How to Navigate Electronic Communication for Medicare

Infographic on Medicare Marketing Guidelines for Electronic Communication Opt-In/Opt-Out

The Medicare Marketing Guidelines update every year. As of 2018, here’s what the MMG says about electronic communication (Sections 70.1, 30.6, and 40.9).

Brokers Can Now Initiate Electronic Contact

Brokers may initiate electronic contact, according to the Medicare Marketing Guidelines (Section 70.1). For example, a broker can send prospects an email prior to the annual enrollment period (AEP), acknowledging that it’s almost time for them to review their plans. Or brokers can send an email that explains new laws such as MACRA and how it pertains to the new Medicare ID card. Still, brokers must include an opt-out process for recipients who no longer want to receive electronic communications.

Requirements for Providing Documents Electronically

Section 40.9 of the MMG has not changed its guidelines about providing materials in electronic media formats (email, CD, DVD, etc.). In order to provide materials (such as Summary of Benefits documents) electronically, brokers must first receive consent. This consent (or opt-in) to receive electronic documents satisfies Medicare’s notice and disclosure requirements.

When requesting electronic document consent, brokers are required to specify:

  • The type of media the documents will be sent through or on (such as email, CD, DVD, etc.).
  • The documents to be sent (such as Summary of Benefits documents).

Once an individual has opted in, a broker must provide:

  • An opt-out process.
  • The ability to receive hard-copy mailings, if requested.
  • The ability to send hard copies if electronic versions are undeliverable (for example, if an email address does not work).

Brokers sending electronic documents are also expected to:

  • Ensure that enrollees’ contact information is current, materials are deliverable and received in a timely manner, and important documents are identified in a way that signifies their importance.
  • Comply with Health Insurance Portability and Accountability Act (HIPAA) and privacy rules.

Requirements for Electronic Enrollment Communications

Any electronic contact that includes an enrollment mechanism must also include the following:

  • star ratings document
  • summary of benefits

These items must be made available prior to completion and submission of an enrollment request. Appropriate disclaimers, located in Appendix 5, are also required. For example:

  • “Medicare beneficiaries may also enroll in [plan name] through the CMS Medicare Online Enrollment Center located at”

Find More With Excelsior

Excelsior’s resource center offers a wealth of information to help you sell and market Medicare plans compliantly. To learn more about the Excelsior team and how we can help you double, or triple, your income, contact us.

Note: For the most current information, see the CMS Medicare Marketing Guidelines.



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