Can Insurance Agents Call Me about My Medicare Coverage? New Rules Just Released

medicare marketing insurance agent

New rules for Medicare insurance agents and insurance plan representatives make it easier to contact potential customers

There are some new rules going in place for Medicare insurance agents and Medicare insurance companies around the Marketing of Medicare Plans for 2018 and 2019.  These rules outline exactly what type of communication is and is not acceptable as marketing and advertising during the Medicare open enrollment period. The new rules start with setting a clear definition regarding what marketing and communication are, as well as how each is determined, and what exactly is required by each.

Medicare Marketing Versus Communication – And What Each Means for You

While the two words may appear to be similar, when it comes to the marketing of Medicare, the terms communication and marketing can have some significant differences. Based on the new 2019 Medicare Communication and Marketing Guidelines, these two terms are defined as follows:

Communications – Communications refers to activities and the use of materials to provide information to current and prospective Medicare enrollees. This means that all activities and materials that are aimed at prospective and current Medicare enrollees – including their care givers and other decision makers who are associated with a prospective or a current enrollee – are considered to be communications. (1)

Marketing – Marketing is actually a subset of communications. Based on the new guidelines, marketing includes activities and use of materials that are conducted by the Medicare Advantage Plan and / or Medicare Part D sponsor with the intent to draw a beneficiary’s attention to Medicare Advantage plans and to influence a beneficiary’s decision making process when selecting such as plan for enrollment, or deciding to stay enrolled in a plan. In addition, marketing also contains information about the Medicare plan’s benefit structure, as well as its cost sharing, and its measuring or ranking standards. (2)

New This Year:

One of the ways insurance companies and Medicare insurance agents try to get new customers is through seminar selling.  There are two types of Medicare seminars you may be invited to by insurance agents or by companies.  One is called a Sales Seminar, the other is called an Educational Seminar.  I’ve written a great primer post on seminars, and you can access that by clicking here.

This year, agents or plan representatives are allowed to set up set up a future marketing appointment and distribute business cards and contact information for potential customers.  That’s a big change.

Also new this year – at Educational Events, meals are now allowed to be served.  Previously, only light snacks were able to be offered.

Insurance agents now have a bit more leeway around when they can and cannot call you.  They can now contact you if you give them permission in a multitude of ways.  For example, by filling out a business reply card, sending an email to the Plan/Part D Sponsor requesting a return call, or asking a customer service representative to have an agent contact them, agents can now proactively reach out to you.

Same rule of thumb applies to what I’ve written before – if you’re giving up personal information over the phone or online to an insurance company or an insurance agency, you’ll probably be considered a “lead” and have granted permission to contact you.  If you don’t want to be contacted in the future, explicitly say so and ONLY request plan information be mailed to you.

That said, it’s often very helpful for folks to sit down with a Medicare insurance agent to review their options.

Insurance agents and insurance companies can now spend $75 per year on “promotional activities.”  These are generally designed to attract your attention as a consumer and encourage you to either stay in the plan you have, or join a new one.

Gifts – insurance companies and insurance agents can give you a gift if you attend a seminar, make a phone call or otherwise respond to advertising.  However, this gift may only have nominal value (be worth no more than $15).  Plus, they can’t pick and choose who they give this to.  It must offered to all potential customers regardless of whether they enroll, and without discrimination.

The Takeaway:

Insurance agents and Medicare insurance companies are bound by some pretty strict rules when it comes to contacting potential customers.   They are still prohibited from contacting you or approaching you through what’s termed,  “unsolicited direct contact,” which includes but not limited to:

– Door-to-door solicitation, including leaving information such as a leaflet or flyer at a residence or car

– Approaching potential customers in common areas (e.g., parking lots, hallways, lobbies, sidewalks, etc.)

But the recent changes have loosened up how and when agents and insurance companies can contact you.  They also clarify what kind of gift, and how much value it can have that can be offered for engaging an agent or a company.   If you don’t want to be contacted by anyone in a sales capacity, clearly say so.  If you’d benefit from additional consultation or an in-home appointment with a certified sales representative, clearly say so.