Preparing for the 2024 Annual Enrollment Period (AEP)

Preparing for the 2024 Annual Enrollment Period (AEP) in the Medicare market requires strategic planning and a proactive approach to effectively meet the needs of beneficiaries. As this critical period approaches, there are several key steps to consider in order to maximize your success and provide valuable services to your clients.

First and foremost, staying updated on changes to Medicare regulations, plan offerings, and industry trends is paramount. The healthcare landscape is constantly evolving, and being well-informed positions you as a reliable source of information for beneficiaries seeking the right coverage. Attend seminars, webinars, and training sessions provided by insurance carriers to ensure you're up-to-date with the latest developments.

Reviewing your marketing and outreach strategies is essential to engage potential clients during the AEP. Refresh your online presence by updating your website, social media profiles, and other digital channels. Consider creating informative content such as blog posts, videos, and downloadable guides that address common questions and concerns about Medicare plans. Tailoring your messaging to highlight the advantages of different plans can help beneficiaries make informed decisions.

Focusing on compliance is also crucial during the AEP. Familiarize yourself with the Medicare Marketing Guidelines issued by the Centers for Medicare & Medicaid Services (CMS). These guidelines outline the dos and don'ts of marketing Medicare plans. Ensuring that your marketing materials are accurate, transparent, and compliant will maintain your reputation and prevent potential legal issues.

Lastly, anticipate the surge in inquiries and be prepared to offer personalized assistance to beneficiaries. Consider implementing systems to manage incoming queries efficiently, whether through your website, email, or phone. Providing clear and concise information, as well as addressing concerns promptly, can set you apart as a trustworthy advisor. By offering exceptional customer service, you'll establish strong relationships with clients that extend beyond the AEP.

By strategically approaching this period, you'll not only serve your clients effectively but also position yourself as a knowledgeable and reliable Medicare advisor.

At PSM, we are committed to providing our agents with a range of resources and support to help them succeed. From personalized marketing materials to interactive sales strategies, our goal is to empower agents with the latest tools, technology and mentorship to achieve new levels of success this AEP.

AEP Resources:

Powerful Partnerships:

We are committed to providing our agents with a range of resources and support to help them succeed: Our powerful partnerships include:

Strong relationships with insurance carriers and industry experts to provide agents with access to the best products, tools, and support.

Capital infusion and acquisition strategies to help agents expand their business and reach their ultimate goals.

Dedicated service and mentorship from experienced professionals to help agents build a successful business.

Proprietary lead, training, marketing and enrollment platforms to streamline your sales process and business practices.

Compliance oversight to ensure agents are meeting regulatory requirements and operating ethically.

Succession planning and agency building support to help agents plan for the future and achieve long-term success.

AEP Helpful Guides:

We are here to support!

As a reminder, We pride ourselves on a "Do the Right Thing" approach and will go above and beyond to service the needs of our agents. We look forward to having a successful AEP and supporting you with products, technology and the personalized service you have come to expect from PSM. We appreciate the opportunity to earn your business and wish you the best!

The Inflation Reduction Act of 2022 was signed into law on August 16, 2022. The new law provides meaningful financial relief for millions of people with Medicare by improving access to affordable treatments and strengthening the Medicare Program both now and in the long run. The law makes improvements to Medicare by expanding benefits, lowering drug costs, keeping prescription drug premiums stable, and improving the strength of the Medicare program. The law also extends enhanced financial help to purchase HealthCare.gov and state-based Marketplace plans and expands access to Advisory Committee on Immunization Practices (ACIP) recommended vaccines for adults with Medicaid coverage.

This law means millions of Americans across all 50 states, U.S. territories, and the District of Columbia will save money from meaningful benefits. The Inflation Reduction Act is accomplishing the following just one year after being enacted:

• Saving Affordable Care Act Marketplace consumers an average of more than $800 per year from continued expansion of financial assistance, based on national estimates.
• Driving the nation’s uninsured rate to historic lows.
• Lowering insulin costs for 4 million seniors and other Medicare beneficiaries with diabetes by capping a month’s supply of each covered insulin at $35.
• Providing ACIP-recommended adult vaccines at no cost to millions of people with Medicare.
• Lowering out-of-pocket costs for some people with Medicare for certain Part B drugs and biologicals with prices that have increased faster than the rate of inflation.
• Projecting savings for nearly 19 million seniors of an average of $400 per year when the $2,000 cap on out-of-pocket prescription drug costs goes into effect in 2025.

“Medicare beneficiaries were at the center of the conversation when CMS enacted new marketing rules earlier this year. But with these changes agents may find they will need to pivot from their familiar marketing approach.”

Good news: PSM anticipated these changes and activated a task force to study the published rules and clarify any implications for agents.

More good news: With AEP a few short weeks away, agents have the tools to ensure your marketing efforts and activities are compliant with the new rules. Let’s look at the rules changes.

July 7 marked 100 days until the start of Medicare's Annual Enrollment Period – affectionally known as AEP – and it's time to get excited! With new rules and regulations from CMS taking affect and new carrier products to learn and master, it's important that all of us to stay up to date and think through our collective strategies. According to recent statistics, more than 30 million Americans are enrolled in Medicare Advantage plans, making them eligible to sign up or renew their coverage during this AEP and start their new Medicare benefits on Jan. 1, 2024.

The best way to stay informed and prepared for the upcoming enrollment period is through research and leaning in to all the available resources at your fingertips. Make sure to review the new CMS rules and regulations as they are released and familiarize
yourself with the available products. Our CMS Task Force, led by our compliance and legal teams, is hard at work deciphering, analyzing and understanding processes for all of us to remain successful, while keeping compliant. As a reminder, our CMS FAQ webpage is your one-stop resource for rules interpretation, as well as for answers to question many colleagues have already submitted.

Get to know the Medicare products you are selling! Become knowledgeable about the benefits of the different plans available, rate changes heading into 2024, and competitiveness of the offerings in the areas you serve. Check out the new 2024 Medicare Advantage and Part D Rate Announcement Fact Sheet and the 2024 Medicare Advantage and Part D Final Rule – both available on the CMS.gov website.

Now is the time to reconnect with key clients ahead of the AEP 2024 selling season. Take
the opportunity to educate and reaffirm your relationships, while also establishing new ones. Aligned with new CMS marketing rules, this is also a great opportunity to follow best practices in informing clients of any new ancillary products that will be available when the enrollment period begins.

At the same time, now is also the time to start strategizing for how you’ll achieve your objectives this AEP, noting the important role this selling season plays in setting the tone for the new year. It starts with recruiting and certifications, and then fleshing out your game plan for how you’ll drive productivity throughout the AEP selling season.

Figure out which platforms you want to use, create and organize your promotional materials and plan out how you’ll drive activity. Doing this ahead of time will ensure that you are well prepared when the enrollment period begins. And don’t forget about our AEP Resource Page as your one-stop shop.

We are prepared to help you execute your AEP objectives

The complexity of the AEP process and the everchanging landscape of health care requires a comprehensive understanding of different types of plans and coverage options, timelines, and deadlines associated with AEP. Preparing your team for AEP is key! PSM’s approach - crafted and fine-tuned - takes a holistic approach to insurance distribution, one that allows us to create tailored partnership models with our agents and financial professionals and their affiliated companies to deliver what they and their clients need.

This includes a product portfolio of the nation’s best health and wealth solutions designed to meet the needs of consumers’ health and financial wellbeing, no matter where they are on their retirement journey.

The start of Medicare’s Annual Enrollment Period is just around the corner, and the time to prepare is now. Research the new rules and regulations, familiarize yourself with the different plans, and map out strategies that align with your goals. With the support and preparation from your PSM team, you will be ready and excited to help your clients make the best choices to live a happy, healthy retirement.

The AEP is right around the corner and there are some exciting opportunities on the horizon for 2024. Get prepared early to ensure a successful Annual Enrollment Period. We are here to help!

Check out the latest Marketing Masterminds webinar to learn how our direct qualified leads can help you win big this AEP.

Recorded webinar link available here.

Marketing Masterminds: Mastering Inbound Calls with LeadStar Marketplace

William and Megan discuss the need to launch campaigns on a monthly basis and the benefits of using the Lead Star marketplace for inbound calls, highlighting cost savings for agents and agencies. They also highlight the platform's performance for Medicare data leads, with a better than average CPA.

Recorded webinar link available here. 

Before we dive in, it's crucial not to solely depend on these key points, as they are only a portion of the overall impact. We strongly advise reviewing the regulation and guidance thoroughly in order to gain a comprehensive understanding of each requirement and the potential changes you may need to implement. Also, be sure to visit https://yourfmo.com/cms-faqs which is frequently updated as we receive guidance from CMS and our carrier partners. 

Sales and Marketing Activities 

• Visiting a beneficiary without an appointment is always prohibited, even when the beneficiary has expressed an interest in MA products.
  
  
• You may no longer set up future personal marketing appointments or have beneficiaries complete Scope of Appointment forms at educational events.
  
  
• Marketing events are prohibited from taking place within 12 hours of an educational event in the same location. The same location is defined as the entire building or adjacent buildings.
  
  
• You must wait 48 hours between the completion of the Scope of Appointment and the start of the personal marketing appointment except when:
  • • SOAs are completed during the last four days of a valid election period.
    • Unscheduled in-person meetings (walk-ins) are initiated by the beneficiary.
    • Note: CMS has indicated that this 48-hour period is not required for inbound calls from enrollees. At this time, unless CMS provides further clarification, this requirement applies to outbound calls.
      
      
• The pre-enrollment checklist (PECL) must be provided prior to enrollment, including telephonic enrollments. "Effect of current coverage" has been added to the PECL.
  
  
• TPMOs must provide the number of plans and products it offers, as well as SHIP contact information in its disclaimer. TPMOs who offer all plans and products must also provide a version of this disclaimer.
  
  
• TPMOs must record all marketing, sales, and enrollment calls, including the audio portion of calls via web-based technology, in their entirety. Other types of calls have been excluded.
  
  

Marketing Materials 

• Authorized TPMOs must submit multi-plan materials to HPMS after pre-review by MA organizations.
  
  
• The use of superlatives such as "best" or "most" is prohibited unless specific criteria for supporting documentation are fulfilled.
  
  
• Do not use the Medicare name and CMS logo in a misleading way. Use of the Medicare ID card image must be authorized for use by CMS.
  
  
• The MA organization name or marketing name(s) as listed in HPMS must be identified in the marketing of any products, plans, benefits or costs.
  
  
• Marketing communications may not include information regarding potential savings that are based on a comparison of typical expenses borne by uninsured individuals, unpaid costs of dually eligible beneficiaries, or other unrealized costs of a Medicare beneficiary.

For Agent Use Only.

On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) issued long-awaited rules pertaining to, among other matters, the marketing of Medicare Advantage (MA) plans. YourMedicare and its partners had been anticipating these changes and have activated a task force to study the newly published rules in detail and clarify their implications for our affiliated agents’ businesses.

The FAQ is the culmination of that effort. Here you will find answers to a number of questions we have received since April 5, as well as clarification on the new rules our team is proactively providing.

Please bookmark this page for future reference. As new information and interpretations become available, we will add those to this page.

Date: May 10, 2023

To: Medicare Advantage Organizations, Medicare Advantage-Prescription Drug Plans, Prescription Drug Plan Sponsors, and Section 1876 Cost Plans

From: Kathryn A. Coleman, Director

Subject: Definition of Marketing

📑 Download the official announcement

In order to ensure Medicare beneficiaries are making enrollment decisions based on up-to-date and accurate information, the Centers for Medicare & Medicaid Services (CMS) is issuing this memo to clarify the definition of marketing for Medicare Advantage-Prescription Drug Plans, stand-alone Prescription Drug Plans, 1876 Cost Plans, and Third-Party Marketing Organizations (TPMOs).

Regulations at 42 CFR §§ 422.2260 and 423.2260 define marketing as communication materials and activities which meet specific intent and content standards.

• The intent component of the definition of “marketing” is met when any material or activity is intended to draw a beneficiary's attention to plan or plans, influence a beneficiary's decision-making process when selecting a plan, or influence a beneficiary's decision to stay enrolled in a plan (that is, retention-based marketing).
  
  
• The content component of the definition of “marketing” is met when any material or activity includes or addresses plan benefits, benefits structure, premiums, or cost sharing; measuring or ranking standards; or rewards and incentives.

To date, CMS has permitted the mentioning of widely available benefits (i.e., vision, dental, premium reduction, and hearing) in materials or activities without those materials or activities being considered marketing subject to the marketing regulations. We did not believe the general descriptions were made with sufficient intent to draw attention to a particular plan or subset of plans. This interpretation was predicated on the assumption that a beneficiary would be unlikely to make an enrollment decision based on widely offered benefits advertised without information on the associated costs for enrollees. CMS monitors both organization and TPMO marketing by reviewing marketing and communication materials and activities, reviewing complaints received through 1-800-Medicare, and listening to marketing and enrollment calls.

Due primarily to the recent proliferation of TPMO advertising, we have found, however, through our surveillance, reviews, and discussions with interested parties that many beneficiaries do inquire and some enroll based on the original advertisement of these types of benefits. Beneficiaries have contacted agents, made calls to 1-800 numbers, and responded to flyers asking about the dental, vision, hearing, and cost-savings being marketed. Therefore, we are expanding our interpretation of the regulatory definition of “marketing” to include content that mentions any type of benefit covered by the plan and is intended to draw a beneficiary's attention to plan or plans, influence a beneficiary's decision-making process when selecting a plan, or influence a beneficiary's decision to stay enrolled in a plan (that is, retention-based marketing) and thus subject to review.

As stated above, marketing requires both intent and content. Content that beneficiaries can receive benefits such as dental, vision, cost-savings, and/or hearing services is sufficient information about plan benefits, benefits structure or cost sharing to meet the content standard in the definition of marketing in §§ 422.2260 and 423.2260. Further, the use of these statements in advertisements and activities directed to Medicare beneficiaries clearly meets the intent standard. Therefore, beginning July 10, 2023, any material or activity that is distributed via any means (e.g., mailing, television, social media, etc.) that mentions any benefit will be considered marketing and must be submitted into HPMS. This clarification, along with the new marketing safeguards codified in the Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly final rule (CMS-4201-F), will help ensure that beneficiaries have accurate information when shopping for Medicare coverage and are protected from potentially misleading marketing activities.

Questions may be sent to marketing@cms.hhs.gov. Please copy your Marketing Reviewer.