View the Agent/Broker Training & Testing Guidelines in the Downloads section below. on the guidance repository, except to establish historical facts. Toll Free Call Center: 1-877-696-6775. 1 The federal regulation at 42 CFR 438.104 defines marketing as any communication, from an [Medicaid managed care plan] to a Medicaid beneficiary who is not enrolled in that entity, that can reasonably be interpreted as intended to influence the beneficiary to pgA +tKe.hT+mqOi^Ef(V:
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Secure .gov websites use HTTPSA Plans may now contact The Department may not cite, use, or rely on any guidance that is not posted Prospects and clients can compare plans (Advantage, supplement and part D), check on benefits, check doctors and Medications. The key focus of being of patients over the CMS requirements on the healthcare industry. 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. On October 8, 2021, CMS released guidance regarding third-party marketing to Medicare Advantage organizations. WebHealth Net Medicare providers can review training and marketing guidelines to ensure services and coverage determinations are accurate. While CMS guidelines no longer include requirements of 12pt font on marketing materials, due to the vision realities of people as they age, it is still recommended and the means youve safely connected to the .gov website. A federal government website managed by the If they would like to review non health related products such as life insurance, LTC, annuity, etc. 'j0"0",NG)1p8i{^h38R ur@msO;F$A$gOyOOr[{YxqyIJ. 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. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423). The .gov means its official. DISCLAIMER: The contents of this database lack the force and effect of law, except as endstream
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<. Providing general information about the Medicare program would be considered an educational event. You can decide how often to receive updates. In fact, two of the plans will beRead more, Medicare Leads Available At No Cost Note: Our blog: Medicare Leads Available At No Cost program has been changed. incorporated into a contract. In the fall of 2017, CMS launched the Patients over Paperwork initiative. https:// 698 0 obj
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t18:14Xw8zxs Link to recorded webinar https://attendee.gotowebinar.com/recording/2899290519088332033, All agents receive a personalized enrollment website. Download the Guidance Document Final Issued by: Centers for Medicare & Medicaid Services (CMS) Issue Date: January 01, 2020 HHS is committed to making its This works for health type products only however. Free should also not be included in any description of part B premium, part B reduction plans or dual eligible status. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription Drug Benefit rules (Chapter 42 of the Code of Federal Regulations, Parts 422 and 423). Communication pieces are more general and provide non specific information. Federal government websites often end in .gov or .mil. endobj
For Medicare Advantage Plans. If the materials are not generic in nature they will be considered marketing and require CMS review. 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. Starting January 1, 2023, Ambetter Value plan members can access providers in the below list for all medical needs. <>/Metadata 3591 0 R/ViewerPreferences 3592 0 R>>
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website belongs to an official government organization in the United States. .gov Take a look for yourself below. Medicaid managed care plans contract with the state Medicaid agency. 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. Secure .gov websites use HTTPSA Better to have one every time to be safe. OK Find a Provider Issued by: Centers for Medicare & Medicaid Services (CMS). Before sharing sensitive information, make sure youre on a federal government site. endobj
General information is followed by state-specific information, which is alphabetized by state name. WebMarketing Guidelines such that the MAO cannot comply with both, the MAO must comply with 2021, a communication plan and all draft communication(s) for that change, must be All other CMS requirements relating to the review of marketing materials under 42 C.F.R. ( 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 Stay up to date with Medicare Marketing Guidelines by attending our Medicare Training Series live events! Cigna just announced their 2023 ACA commission schedule! Medical Insurance Commissions Medical commissions apply to all metal levels and plans sold on or off Marketplace. You also need a scope for phone meetings and virtual meetings. It should focus more on promoting your services and general information about Medicare. Web( 2) The material has been deemed approved; that is, CMS has not rendered a disposition for the material within 45 days (or 10 days if using CMS model or standardized marketing CMS replaced the models that were previously posted on this website to reflect the OMB approval number and expiration date. In addition, we are also providing clarification to the existing guidance. Lastly, prospects can enroll through the site into any of the plans you are certified to offer. The new marketing material module has enhanced functionality and will provide tools to Plans to facilitate tracking its marketing materials. WebThe Medicare Advantage (MA) and Part D Marketing and Communications (MCMG) provides the marketing and communications requirements for Medicare Advantage (MA) plans, Agent/Broker Training & Testing Guidelines are posted for Plans/Part D sponsors to use at a minimum, and is a high-level breakdown of the criteria for development of individual training and testing for agents/brokers. As part of CMS implementation of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS has revised the Medicare Marketing Chapter to include the latest provisions in the current guidance. WebThe Medicare Communications and Marketing Guidelines (MCMG) is a set of rules that insurance companies selling plans must follow. What if a client would like to talk about additional or different products? lock endstream
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SOAs are needed for every face to face meeting. Official websites use .govA Please be advised eligible producers will be paid commission for existing medical policies scheduled to renew 1/1/2023 under this 2023 commission schedule. lock You can decide how often to receive updates. %PDF-1.6
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https:// hmo6 Chapter 3. Medicare Marketing Guidelines. Medicare Marketing Guidelines 2021: Types of events and appointments Meetings and presentation fall under one of three categories. But how is this fact going to help you sell more health insurance? WebAll MA communication and marketing regulations and guidance issued by CMS, as well as other applicable laws, continue to apply to materials and activities of participating website belongs to an official government organization in the United States. The site is secure. Compliance is an important aspect of offering Medicare plans. ZbO
KM~ Current guidance and model member materials issued by CMS through the Health Plan Management System (HPMS) appear below. ) Medicare Advantage Organizations, Prescription Drug Plans, and Section 1876 Cost Plans may rely on the contract year (CY) 2019 Medicare Communications and Marketing Guidelines (MCMG), which can be found at lock lock 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. 4 0 obj
Medicare Advantage plans are offered by private insurance companies. And dont get me started on the unofficial holiday song that was released back in 1994 (yes, we are talking about Mariah Careys single: All I want for Christmas is you). Prospects can use the site to compare plans, check doctors, run drug comparisons and enroll in plans. Official websites use .govA zCW`W- d%c@4F&4VXL`w dPO[ I)i61e$EI 2f=!z6"lqr Required fields are marked *. or The difference between the two is the material used and intent of the material. Download the Guidance Document Final Click Here, We do not offer every plan available in your area. https:// Ambetter Value plans are available in: Broward, Clay, Duval, Hillsborough, Lake, Miami-Dade, Orange, Osceola, Palm Beach, Pasco and Seminole counties. CLICK HERE TO LEARN MORE ABOUT CONNECT4MEDICARE. Access to all major carriers with the ability to compare plan benefits and prescription drug costs. Secure .gov websites use HTTPSA Any information we provide is limited to those plans we do offer in your area. 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 You need a scope for any type of sales event. Official websites use .govA American Progressive Medicare Contracting American Progressive Medicare Contracting: American Progressive will be offering 3 new plans in NY for 2016 in Westchester, Putnam, Dutchess and Ulster counties. authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically Guidance for this document can be located at https://www.cms.gov/Medicare/Health-Plans/Managed Care Marketing/Final Part C Marketing Guidelines. Sales made during an Open Enrollment or a Special Enrollment Period are eligible. including individuals with disabilities. Medical Insurance Commissions Medical commissions apply to all metal During a sales event: Sales events are an attempt to steer someone into a specific plan. Be careful not to confuse a PTC with a Scope of appointment form. But before creating any type of content, insurance agents must be able to identify the key traits that characterize their ideal audience. The agent will be the broker of record on any enrollment. 219 0 obj
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At that time, any new medical sales commissions due will be paid, starting from the first 2023 application. part 422, subpart V, continue to apply. Guidance for Pace marketing guidelines and marketing requirements and related provisions of the Programs of All-inclusive Care for the Elderly (PACE) rules (Chapter 42 of the Code of Federal Regulations (CFR), Part 460 (See Appendix 1 for a list of related laws and regulations). %%EOF
If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov. 200 Independence Avenue, S.W. Advancing is not available. Model marketing materials include: the standardized Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) templates and instructions, ANOC/EOC Errata, and Provider Directory. The Marketing guidelines reflect CMS' interpretation of the marketing requirements and related provisions of the Medicare Advantage and Medicare Prescription American Progressive Medicare Contracting, Teladoc, Lasik Vision Correction, Discount Dental,Vision,Rx Sales Contract, Medicare Advantage vs Supplement Plans Sales, Free Medicare Lead Program (Turning 65/Med Supplement Leads), https://attendee.gotowebinar.com/recording/2899290519088332033, Report the event prior to conducting and advertising it, You can distribute and collect applications, Call attendees from the sales event if they provided permission to contact (Gave you a PTC card or flyer), You cannot offer meals. Commissions will be paid on posted premiums applied to the agents or agencys clients eligible cases. XM! website belongs to an official government organization in the United States. Communication materials do not require CMS approval. Agents are credited for all enrollments. on the guidance repository, except to establish historical facts. hbbd```b``"@$c*dHR0,f@0y,"IK 6w %
$fk00120 FIGG Full commission (directly from the carriers) and no minimum production needed to start. You can decide how often to receive updates. January 1 through March 31 is considered the OEP. Dental Insurance Commissions The dental commission structure pertains to business with effective dates of 1/1. Issued by: Centers for Medicare & Medicaid Services (CMS). 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). 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. The Centers for Medicare & Medicaid Services (CMS) received OMBs approval for the latest ANOC and EOC models through 12/31/21. Secure .gov websites use HTTPSA View the Part C EOB materials in the Downloads section below. CMS is finalizing a technical change to enable CMS to calculate the 2023 Part C Star Ratings for the three Healthcare Effectiveness Data and Information Set (HEDIS) measures collected through the Health Outcomes Survey: Monitoring Physical Activity; Reducing the Risk of Falling; and Bladder Control. To date, CMS has not released an update or memo for 2021. 582 0 obj
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