Marketing appointment rules

Medicare fraud and abuse overview

Marketing appointments are meetings you arrange with a representative or agent of an insurance company to discuss your private plan options (including Part D, Medicare Advantage, and Medigaps). If you call a plan to make an appointment, an agent will come to your home and speak to you about your options, depending on what you requested. Plan agents cannot come to your home without invitation. There are also rules for what a plan agent can do at a marketing appointment.

  • Agents can only speak to you about products you asked to discuss. The scope of the appointment is limited to what you requested when arranging the appointment. Agents may represent Part D, Medicare Advantage, and Medigap plans, but they should only present information about the products you are interested in.
  • You must complete a scope of appointment form before your appointment. The plan or agent may send you a scope of appointment form that you must fill out and return, or the plan may call you and record your responses. Remember, agents should not discuss anything during your appointment that is not in the scope of the appointment form, unless you ask. If you want to discuss additional products, the agent should ask you to fill out another form first.
  • Most marketing appointments take place in the home, but sometimes they may be at a library or other location.

During your meeting, plan agents may:

  • Give you plan materials, including educational materials or the plan’s enrollment kit
  • Tell you where to find information about the plan (website, business cards, customer service number)
  • Discuss different plan options
  • Provide and collect enrollment forms if you have the right to enroll

During your meeting, plan agents may not:

  • Discuss anything outside the scope of your appointment
  • Market non-health related products to you, such as life insurance or annuities
  • Ask for referrals to others (family, friends) who might be interested in the plan
  • Take your enrollment application outside enrollment periods—such as Fall Open Enrollment—or when you do not have the right to enroll