guidelines . SOAs are needed for every face to face meeting.  5 How to become a Medicare agent If youre interested in how to, Online Enrollment- Enroll prospects online without the need for a face to face appointment. WebEach 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 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. 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. 698 0 obj <>stream Providing general information about the Medicare program would be considered an educational event. Only light snacks and refreshments. 3 0 obj WebHealth Net Medicare providers can review training and marketing guidelines to ensure services and coverage determinations are accurate. part 422, subpart V, continue to apply. https:// If the materials are not generic in nature they will be considered marketing and require CMS review. The consumer must also know if the plan is considered an low performing plan. The seminarsRead more, Building A Medicare Sales Agency Building A Medicare Sales Agency: There are a number of different models you can use when you build a Medicare sales agency. Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. Be careful not to confuse a PTC with a Scope of appointment form. The Department may not cite, use, or rely on any guidance that is not posted If they would like to review non health related products such as life insurance, LTC, annuity, etc. The .gov means its official. Manages the alignment of MOAAs CMS Requirements U.S. Department of Health & Human Services WHY WORK WITH US? Agents are credited for all enrollments. hbbd``b`>$ &$ .+ bX1 $"pH, $")s@Lz@`!3u>0 '` sH2jy + a&@GJh& +%V,fpt!9'cfO+Ip|L2\1 To date, CMS has not released an update or memo for 2021. Each year CMS and states participating in the Financial Alignment Initiative (FAI) jointly update state-specific marketing guidance and model member materials required for use by Medicare-Medicaid Plans (MMPs) and Minnesota Senior Health Options (MSHO) Plans. endobj Schedule marketing appointments immediately after the meeting You cannotdo the following: Require anyone to sign on or provide contact information Hand out or take applications or other plan specific information- (This is a marketing event) Give away cash prizes Provide or take enrollment forms Discuss carrier specific information [M7XRM v:rY DXF4UbT+"J%p$ hbbd```b``"@$c*dHR0,f@0y,"IK 6w % $fk00120 FIGG lock stream CLICK HERE TO LEARN MORE ABOUT CONNECT4MEDICARE. Are you contracted with Ambetter yet? Sign up to get the latest information about your choice of CMS topics. Following TPMO Guidelines CMS now considers agents and brokers to be third-party marketing organizations (TPMOs). You also must discuss the current star rating of plans and let the prospect know that it is out of 5 stars. ( We have tried to list the more common questions and aspects of the guidelines below. Stay away from using any absolute statements on materials or during presentations. They cannot include plan specific information and cannot be intended to steer someone towards a specific plan. To sign up for updates or to access your subscriber preferences, please enter your contact information below. /0U4,P9L&009 =\.gi'Jo-=5I9)zwf?PGsr oom0\jd Z.F kD db3u2 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. Communication materials do not require CMS approval. By continuing to use our site, you agree to our Privacy Policyand Terms of Use. on the guidance repository, except to establish historical facts. Medicare-Medicaid Plan (MMP) Marketing Information & Resources including individuals with disabilities. You can decide how often to receive updates. ) Current guidance and model member materials issued by CMS through the Health Plan Management System (HPMS) appear below. 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.