At PSM, we have been receiving some questions regarding the topic of gifts/promotional items and want to share some further guidance on these regulations. The Social Security Act prohibits offering anything of value to a Medicare beneficiary in exchange for a referral or to influence their decision to enroll into a Plan.
There is an exception to this rule which states that marketing representatives may provide gifts, prizes, or promotional items to beneficiaries for marketing purposes as long as:
The value of the item may not be worth more than $15.
The item must be provided regardless of enrollment and without discrimination.
When more than one gift is offered on one occasion, the combined value of all items must not exceed $15.
Multiple gifts given to a beneficiary on different occasions may not exceed $75, per person, per year.
Cash or monetary rebates may not be given as a nominal gift.
Meals may not be given as a nominal gift. Only light snacks and refreshments can be provided at marketing events
It’s important to note that agents are not permitted to provide anything of value (e.g., gift card, flowers) to a consumer/member in exchange for a referral (i.e. contact information including name and telephone number/email). The key difference is the purpose of the gift. If it’s given in exchange for a referral, it’s not allowed.