When and How to Use NCQA SNP Approvals in Marketing Material

Infographic of the Medicare Marketing Guidelines for Special Needs Plan Approval

Every Medicare Special Needs Plan (SNP) is assessed by the National Committee for Quality Assurance (NCQA) based on detailed Model of Care (MOC) guidelines created by CMS. Depending on the score a plan receives, it is granted a one-, two-, or three-year approval. If you want to mention NCQA approvals in your SNP marketing materials, there are limitations you need to consider.

Can I Discuss NCQA Approval in SNP Marketing Materials?

According to CMS rules (MMG Appendix 5 – Disclaimers), you can mention NCQA SNP approval, but only with the following language: [Insert Plan Name] has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until [insert last contract year of NCQA approval] based on a review of [insert plan name’s] Model of Care.

Can I Mention the NCQA SNP Score on a Press Release or a Brochure?

No. You can only use the language above when referring to NCQA SNP plans in any marketing or public relations communications.

Can I Present SNPs With Other Types of Plans Within the Same Document?

CMS rules (MMG Appendix 4 – Summary of Benefits Instructions) state that you may include SNPs with other plans in your document, but they need to be presented separately from non-SNP plans. For example, do not include an SNP plan in the same chart that has non-SNP HMO or PFFS plans.

Where Can I Get More Medicare Marketing Guidance?

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.

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


https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/CY-2018-Medicare-Marketing-Guidelines_Final072017.pdf | http://snpmoc.ncqa.org/

Ready to engage with Excelsior?

Contact us