Offering Gifts to Potential & Existing Medicare Enrollees


As a Medicare broker, you may want to conduct marketing events for current clients or potential enrollees that involve giving away gifts.  Offering gifts is acceptable, but you need to be mindful of a few rules to stay compliant while creating your incentive.

Is There a Limit to the Value of the Gift?

Yes. A gift for a current or prospective enrollee cannot exceed a fair market value of $15, according to the Medicare Marketing Guidelines, Section 40.4. For example, you could hand out one of these items as a gift, as long as they are priced at $15 or less:

  • A branded coffee mug
  • A branded pen or pencil
  • A branded notepad

Is There a Limit to the Amount of Gifts a Person can Receive?

Yes. One person cannot receive more than the value of $75 per year. Brokers are not required to track promotional items per person, but you can’t intentionally plan to give anyone more than $75 per year.

Brokers may give out larger gifts (think: concert tickets, raffles, or drawings) as long as the overall price does not exceed a $15 fair market value per person expected to attend or participate in the sales or marketing event. When determining how much the gift can cost, you may use anticipated attendance as long as it’s based on the venue’s size, response rate, and/or advertisement circulation.

Consider this scenario: Twenty people have sent back positive RSVPs to your next event. You are conducting a raffle, which everyone has agreed to enter. The gift prize cannot be worth more than $300. (That’s $15 multiplied by 20 expected attendees).

Can the Gift be in Cash?

No. Gifts cannot be in the form of cash or other monetary rebates. This is true even if the worth of the cash gift is less than or equal to $15. Gift cards are a gray area for the Medicare Marketing Guidelines. While it may be easiest to avoid them, the Office of Inspector General’s website has given some advice and leeway in specific situations.

Can Brokers Select Which Medicare Enrollees will get a Gift?

No. Gifts must be offered to all potential enrollees, whether they purchase a plan or not, without discrimination.

Can Brokers Offer Free Medical Checkups or Discounted Medication as Gifts?

No. You cannot offer anything that is considered a drug or health benefit. Similarly, you cannot offer a gift that is connected directly or indirectly to the provision of any other covered item or service.

Where can I get More Medicare Marketing Guidance?

Excelsior’s resource center offers more MMG-centered topics ranging from event-specific contact to proper venues for educational events. Our resource center is available 24/7 to give you the help you need with Medicare guidelines, sales advice, and more to keep your business on track. To learn more about the Excelsior team and how we can help you, contact us.

Source: https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/CY2019_Medicare_Communications_and_Marketing_Guidelines.pdf

EXCL000065


EXCL000065

References
http://www.excelsiorinsurance.com/medicare-marketing-guidelines-for-offering-gifts/

Read this Next

Ready to engage with Excelsior?

Contact us