Last updated: September 12, 2026
Nothing here is legal advice, and the federal requirements below are described rather than interpreted. Check every rule against the current CMS text and your own counsel.
What the Medicare Advantage marketing rules cover
CMS marketing rules for Medicare Advantage govern what plans and the organizations selling them may say, how materials get reviewed, how events run, and what an agent has to disclose on a call. Marketing and communications are governed differently, and that line decides which requirements apply to a given piece. The current set took effect October 1, 2026.
What changed for contract year 2027
| Rule | Contract year 2026 | Contract year 2027, effective October 1, 2026 | Changes what an agent says |
|---|---|---|---|
| TPMO disclaimer timing | Within the first minute of the call | Before any discussion of plan benefits | Yes, the running order |
| SHIP referral inside the disclaimer | Required | Removed | Yes, the wording |
| Marketing and sales call retention | 10 years | 6 years | No |
| Enrollment record retention | 10 years | 10 years | No |
| Scope of Appointment waiting period | 48 hours before the appointment | Eliminated, SOA still required | No |
Two rows move the script. The disclaimer trigger came off the clock and onto the conversation, which reorders the opening of every sales call, and the State Health Insurance Assistance Program referral came out of the standardized language, which changes the sentence itself. An agent who reads last October's disclaimer word for word this October is reading something that no longer matches the regulation, and doing it perfectly.
Retention reaches nobody on the floor. Six years instead of ten cuts what your storage vendor bills you, enrollment records stay on their own ten year path, and a blanket delete at six years is therefore a mistake. CMS call recording requirements carries the format split and the arithmetic.
The Scope of Appointment change moves a calendar. An agent who takes an SOA on Tuesday morning can hold the appointment Tuesday afternoon, and the form still has to be agreed and documented before plan specific discussion starts. Scope of Appointment rules covers what it has to capture.
Marketing and communications are governed differently
Communications is the wide category. Marketing sits inside it, carved out by two things: what the piece is meant to do, and what it actually contains.
Intent is the first test, and it asks whether the piece is aimed at drawing attention to a plan or moving somebody toward enrolling. The second asks about content, meaning benefits, premiums, cost sharing, or how a plan measures up against another. Material that clears both lands on the marketing side, where the heavier obligations attach.
| Usually reads as communications | Usually reads as marketing |
|---|---|
| Confirming an appointment time with a beneficiary | Naming a plan and its premium on that same call |
| An explanation of how Medicare Advantage works, no plan named | A mailer comparing current coverage against a plan you sell |
| Service call about a denied claim | Landing page with a plan name and an enrollment button |
| Notice that the Annual Enrollment Period opens October 15 | Postcard promising a zero dollar premium |
The row we are least sure about is the first one. An agent confirming a time has not named a benefit, so it reads as communications, and that same call slides into a plan question about thirty seconds in more often than not. Our working answer is that the label belongs to the call as it actually happened rather than to the reason it was placed. Put that one to your plan partner's compliance desk before you train on it, because we would rather be corrected than quoted.
The consequence of the line is review. A piece on the marketing side generally moves through the plan before it goes out, and a piece on the communications side generally does not, which is why an agency that guesses wrong on the label finds out through an audit rather than a rejection.
The rules that attach to a phone call
Five obligations reach an agent while the call is live, and status decides all five.
Being a third party marketing organization follows compensation rather than the name on your door, so an agency, an FMO, a lead vendor transferring live calls, and an outsourced center taking AEP overflow can all sit inside the same definition. What a TPMO is runs it against real arrangements.
The disclaimer is standardized language delivered verbally during sales calls before any discussion of benefits, in one of two versions depending on whether you represent every plan in the service area. Both versions sit on the TPMO disclaimer on a sales call, which is why this page does not reproduce them.
Recording covers marketing and sales calls in their entirety, including the audio portion of calls held over web based technology. Nothing in that paragraph carves out the first conversation.
Permission to contact sits upstream of everything else, since prior express written consent decides whether the call could happen at all. Consent captured for one product line does not carry over to another, and that is a question for counsel rather than a blog post.
Benefit accuracy is the fifth and the hardest to hold. Language belongs to approved plan materials for the plan year in question, and an agent paraphrasing a benefit in their own words has left that boundary without noticing. Writing a compliant Medicare call script puts the five in running order.
Material review and submission
An agency that writes its own material runs into a question this page will not answer for you.
Marketing material generally moves through plan review, and CMS runs a submission system on the plan side called HPMS. Which categories require review, who files, and how long it takes are not stated here, because we have not read the governing paragraphs and an agency acting on somebody's summary of them is exactly how this goes wrong.
Ask your plan partner for their material review process in writing, then ask which of your own pieces they treat as marketing under the definition. Those two answers set your workflow for the year, and they come from the carrier rather than from us.
Events, in person and online
Marketing events and educational events are governed as separate things, and an event's label follows what happened in the room rather than what the invitation promised. An educational event stays informational and does not steer anybody toward a specific plan. A marketing event does, and it carries its own notice and conduct expectations.
The line gets blurry online. A webinar that opens as education and closes with an enrollment link has probably become a marketing event, and the recording of it becomes the evidence either way.
Agent compensation and the chain of enrollment
Compensation is the mechanism that makes any of this reach you.
The definition turns on being paid to perform lead generation, marketing, sales, or enrollment related functions as part of the chain of enrollment. A lead vendor that never speaks to a beneficiary about a benefit can still land inside it, because the compensation and the position in the chain are what count.
The chain runs upward too. A carrier is accountable for the conduct of the organizations beneath it, which is why oversight usually shows up as a plan partner asking your agency for evidence rather than as a letter from CMS. That is the practical enforcement path for most of what is on this page.
A field marketing organization answering for its downline reads these rules across many agents at once, which the FMO page covers directly.
Frequently asked questions
What is the difference between marketing and communications in Medicare?
Every marketing piece is also a communication, and marketing is the narrower label of the two. A piece reads as marketing when it is intended to draw attention to a plan or move somebody toward enrolling, and when its content addresses benefits, premiums, or cost sharing. The practical consequence is plan review, which attaches on the marketing side.
What are the CMS marketing guidelines for Medicare Advantage?
They live in Subpart V of 42 CFR Part 422, with the Part D counterpart in Part 423. The subpart covers definitions, what may be said about benefits, material review, events, required disclaimers, call recording, and plan oversight of third party marketing organizations. This page describes the shape rather than enumerating every provision.
Can Medicare agents advertise on their own?
Agencies do produce their own material, and the live question is which pieces count as marketing and therefore run through plan review before anybody sees them. We have not read the governing paragraphs against primary text, so get your plan partner's review process in writing instead of working from a summary, this page included.
What is the chain of enrollment?
The chain of enrollment is the path from first contact to an enrolled member, and every compensated party standing on it. Being paid for lead generation, marketing, sales, or enrollment related work inside that chain is what makes an organization a TPMO under 42 CFR 422.2260. What a TPMO is works through real arrangements.
What changed in the Medicare marketing rules for 2027?
The marketing provisions took effect October 1, 2026. Four things changed that an agency notices: the disclaimer trigger moved to before any benefit discussion, the SHIP referral came out of the required language, marketing and sales call retention dropped from ten years to six, and the 48 hour Scope of Appointment wait was eliminated.
Which of these rules a recording can settle
Sort the rule set by where the evidence lives and it comes apart cleanly.
One group happens out loud on a phone call: whether the disclaimer was delivered and where it landed against the first benefit mention, if the call was recorded at all, whether the agent stayed inside the product types on the Scope of Appointment, and how closely the benefit language matched approved materials. Each of those has a second attached to it and two lines of transcript behind it.
The rest lives in documents. Material review, mailers, print, television, website placement, event conduct, and compensation structure produce no audio, so no call QA product reaches them, ours included. That half gets solved with your plan partner, your counsel, and a filing calendar, and anybody selling you software for it is selling you something else.
CallSniper works on the first group. Calls are ingested after they end, transcribed and diarized, then scored against a scorecard your team defines, with the disclaimer held as a phrase set so a missing or late delivery can be set as a critical fail rather than a deduction that leaves an 87 on a non compliant call. Manual upload takes last season's folder without touching your dialer, and Trinsic's own model runs on its own infrastructure, so beneficiary audio never reaches a public model provider. More on call QA for Medicare agencies.
Two limits belong in the body rather than a footnote. Machine scoring holds up on a fixed phrase at a fixed point in a call and gets soft on anything asking for a read on tone, which Aircall and StackAI both say about automated QA generally. The second one is worse for us: scoring proves your agents followed the script, and it says nothing at all about whether the script was right.
Schedule a demo and we will score last AEP's audio at a fixed pilot price, since the disclaimer question is the only one on this page with an answer already sitting in your archive.
Sources
- Marketing and communications definitions, 42 CFR 422.2260. Only the TPMO definition on that page was read, via Cornell LII on 2026-09-09, where the most recent amendment shows as 87 FR 27898 dated May 9, 2022. The intent and content framing is unverified and labeled in the body.
- TPMO definition and the chain of enrollment phrase, 42 CFR 422.2260, read via Cornell LII on 2026-09-09. Verified against a primary text mirror. The description of the chain itself is an editorial reading.
- Disclaimer wording and the timing trigger, 42 CFR 422.2267(e)(41) and (e)(41)(ii), read via Cornell LII on 2026-09-09. Page shows most recent amendment 91 FR 17583, April 6, 2026. Verified against a primary text mirror. Detail belongs to the TPMO disclaimer page.
- Recording obligation and retention, 42 CFR 422.2274(g)(2)(ii), read via Cornell LII on 2026-09-09. Page shows most recent amendment 91 FR 17583, April 6, 2026. Verified against a primary text mirror. The Part D counterpart at 423.2274 was not read.
- Scope of Appointment and event provisions, 42 CFR 422.2264 and 423.2264. Not read. Unverified.
- Marketing prohibitions on benefit language and comparisons, 42 CFR 422.2262. Not read. Unverified, and no specific prohibition is named on this page.
- Material review categories and HPMS submission. Not sourced. Unverified, and no rule is stated on this page.
- CY2027 final rule (CMS-4208-F3) for the October 1, 2026 effective date, the retention reduction from ten years to six, removal of the SHIP referral, and elimination of the 48 hour Scope of Appointment waiting period. Secondary, from agent facing summaries gathered 2026-09-08. The Federal Register citation is not in hand. Verify before publishing.
- Enrollment record retention of ten years. Secondary, from the same summaries. Not confirmed against primary text.
- Annual Enrollment Period opening October 15. Standard CMS enrollment calendar, widely established. Confirm on cms.gov or medicare.gov before publishing.
- Aircall and StackAI, on automated scoring being more reliable on rule based criteria than on subjective tone. Third party, gathered 2026-09-08. Unverified.
- Marketing and communications example table, and the reading that the label attaches to the call as it happened. Editorial interpretation for this page, labeled as such in the body.
- Transcription, speaker diarization, vocabulary library phrase sets, critical fail flags, manual upload, and the model on Trinsic infrastructure. CallSniper product documentation. Verified.