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How To Walk the Medicare Advantage Communications Tightrope

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What You Need to Know

  • Disclaimers are your friends.
  • Verbs that convey some uncertainty are your friends.
  • The rules for mentioning specific carriers, plans and benefits are not your friends.

If you’ve worked in the Medicare Advantage space, you probably know that finding the right balance between compelling and compliant marketing content is like walking a tightrope.

If you lean too far in the direction of “compelling,” you could fall off into the abyss of the CMS’ Medicare Communications & Marketing Guidelines (MCMG) and find yourself in some hot water. If you lean too far in the direction of “compliant,” you could find yourself in the black hole of painfully boring copy that makes your customers’ dishwasher instruction manual seem like a light, breezy read.

As a compliance manager at a large direct-to-consumer insurance agency, I’m responsible for reviewing all of our marketing content before it’s published or aired on TV. And I’ve seen it all — some really good stuff and some really bad stuff. The really good stuff makes a compelling case for enrolling in a Medicare Advantage plan while keeping it simple. The really bad stuff, well, gives me heart palpitations.

Threading that needle is a challenge. I get it. I empathize with marketers because I was a content writer before I went over to the “dark side” of compliance. But there are some common-sense ways to keep you on the right side of the compliance line without sacrificing good copy.

Here are three easy tips I give to any marketer or insurance agent who is producing content to promote Medicare Advantage plans.

1. Qualify, qualify, qualify.

One surefire way to make customers angry and wind up on a regulator’s radar is by overpromising and underdelivering.

The truth is, Medicare Advantage plans and their benefits can vary a lot depending on location. Highly competitive areas (like Florida) may have plans with all sorts of eye-catching extras. But if you go to some rural county out west, there may not be a single plan available, let alone one with all the bells and whistles. You don’t want to imply — or worse, explicitly state — that someone in one of those rural areas can definitely get a plan like that.

Qualifiers like “may,” “could,” and “can” (especially “may”) are your best friends. For example, “Medicare Advantage plans may include additional benefits like routine vision coverage.” This makes it clear that while routine vision coverage is generally available, it isn’t available everywhere. This mitigates some of the risk of accidentally misrepresenting the benefit.

Also, slapping the general disclaimer “Plan availability varies by region and state” below of a list of potential benefits — clearly and conspicuously, of course — is a good best practice.

2. “Communicating” is easier than “marketing.”

CMS made life easier for the MA marketing world a few years ago when it started differentiating between “communications” materials and “marketing” materials. Back in the day, there were only a few exceptions to submitting content to CMS for review and filing. Now, only materials that meet the definition of “marketing” need to be filed via an insurance carrier. This gives us a lot more flexibility (and time-savings).

You should definitely read what MCMG has to say on this subject, but the tl;dr explanation is, as long as you stay away from carrier- and plan-specific information — i.e., trying to encourage a beneficiary to enroll in particular plan or with a particular insurance company — you shouldn’t need to file your content.

This doesn’t mean you can’t say anything about MA benefits. As long as you stick to widely available plan features ($0 monthly premiums, annual out-of-pocket maximums, vision, dental, hearing, etc.), you should be on the right side of the line. Once you start mentioning carrier names, plan names, and specific benefits, you’re venturing into “marketing” world.

That’s not to say you shouldn’t “market,” but just know it requires more time. Plus, it’s not a great idea to use a carrier’s intellectual property without their approval.

3. Stay out of the weeds.

I’m a pilot in my spare time. When I was prepping for my private pilot flight test way back, my instructor held up a pen and asked me what it was. I immediately launched into a detailed explanation of the ink color, the grip, the brand, and a whole bunch of other extraneous garbage.

He eventually cut me off and said “No. I asked what it was. It’s a pen. That’s it.”

His point was the examiner knew more than I did. If she asked me a simple question and I started trying to impress her with my “vast” knowledge about some particular subject, I’d eventually trip up and fail the checkride. Same sort of situation with Medicare content.

A really common issue I see is an ambitious writer trying to explain all sorts of technical details of the Medicare Advantage program in a simple landing page that is supposed to provide an overview. While it’s well-intentioned, almost inevitably the writer gets too far down the rabbit hole and describes something incorrectly.

Save yourself the trouble and keep things high-level. Even if you nail the details, it could still confuse your reader. Trust me, beneficiaries are just trying to pick a plan and be done with it. They don’t care about MA capitation rates in 2020 or the nuances of provider reimbursement.

Best of luck on your content creation journey!


John Krahnert III (Photo: TZ) John Krahnert III is the marketing compliance manager for MedicareAdvantage.com, a Medicare consumer website site affiliated with Tranzact, an arm of Willis Towers Watson LLC.

(Photo: Adobe Stock)