Things you can’t say when selling Medicare
There are very strict guidelines put in place by CMS that state the things you can’t say when selling Medicare plans. We will cover some (not all) of them in this post.
It may be difficult to understand but the CMS’ Final Rule 2024 states that agents must not use the word Medicare in any way that could be misleading or confusing either on your website or in the name of your business. In some areas, you may need to remove the word Medicare from your business name. Using the word Medicare in your business’ name may lead people to believe that you work for the government,
It is important that prospects understand you are an independent advisor and represent a limited number of Medicare plans in any given area. This language should be clearly stated on your website, business cards or any other marketing materials you hand out.
We offer every Medicare plan available:
Statements like this are not accurate considering that there are plans that do not even work with independent agents. You may be appointed to sell several great plans, but misleading potential clients is not acceptable. You must be very careful with the wording of anything you say or printed materials you use to represent your business.
To read more about CMS’ 2024 Final Rule, click here.
CMS also requires all TPMOs to put a disclaimer on all marketing materials or communications. The disclaimer is also required when making phone calls to prospective clients.
You cannot state that any Medicare plan is free:
The marketing guidelines of CMS clearly state that neither Plan D plan sponsors nor agents can use the word free when describing a plan premium. They are also not allowed to use the term free to describe a deductible or premium reduction a low-income subsidy or any cost sharing pertaining to dual eligible individuals.
Although there are currently many Medicare Advantage plans that offer enrollees a $0 premium, using the word free to describe any plan can be confusing to some people. Even if some plans do not charge a premium or co-pays for some services, that still does not mean the plans are free. Enrollees will still need to pay co-pays, deductibles and co-insurance. Clients must also use specific in-network providers for many services to be covered.
Do not claim any plan will cover all of someone’s needs:
There is no such thing as a plan that can cover every need of its members. As an agent you should always look for the plan that best fits the needs of each individual client. That is all anyone can do. You must explain the pros and cons of each plan and provide a comparison of potential plans. This way the client can choose which is the best fit.
Never claim any one plan is the best plan available:
As a sales agent, it may be easy to say one plan stands out as the best. You should also know that the best plan for one person is not the best for another. In this business there is no one fits all plan. Each person has their own needs and wants when making a decision on which plan to choose. Do not use misleading superlatives or unsubstantiated claims for advertising or when describing a plan to potential members.
The only time it is ok to use superlatives in a plan description is when you have actual data to support your claim. All claims either written or spoken must meet CMS requirements.
A few more things not to say to clients:
Do not tell a client that their current coverage might change.
If you are looking at plan options for a potential client, you must explain the differences between a potential new plan and their current coverage. This ensures they are satisfied with any plan changes they make.
Never claim that Medicare approves of the benefits offered by a plan.
Do not use this terminology when communicating with clients/potential clients either in person or on any marketing materials you use.
Don’t mention products in a sales appointment that are not on your scope of appointment.
If a client requests information about non-Medicare products during a Medicare sales appointment, you must tell them you can discuss these products at another time. You should not try and bring up products that they did not agree to talk about when they signed the scope of appointment. If they want to discuss life, annuities or other products, simply suggest an alternate time to discuss those products.
Do not ask for contact information for your client’s friends or family.
It is ok to let your clients know you appreciate a good review or referral. It is not ok to ask for anyone’s phone number or address if they did not consent for you contacted them. You can provide clients with extra business cards to give to anyone who is interested in your services. This way they can contact you if they choose.
Never offer a gift or money to anyone for enrolling in a plan.
It is important to know, it is illegal to offer gifts or financial incentives in exchange for enrollments.