Agent compliance • 2026 compliance resource

Medicare marketing rules explained

Medicare communications and marketing rules apply across the full beneficiary journey: lead generation, permission to contact, educational activity, personal appointments, plan discussion, enrollment, call handling, and record retention. A compliant workflow is more than using an approved brochure.

Start with the activity’s purpose and content

CMS defines marketing as a subset of communications. Classification depends on both intent and content, not merely the label an agent or organization gives the material. Plan-specific benefits, premiums, cost sharing, comparisons, or enrollment calls to action can change the applicable review and conduct requirements.

Core operational controls

• Use permitted contact methods and maintain evidence of beneficiary permission where required.
• Do not cold call, send unsolicited text messages, approach beneficiaries in prohibited common areas, or conduct door-to-door solicitation.
• Document the Scope of Appointment before personal marketing appointments and remain within the agreed scope.
• Use current approved or accepted materials according to carrier and CMS requirements.
• Apply required TPMO disclosures and call-recording rules to the correct workflows.
• Protect beneficiary information and retain required consent, training, call, and enrollment records.

Agent readiness is annual and plan-specific

CMS states that agents must be properly licensed, complete annual Medicare training and testing, and understand the specific benefits of the plans they sell. Carrier authorization, product availability, and ready-to-sell status must be confirmed before marketing or enrollment activity.

Current sources

Source note: The CMS Medicare Communications and Marketing Guidelines page includes older and archived guidance. For current requirements, use the current eCFR, current-year CMS training and testing guidance, applicable HPMS memoranda, and current plan, carrier, agency, and state procedures.

• 42 CFR Part 422, Subpart V
• CMS Medicare Marketing Guidelines
• CY 2026 Agent/Broker Training and Testing Guidelines

---

Related resources

• Educational vs. marketing events
• Medicare Agent Resource Center
• Scope of Appointment explanation