Medicare compliance questions, answered with citations
Medicare agents' questions on CMS marketing and enrollment rules, answered with verbatim quotes and citations to 42 CFR, the MCMG, and CY 2027 guidance. Regulation text: eCFR as of 09/15/2026.
42 CFR Part 422
- I'm confused about OEP. What can I advertise during that time and who can I reach out to?
- Do I still have to wait 48 hours after a client signs a scope of appointment before I can meet with them?
- Can I cold call a Medicare beneficiary?
- My client moved to a new county. What election period can they use?
- What is the maximum value of a gift I can give at a sales event?
- How long is a business reply card or permission to contact good for?
- My client wants to cancel the enrollment and switch plans. What steps should I take, and how do I help them file a complaint if they want to?
- How long is a scope good for? I got one signed a couple of months ago.
- My client has Extra Help but doesn't have Medicaid. Does that qualify them for a D-SNP?
- What SEP does my client qualify for, and do I need proof? They just moved to another county.
- When does OEP begin?
- A client gave me her neighbor's number and said she needs Medicare. Can I call her, or does she have to contact me first?
- Can I enroll a member at an event?
- When is the Medicare Advantage open enrollment period and what changes can a client make?
- When does coverage start for someone who enrolls in an MA plan during their initial coverage election period?
- Can a doctor's office hand out my plan's marketing materials to patients?
- Do I need a state insurance license to sell Medicare Advantage plans?
- When does the initial coverage election period start and end for someone new to Medicare?
- Do I need a scope of appointment for an existing client? And does the waiting period still apply?
- Can I enroll this client today, or do they have to wait until AEP?
- Can I advertise a $0 premium or Part B giveback? What disclosures would I need?
- What verification is required for a C-SNP, and what happens if the provider doesn’t confirm the qualifying condition?
- When do I use IEP vs. ICEP?
- When do I need to give the required disclaimer, and where can I find the correct wording?
- Does a Medicare Advantage plan have to accept my client's application if they apply during the annual election period?
- How long do we have to keep call recordings and SOAs? Does the same rule apply to permission to contact?
- Can a spouse or caregiver sign the enrollment application? What documentation is needed if someone has power of attorney?
- Which calls do I have to record?
- How long does someone have after they move to make a change?
- Which calls do I have to record? Does that include calls where I’m only helping an existing client with a service issue?
- Can I knock on doors to sell Medicare Advantage plans?
- Can I market to someone during the Medicare Advantage open enrollment period?
- When does the annual election period run?
- How does a client disenroll from a Medicare Advantage plan?
- My client wants to switch to a 5-star plan mid-year. Is there an election period for that?
- Do I have to record my sales calls with beneficiaries?
- Can I run a marketing campaign that only targets wealthier neighborhoods?
- When can I start marketing next year's plans?
- What’s the difference between what I can do at an educational event and a sales event?
- My client wants to discuss a product that wasn’t listed on the SOA. Do I need a new one before we continue?
- When do commissions get paid and how does renewals work?
- What causes a commission chargeback, and what happens to my renewal commissions and book of business if I change agencies?
- What is the difference between initial and renewal compensation?
- Can a Medicare Advantage plan drop a member for not paying premiums?
42 CFR Part 423
- Can I give gas cards or gift cards at an event?
- What can I not do at an educational event?
- How often can a dual eligible client change plans?
- Can I call, text, or email someone who filled out a form on my website?
- What is FBDE?
- What changed in the enrollment guidance for 2027?
- How does someone sign up for a stand-alone Part D plan?
- What is File and Use, and how soon after submitting a marketing piece can I use it?
- When does Part D coverage start for someone who enrolls during their initial enrollment period?
- Can a client join a PDP during the annual coordinated election period?
- When can a Medicaid member change plans and how many times?
- Can someone with power of attorney sign the enrollment application for my client?
- A hurricane was declared a disaster in my client's county and they missed the election period. Can they still enroll?
- Do I need to be a licensed agent just to hand out factual plan information or take down demographic info for an application?
- Can I provide food or small gifts at an event? What about a raffle or a thank-you gift for referrals?
- How can I generate referrals and work with churches, senior centers, or other community organizations while staying compliant?
- Can I collect phone numbers and schedule appointments at an educational event? What if somebody wants to enroll right there?
- Which Special Enrollment Period applies, and what documentation do I need?
- Can I hold a sales event right after an educational event in the same building?
- Can I provide a meal at a sales event?
- What has to be on a Part D plan's website?
- What effective date should I put on the application if I submit it today?
- When does an enrollment made during the annual election period take effect?
- Can I take an enrollment over the phone if I was the one who called the client?
- What permission to contact documentation should I get from a lead vendor?
- My application is still pending and another one got rejected. Where do I find the reason and how do I fix it?
- How much notice does a Part D plan have to give members before a midyear change in plan rules?
- What happens to my commission if the client disenrolls within three months?
- Can a Part D plan disenroll a member for disruptive behavior?