Medicare Agents as TPMOs: Compliance and Best Practices for Medicare Agents
As a Medicare agent, you are more than just a licensed professional helping beneficiaries find the right coverage; you are officially recognized by CMS as a Third-Party Marketing Organization (TPMO). Understanding Medicare agents as TPMOs is crucial to protecting your business and staying compliant.
What Is a TPMO
CMS defines a TPMO as any organization or individual compensated to perform lead generation, marketing, or enrollment activities for Medicare Advantage (MA) or Part D plans. That means independent agents and brokers fall under the TPMO umbrella whenever they market or sell these plans.
Why It Matters
The TPMO designation exists to ensure transparency, accountability, and consumer protection. CMS tightened these rules in response to misleading advertisements and beneficiary confusion. As a result, every agent who sells MA or Part D plans must meet strict communication and documentation requirements.
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Key Compliance Requirements
Here are the most important rules every TPMO must follow:
- Mandatory Disclaimer: Every piece of marketing material, website, or verbal outreach must include the approved CMS disclaimer: “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.”
- Call Recording: Any phone call that discusses MA or Part D benefits; even informational calls must be recorded and securely stored for at least 10 years.
- Scope of Appointment (SOA): Always obtain an SOA before discussing plan details. Electronic and paper SOAs are acceptable but must be saved for recordkeeping.
- Avoid Misleading Language: Never imply government affiliation or say you offer “every plan” unless that is true. Be careful with phrasing on social media, websites, and mailers.
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Best Practices for Sales and Marketing
To remain compliant and build trust with clients:
- Lead with education, not sales. Help beneficiaries understand their options before recommending a plan.
- Use CMS-approved materials. Avoid customizing carrier pieces unless approved for agent use.
- Document everything. Keep records of calls, SOAs, and marketing pieces.
- Stay current on CMS updates. Rules can change annually; follow your FMO and carrier training closely.
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Being classified as a TPMO isn’t just a compliance label; it’s a reminder that agents play a critical role in maintaining Medicare integrity. By following CMS rules, staying transparent, and putting client education first, you protect both your license and your reputation in the Medicare marketplace.