When Does Permission to Contact Medicare Beneficiaries Expire?
BY PATRICK RODRIGUEZ
What is the Purpose of Permission to Contact?
Before we explore the question of “When Does Permission to Contact Expire,” (PTC) it’s important to understand what it is and who it covers. When contacting current or future Medicare beneficiaries, brokers must stay on their toes. The Centers for Medicare & Medicaid Services (CMS) have published the 2022 Medicare Communications and Marketing Guidelines (MCMG) which governs the kind of language brokers and agents can use in informational and marketing materials. In addition, you must be very careful about when and how you contact beneficiaries.
On the nose, the guidelines set forth by CMS may seem rather strict. However, these rules were set in place because a few agents used unethical tactics during enrollment to get people to sign up for prescription drug plans, along with other products. Some people reported feeling intimidated into agreeing to sign up for a specific plan, even though their doctors weren’t part of it. Often the agent had a financial incentive for certain plans. Other beneficiaries were signed up for life insurance or other products without their knowledge. Ultimately, extensive guidelines were issued to protect beneficiaries from misinformation, pressure tactics and fraud.
Permission to Contact Guidelines
Specifically, the Medicare Permission to Contact (PTC) rule outlines when it is okay to contact a current or potential Medicare beneficiary, the specific products they are giving you permission to contact them for, how you can approach them, and when you can contact them.
How to Compliantly Receive Permission to Contact
According to MCMG Guidelines, agents must have permission before they can make marketing calls. The following activities are strictly forbidden:
• Cold calling
• Direct messaging via social media
• Text messaging
• Canvassing door to door
Here are a few ways an agent can get permission to contact:
- Have potential clients fill out a Business Reply Card (BRC)
- The beneficiary emails a Plan or Part D Sponsor and requests a return call
- Beneficiaries ask a customer service representative to have an agent contact them
It is vital that the beneficiary initiate the contact.
On the BRC, phone call, or email, the consumer will indicate what program they want information about. A client should indicate whether they want information on Medicare Supplements, Medicare Advantage, or both.
Once a beneficiary gives permission for an agent to contact them, the agent still has to be careful. The permission only covers a very small window of service. Specifically, beneficiaries can only be contacted by the entity they’ve requested contact from, and the agent can only discuss the products indicated on their BRC.
When Does the Medicare Permission to Contact for Medicare Advantage and Prescription Drug Plans Expire?
Now to answer the all-important question: “When does permission to contact expire?” Well, it depends on what the scope of the appointment is for as indicated by the beneficiary.
For Medicare Advantage plans (MA) or Prescription Drug Plans (PDP), PTC expires 9 months after the date the request is received. The PTC for Medicare Supplement products is 90 days.
It is important to note that the PTC must be renewed if it expires, even when ongoing contact is intended. In addition, the method of communication will be dictated by the beneficiary, (i.e. direct mail, phone call, email).
What About My Current Clients?
An agent may contact a client without PTC if one of these criteria are met and the burden of proof can be met:
1. Current, active contract with another product (i.e. life insurance)
2. Ongoing, active business relationship
3. Agent of Record (AOR) for the beneficiary’s plan they are currently enrolled in
Set Yourself Apart with PTC Compliance
Rather than thinking of the Permission to Contact as a silly and annoying rule, agents and brokers
can present it so that they seem more trustworthy to potential clients. Medicare enrollees get tons of unsolicited calls from pushy agents. Dozens of mailers arrive, some with very deceptive wording or images. When agents emphasize they want to make sure the beneficiary is only presented with information that is valued and desired, they set themselves apart.
If you would like to be better supported in compliance, find out more about our Agent Programs at appliedga.com.
PATRICK RODRIGUEZ is owner and president of Applied General Agency, Inc., one of the largest Medicare-focused Field Marketing Organizations (FMO) nationwide. Patrick has been navigating the ins-and-outs of the independent agent marketplace for over 30 years. He founded AGA in 1993 with the intention of providing unprecedented value to overworked agents who had more obligations than time.