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This guide is for training purposes only and should be used in conjunction with current CMS guidelines and carrier-specific compliance requirements. All agents must stay up-to-date with the latest Medicare regulations and compliance standards. The examples provided are for illustrative purposes and should be adapted according to specific situations and requirements.

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Category: Compliant Medicare Sales Calls

Last Updated: March 12, 2025

CMS Reference:

• 42 CFR § 422.2262(a)(1)(i),(iii) & 42 CFR § 422.2268 (a)(1),(2)
• 42 CFR § 422.2267(e)(41)
• 42 CFR § 422.111
• 42 CFR § 422.2274(c)(9)(i)
• MMCM CH 2: 40.1.3, 40.2, 40.4.1, Appendix 2, Exhibits 1, 3

Overview

Medicare sales calls must include specific CMS-required disclosures to ensure that beneficiaries fully understand the product, avoid misleading information, and receive accurate plan details before enrollment.

Agents must deliver these disclosures verbatim at the appropriate times during a sales call to maintain compliance.

Key Disclosure Requirements

1️⃣ TPMO Disclaimer – Within the First Minute of the Call

🔹 Regulation: 42 CFR § 422.2267(e)(41)

🔹 When to Say It: Must be stated verbatim within the first minute of every sales call.