At a Medicare sales marketing event, an agent is allowed to present specific Medicare Advantage or Part D plans, hand out CMS-approved marketing materials, accept completed enrollment applications, collect Scope of Appointment forms for future one-on-one meetings, share business cards, and offer promotional gifts worth no more than $15 each. Light snacks are fine. Meals, health screenings, cross-selling of non-health products, and pressure to enroll on the spot are not.
These rules come from federal regulations at 42 CFR Part 422 for Medicare Advantage and Part 423 for Part D. A plan that breaks them can lose its Medicare contract, and an agent can lose the ability to sell Medicare products.
What Agents Can Do
A marketing or sales event is a group gathering where specific Medicare Advantage or Part D plans are discussed, promoted, or compared. Inside that setting, agents have broad latitude to sell.
- Walk attendees through benefits, premiums, copays, formularies, provider networks, and service areas for specific plans.
- Distribute brochures, comparison charts, and other plan-specific materials, provided CMS has reviewed and approved them.
- Hand out and collect completed enrollment forms at the event.
- Have a beneficiary sign a Scope of Appointment form for a follow-up individual meeting.
- Share business cards for later contact.
All of these activities are explicitly authorized under the regulations governing marketing events.1eCFR. 42 CFR 422.2264 – Beneficiary Contact
Sign-in sheets are permitted, but attendance cannot be conditioned on signing in or handing over contact information. If someone walks in and prefers to stay anonymous, they get to sit down and listen. Information collected for a raffle or door prize drawing cannot be repurposed for marketing follow-ups.
Gifts, Snacks, and the Meals Line
Promotional gifts are allowed, but only if they meet the OIG’s definition of nominal value: no more than $15 retail per item, with a total cap of $75 per person per year. Gifts cannot be cash or cash equivalents like prepaid debit cards.2Office of Inspector General. OIG Policy Statement Regarding Gifts of Nominal Value to Medicare and Medicaid Beneficiaries Pens, tote bags, and pill organizers are typical. The gift must be offered to everyone who attends, whether or not they enroll.
Light snacks and refreshments are fine. Meals are not, regardless of who pays. The regulation states plainly that plans “may not provide or subsidize meals” at marketing or sales events.3eCFR. 42 CFR 422.2263 – General Marketing Requirements CMS guidance adds that bundling multiple food items to approximate a meal violates the spirit of the rule. Coffee and cookies pass. A catered lunch does not.
What Agents Cannot Do
The list of prohibited conduct is longer than the list of allowances, and the consequences hit harder.
No Health Screenings or Surveys
Blood pressure checks, glucose screenings, health risk assessments, and similar activities are off-limits. CMS treats them as tools that could be used to cherry-pick healthier beneficiaries or target people with specific conditions.1eCFR. 42 CFR 422.2264 – Beneficiary Contact
No Cross-Selling Non-Health Products
Life insurance, annuities, home warranties, and any other non-health-care product cannot be discussed or marketed during a Medicare sales activity. The regulation calls this cross-selling and flatly prohibits it.4eCFR. 42 CFR 422.2263 – General Marketing Requirements
No Pressure or Forced Enrollment
Agents cannot push anyone to enroll at the event, steer beneficiaries toward plans based on commission incentives, or demand Social Security numbers or other sensitive personal information beyond what’s needed to answer a question or process a voluntary application.5Centers for Medicare & Medicaid Services. Medicare Issues New Rules to Enforce Marketing Requirements During Upcoming Health and Drug Plan Enrollment Period
No Unsolicited Contact
Cold calling, door-to-door visits, and uninvited outreach are prohibited before, during, and after events. An agent can only contact a beneficiary who has invited the contact.5Centers for Medicare & Medicaid Services. Medicare Issues New Rules to Enforce Marketing Requirements During Upcoming Health and Drug Plan Enrollment Period
No Misleading Materials
Everything handed out must first go through CMS review in the Health Plan Management System.6eCFR. 42 CFR 422.2261 – Submission, Review, and Distribution of Materials Materials cannot claim endorsement by CMS, Medicare, or HHS, cannot use the word “free” to describe a $0 premium or reduced cost sharing, and cannot use superlatives like “best” or “highest rated” without a cited data source from the current or prior contract year.7eCFR. 42 CFR 422.2262 – General Communications Materials and Activities Requirements
How a Marketing Event Differs From an Educational Event
CMS separates group events into two categories, and the difference changes what’s allowed. A marketing event promotes specific plans. An educational event is designed to inform people about Medicare in general without pushing any particular plan.
At an educational event, an agent can distribute general communications materials, answer plan-specific questions that a beneficiary raises first, hand out business cards, and make business reply cards available. An agent cannot deliver a sales presentation, hand out plan-specific materials with premiums or copays, distribute or accept enrollment applications, or collect Scope of Appointment forms.1eCFR. 42 CFR 422.2264 – Beneficiary Contact8Medicare.gov. Marketing Rules for Health Plans
The practical difference: an educational event might explain how Medicare Advantage works, what Parts A through D cover, and how enrollment periods run. A marketing event can say, “our HMO plan costs $0 per month and covers dental.” CMS also prohibits holding a marketing event within 12 hours of an educational event in the same building or an adjacent one, to keep the two from bleeding together.
Moving to a One-on-One: Scope of Appointment
If a conversation shifts from the group setting to a private meeting, a Scope of Appointment form becomes mandatory. The beneficiary signs it, and it specifies which product types the agent is authorized to discuss. The agent is bound to those topics. If the beneficiary wants to talk about something else, a second form has to be completed before continuing.
The Scope of Appointment normally has to be agreed to and documented at least 48 hours before the appointment. The beneficiary has to fill it out themselves, in writing or through a recorded call. Two exceptions: appointments scheduled during the last four days of a beneficiary’s valid election period, and walk-in visits the beneficiary initiates without a prior schedule.1eCFR. 42 CFR 422.2264 – Beneficiary Contact One more wrinkle: if a beneficiary attends a marketing event and afterward asks for an individual appointment, the 48-hour wait doesn’t apply, as long as they sign the form first.
How to Report a Violation
If you experienced aggressive or misleading marketing at an event, you can call 1-800-MEDICARE (1-800-633-4227). If you’re already enrolled in a Medicare Advantage or Part D plan, you can also contact the Investigations Medicare Drug Integrity Contractor at 1-877-772-3379. Suspected fraud can be reported online through the HHS Office of Inspector General at oig.hhs.gov.9Medicare.gov. Reporting Medicare Fraud and Abuse
CMS enforcement against plans can include civil money penalties, suspension of marketing activities, freezes on payment, or termination of the plan’s Medicare contract.10Centers for Medicare & Medicaid Services. Part C and Part D Enforcement Actions Individual agents found responsible can lose the ability to sell Medicare products and face state licensing action on top of any federal penalty.