Answering Your Questions About New CMS Rules

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 to clarify their implications for our affiliated agents’ businesses.

The below 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.

To submit your questions to our task force, please use the form below or email

For all other compliance-related matters, please email

This page was last updated September 12, 2023.



When will the carriers start sending policies regarding final rulings?

This is currently undetermined, and we are working with each carrier closely. We will update the FAQ as we have more information.

What are the enacted rules on Educational Events?

Educational events should be used solely for education and not for lead generation or future marketing opportunities for agents. Marketing events are prohibited from taking place within 12 (twelve) hours of an educational event in the same location. The same location is defined as the entire building or adjacent buildings.

What about the non-enacted TPMO rule? Should it be on our radar?

This rule would have impacted third-party lead generation during the upcoming AEP. However, it WAS NOT FINALIZED. CMS indicated they may revisit this proposed rule in future plan years. It’s important to have a diverse source of leads and to encourage self-generation where possible.

If I have the word "Medicare" in my agency name, should I begin the process of changing the name?

The CMS ruling specifically states no one can use the words medicare or Medicaid or a government image in a misleading fashion.

Agencies that conduct business in the state of Florida would have received a letter from the Department of Insurance requiring them to remove the word “Medicare” from their agency name no later than June 30, 2023. If they do not make this change, their licenses will not be renewed on July 1, 2023. Note: They also cannot add a DBA (doing business as) in Florida if they are domiciled in another state; they must change the name of their agency across the board.


Prohibition on Transferring Beneficiary Information Between TPMOs:

The proposed CMS prohibition on transferring information between TPMOs, which would have had a significant impact on third-party generated leads, was not adopted for the 2024 MA plan year. CMS did comment, however, that they “may address it in a future final rule.”  While no action relating to third-party lead generation is required at this time, agents and agencies should be aware that this rule may be considered as soon as the 2025 plan year, re-enforcing the value of a diverse mix of lead sources, including self-generated leads not requiring the transfer of lead data between TPMOs.

How should the disclaimer read if an agent represents multiple states?

The guidance is that the disclaimer must state the number of available products and plans the agent supports in the beneficiary’s area. We’ll release more detailed scripting at a later date.

Will YourMedicare's Compliance team help submit marketing materials to CMS on marketers' behalf?

YourMedicare’s Compliance team will help submit marketing materials to CMS on your behalf as long as you are contracted to sell that carrier’s product with YourMedicare.

While we understand that the CMS disclaimer (i.e., "We do not offer every plan...") is required on calls within the first minute of the interaction, if the call is disconnected — or if the client calls back within the same day (typically a few minutes later) to enroll — does the agent need to restate the disclaimer, or is the criteria for this rule considered to have been met from the first call?

Yes, the agent would need to restate the disclaimer.


Dates of Applicability of New Rules

The new rules, which become official on June 5, 2023, will be applicable to all marketing materials and sales processes starting Sept. 30, 2023 for coverage plan year 2024. This impacts agents and agencies marketing and selling Medicare Advantage plans in two ways: (1) all MA-related marketing materials you are using must meet the compliance standards in the new rules by Sept. 30, 2023; and (2) all MA enrollments during the upcoming AEP period (Oct. 15 – Dec. 7, 2023), and beyond must be generated in a manner compliant with the new CMS regulations.

What are the key enacted rules on marketing materials?

Given several new regulations regarding Marketing Material for AEP ’24, it’s our recommendation that agents/agencies heavily rely on communication versus marketing materials.

  1. Marketing materials must be reviewed by carriers prior to CMS.
  2. Marketing must clarify the number of organizations, products and plans specific to the beneficiary’s area.
  3. Marketing materials must clearly display the name of the sponsor.
What's the difference between marketing and communications?

Marketing is anything that is intended to draw a beneficiary to a specific MA plan and can include any of the following: plan premiums, cost sharing and benefit information. Communication is general in nature.

With respect to listing the number of carriers and plans on marketing materials, must this be done state-by-state, and does this also include PDP plans?

This must be done not state-by-state, but rather county-by-county, and should include PDP plans in the count.

When will the FCC release its likely ruling that could impact lead generation?

There is no firm date for the release of the FCC’s forthcoming rulings, but we anticipate an announcement by midsummer.

Given the new rules, how specific do mailer cards need to be?

Mailer cards must be tailored to individual markets and include dislaimer information (in minimum 12-point font) that specify market-specific carrier information and plan availability.

How long are PTC cards good for on Medicare Advantage?

PTC or a BRC that are collected prior to Sept. 30, 2023, are valid for six months from the date they were received. After Step. 30, 2023, they will be valid for 12 months.

Can you mention general Medicare Advantage benefits on a marketing piece if that piece does not have a carrier logo?

Yes, you can mention general benefits such as dental, vision and hearing. However, upon doing so, these materials are no longer considered communications but marketing and must be submitted to carriers and CMS for approval.

Can we use an image of the Medicare card on marketing pieces such as vehicle wraps or other promotional materials?

The image of the Medicare card may not be used for marketing purposes in any way, however the image may be used for educational purposes, as long as you’ve received prior authorization from CMS.

With respect to the June 21, 2023, ruling on “file and use” from CMS, will agents still need to submit marketing materials to carriers?

Yes, carriers must still pre-review and approve all scripts before agents may submit them to CMS for “file and use” (which may occur on the sixth day after filing).


Will Sunfire automatically pull which carriers an agent represents?

Given the complexity of the ask, we have provided the requirements necessary to our partners at Sunfire. Although we don’t have a firm commitment that they can support and have in place by AEP ’24, we have a commitment that they are actively working to identify a solution. As we have more information, we will be sure to share.

Does the 48-hour rule apply to the last 4 days of the month?

The 48-hour rule applies unless there is a qualifying election code during the last four days of the month. Ruling states “we will not apply the 48-hour rule if the SOA is completed during the last four days of the election period.”

Can a licensed agent collect scope from an unlicensed agent?

This is currently an open question that our team is actively working on to ensure we have an aligned interpretation across all of our carriers, as well as CMS.  Once the interpretation is final, we will release more details.

If you mention a general benefit that COULD be applicable to every carrier but is not carrier-specific, what is the approval process for an ad?

If you leverage Marketing Material, each product/carrier associated with the material must sign off prior to submission to CMS.

Does the 48-hour Scope of Appointment requirement apply to telephonic enrollments?

Yes, the requirement applies to all enrollments, including telephonic enrollments.

Are inbound calls exempt from the 48-hour Scope of Appointment requirement?

Yes, the 48-hour rule applies to all enrollments, including call centers. CMS has clarified that it does not apply to walk-ins and inbound consumer phone calls or those enrolling in the last four days of a valid election period.  If any of the exceptions apply,  then the agent would be able to collect a SOA and then continue with the enrollment, if the consumer wishes to do so.

When will the FCC release its likely ruling that could impact lead generation?

There is no firm date for the release of the FCC’s forthcoming rulings, but we anticipate an announcement by midsummer.

If a client asks about a Medicare Advantage plan during a Final Expense appointment, can the agent take a Scope of Appointment and return to discuss Medicare Advantage coverage 48 hours later?

Yes. If the client asks about a Medicare Advantage plan, the agent can take a Scope of Appointment but cannot discuss MA during the same appointment.

For how long is a Scope of Appointment good after it has been set?

Currently, a Scope of Appointment is good for six months from the date it was set. However, beginning July 10, 2023, a Scope of Appointment will be good for 12 months from the date it was set.

Is it CMS compliant for an unlicensed individual to collect an MAPD or PDP Scope of Appointment?

Our current interpretation is that, yes, a customer service representative can collect a Scope of Appointment for a licensed agent.

Is it CMS compliant for a Scope of Appointment to be passed from either an unlicensed or licensed individual to a third-party licensed individual for enrollment after 48 hours?

No. A Scope of Appointment is specific to an agent and cannot be moved from person to person. In other words, when a Scope of Appointment is collected, the consumer must know who will be contacting them in 48 hours to discuss plan enrollment. This information cannot be left as an open item.

Is there an approved pre-enrollment checklist (PECL) that agents should use, or will the carriers be making this available?

CMS will provide a PECL. There is no expected available date on this currently. 

Can a Medicare beneficiary waive the 48-hour Scope of Appointment requirement?

No. However, they can elect to waive this requirement if (a) they are a walk-in or (b) their request takes place during the final four days of an election period.

If an agent has collected an SOA from their client, is that same agent allowed to supply any quote or comparison information to their client to review before their appointment takes place?

No, agents may not provide quotes or comparisons anytime during the 48 hours prior to their appointments. This is a specific requirement of the SOA. Any such engagement prior to the set appointment would be construed as a “meeting.”

Are agents allowed to collect information from their clients (such as prescriptions, pharmacy or provider information) at the same time during which they collect an SOA to be able to run a comprehensive comparison for their clients prior to their meetings?

Some agents do collect this information from existing clients from year to year, usually via a form that has been mailed to the client and sent back to the agent via mail. Unfortunately, given the recent changes to the SOA, we would advise sending the form to the client to complete prior to your meeting but collect the information at the set appointment. This will allow the client to gather the necessary information together to ensure a more streamlined process and productive appointment.

Can a non-licensed representative collect information from a client for a comprehensive comparison prior to a set appointment?

No. If an appointment is set, the information should be collected at that time. In a call center setting, a customer service representative could take basic information before the agent reviews the sales and enrollment information.

If an individual calls and, via voicemail, sets an appointment to talk at a later date, is a Scope of Appointment (SOA) still required?

Yes, an SOA is needed for all enrollments and must be retained or submitted with the enrollment application.

Can Scopes of Appointment (SOA’s) be collected at marketing events?

No, SOA’s cannot be distributed or collected at marketing events.

Is a Scope of Appointment (SOA) sent via text message to a beneficiary who called in sufficient?

If you have express written consent to text the beneficiary, then yes, an SOA sent via text message – so long as it contains all required information on an electronic or paper SOA – is considered TCPA compliant. As a reminder, the agent would need to retain the SOA via text message for 10 years and be able to produce it if requested by a carrier of CMS.

Must a call center wait 48 hours after receiving a confirmed Scope of Appointment (SOA) via text message?

Yes, a call center must wait 48 hours after receiving an SOA before discussion and enrollment into a Medicare Advantage (MA) plan.

If a beneficiary calls in on a recorded line, is verbal confirmation sufficient to begin the discussion and enrollment process?

Yes, if a beneficiary calls in (i.e., not a warm transfer) and asks to discuss or enroll in a plan, then the 48-hour waiting period does not apply per CMS. As a reminder, the agent would need to retain the call recording for 10 years and be able to produce it if requested by a carrier of CMS.

If a beneficiary calls back to verbally agree to an SOA in on a recorded line, is verbal confirmation sufficient to begin the discussion and enrollment process?

Yes, if a beneficiary calls in (i.e., not a warm transfer) and asks to discuss or enroll in a plan, then the 48-hour waiting period does not apply per CMS. As a reminder, the agent would need to retain the call recording for 10 years and be able to produce it if requested by a carrier of CMS.

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