Where It All Begins: Obtaining Permission to Contact for Medicare Sales

You have to start somewhere with a potential Medicare client, and while it might be tempting to jump right in and start selling, you can’t. There are some things you need to know and do first, chiefly securing permission to contact.

No Medicare sale can truly start without the go ahead from a beneficiary. We’re here to teach you how to connect with potential clients while following all the rules!

What Is Permission to Contact for Medicare Sales?

Permission to contact (PTC) exists to protect beneficiaries from receiving unsolicited outreach from an agent selling Medicare products. In the past, deceitful sales tactics pressured Medicare-eligibles or beneficiaries to enroll in a plan that may have paid out a commission to the agent but didn’t necessarily meet all of the clients’ needs. This is exactly what you don’t want to do.

In the past, deceitful sales tactics pressured Medicare eligibles or beneficiaries to enroll in a plan that didn’t necessarily meet all of their needs.

If you want to remain compliant, it’s vital that the beneficiary initiate the first direct contact. You need to receive a Medicare beneficiary’s express permission to be contacted before you have direct communication with them whether it’s over the phone or through other digital media. This permission must be documented.

Is Permission to Contact the Same Thing as a Scope of Appointment?

PTC and a Scope of Appointment (SOA) aren’t exactly the same, but they do work together to help you make a sale compliantly. Before you can call or send a text message to a beneficiary, you must receive PTC. At that point, you can you collect a Scope of Appointment, which allows agents to engage a discussion, either in person or by phone, with the potential client regarding the specific products they want to discuss at an appointment.

When Do You Need Permission to Contact?

Agents need to secure PTC any time they want to start a conversation with any prospective Medicare client, especially those interested in Medicare Advantage and prescription drug plans. Note: While Medicare Supplement is not governed by CMS rules, it’s still subject to Telephone Consumer Protection Act (TCPA) guidelines. Also, it is inevitable that agents will need to discuss prescription drug coverage for their clients with a Medicare Supplement policy. For these reasons, we always encourage generating permission with all product types, since it is non-compliant to bait-and-switch by selling a Med Supp lead a Medicare Advantage plan.

Proper disclaimers must be included on the PTC form. When the scope of products includes Medicare Supplement products, this disclaimer “This is a solicitation of insurance” must be present.

The only exception for unsolicited beneficiary contact under the CMS rules is that agents may send unsolicited emails to potential enrollees to market their services, but the email must have an opt-out option and the content cannot be deemed as a “marketing material” (e.g., containing plan premium, co-payment, benefits information or intend to steer the prospect into choosing or retaining a plan.) In addition to meeting the CMS-specific marketing guidelines, email solicitation must also meet the CAN SPAM Act requirements.

You do not need to secure PTC for Medicare clients if they are in your current client record.

How to Collect Permission to Contact

So, what can you do to start a conversation with a potential client if the beneficiary must be the one to initiate contact? Agents may send unsolicited emails to potential enrollees that market their services, as long as they meet certain requirements, but to actually have a conversation, you’ll have to collect PTC. We list some guidelines below.

Medicare PTC Guidelines

  • Send out business reply cards (BRCs)
  • Contact a beneficiary after they request a return call
  • Contact a beneficiary after they fill out an online contact form
  • Contact through email with opt-out option
  • Direct message through social media
  • Text message
  • Go door to door
  • Collect contact for spouse (PTC must be provided by each individual)

To draw a prospects’ attention to places where you can collect their PTC, we recommend promoting your services as an agent through affinity partnerships with community businesses, a maintained business website, and placing your phone number alongside advertisements for your services through traditional and modern marketing methods.

PTC & SOAs via Shop & Enroll

With Shop & Enroll, we’ve combined PTC and SOA, so the beneficiary can actually complete both at the same time! All you have to do is get your own free Shop & Enroll site, which also serves as a quoting and enrollment tool. As long as you have at least one qualifying contract through Ritter Insurance Marketing, you can do all of your business in one place.

BRCs via ShopRitterIM

You can also use ShopRitterIM to order personalized, CMS-compliant BRCs. This makes it easy to acquire leads. Just order the cards, mail them out, and wait for them to return!

Agents must register with Ritter and have at least one active contract through Ritter to purchase marketing materials on ShopRitterIM.com. Orders will be rejected if both requirements are not met.

When Does Medicare Permission to Contact Expire?

Once the PTC request is received, an agent selling Medicare or prescription drug plans has 12 months, from the beneficiary’s signature date or the beneficiary’s request for more information, to contact the beneficiary before it expires.

How to Remain Compliant If You Work with a Third-Party

If you use a third-party lead provider to connect with beneficiaries, they must also follow these requirements on your behalf:

  • Disclose to Ritter and or carriers any subcontracted relationships (such as the use of a third-party lead-generation company) used for marketing, lead generation, and enrollment
  • Report to Ritter and or carriers monthly any staff disciplinary actions associated with beneficiary interaction to the plan
  • Disclose to the beneficiary when conducting lead-generating activities that his or her information will be provided to a licensed insurance agent for future contact:
    • Verbally when communicating with a beneficiary through the telephone
    • In writing when communicating with a beneficiary through mail or other paper communication
    • Electronically when communicating with a beneficiary through email, online chat, or other electronic messaging platform
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All agents want to get out there and start talking to potential clients, but it’s crucial to understand all of the things that need to happen before you even begin conversations. Use our Medicare PTC guidelines to get things started and remain compliant every step of the way!

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