The key consideration in marketing guidelines on required disclaimers is whether a particular material constitutes marketing material or communication material.
Marketing Material — materials that contain carrier and/or product information (e.g., plan name, plan costs/benefits).
In 2023, CMS expanded the definition of marketing to “include content that mentions any type of benefit covered by the plan and is intended to draw a beneficiary’s attention to plan or plans, influence a beneficiary’s decision-making process when selecting a plan, or influence a beneficiary’s decision to stay enrolled in a plan (that is, retention-based marketing).”
CMS further clarified, “content that beneficiaries can receive benefits such as dental, vision, cost-saving, and/or hearing services is sufficient information about plan benefits, benefits structure, or cost sharing to meet the content standard in the definition of marketing. “ The use of these statements in advertisements and activities directed to Medicare beneficiaries clearly meets the standard.
Any material or activity that is distributed via any means (mailing, tv, social media, etc.) that mentions any benefit will be considered marketing and must be Carrier and CMS approved. Click HERE for Spark assistance in submitting to the carrier/CMS for approval
(Generic) Communication Material — materials that are free of any plan, benefit or product information, brands or carrier logos (e.g., agent’s flyer for his/her business). Does not need to be CMS approved, but must comply with CMS guidelines.
Communication material must be approved by Spark and may need Carrier approval. Please submit material HERE for compliance review.
Note: Medicare Advantage and Prescription Drug Plan carriers may allow the use of their logo or name in certain circumstances such as on websites, but agents must get written carrier approval first. See HERE for Carrier Guidelines & Logo Approvals.
🗣️ If you need help writing the latest marketing disclaimer, including the number of organizations and plans, click here: Build your disclaimer.
Use of Disclaimers
Disclaimer name | Material type required on | When required / exceptions | Required language / content |
Not affiliated with Medicare / government | Marketing & Communications | Required on all materials. | Not affiliated with or endorsed by any government agency, or Not affiliate with the U.S. Government or the Federal Medicare program. If 'Medicare' appears in org name/logo, 'a non-government entity' or 'a non-government agency' tagline must appear directly below. |
Notice of contact with a licensed agent | Marketing & Communications | Required on materials that include a phone number connecting to a sales agent. | Immediately prior to the agency's number or any number reaching a sales agent, state that the number will dial a 'licensed sales agent' or 'licensed insurance agent'. |
Lead generation / permission to contact (PTC) | Marketing & Communications | Required on all Business Reply Cards (BRC/eBRC)/Permission to Contact (PTC)/Lead Generation forms. Lead gen mechanisms may only collect info for one individual (no dual spouse fields). PTC for text expires 12 months from consent date (or 90 days for DNC registry/Med Supp). Must clearly inform beneficiary their info will be provided to a licensed sales agent; must include scope of product (MA, Part D, Med Supp); must include 'This is a solicitation for insurance.' for Med Supp-linked PTCs; must list contact methods that match form fields; if leads shared, list each receiving entity with individual consent/reject option. | “By providing your name and contact information you are consenting to receive sales and marketing calls, text messages and/or emails from the <licensed insurance agent/agency> about Medicare Plans at the number provided, and you agree such calls and/or text messages may use an automated system for the selection or dialing of telephone numbers, automated voice calls, AI generative voice calls, pre recorded messages played when a connection is made, or pre recorded voicemail messages, even if you are on a government do-not-call registry. These calls are for marketing purposes and cellular charges may apply. This agreement is not a condition of enrollment and you can change your permission preferences at any time by contacting the agent listed on this form." |
Accommodations disclaimer | Marketing & Communications | Required on all invitations to educational and marketing/sales events. | For accommodations of persons with special needs at meetings call [phone] and [TTY number]. |
Promotional drawings / prizes / free gifts | Marketing & Communication | Required on materials when promoting drawings, prizes, or free gifts. | Eligible for a free drawing, gift, or prizes with no obligation to enroll. |
HIPAA privacy statement | Marketing & Communications | Required on scripts or any format where health information is requested. | If health info required for eligibility: 'You are not required to give any health related information; unless the information is needed to determine your eligibility to enroll in the [plan/program]…' Otherwise: 'You are not required to give any health related information.' |
Allowance disclaimer (OTC / flex / spending card) | Marketing & Communications | Required on any material that mentions benefit allowances such as OTC, Healthy Options, or flex/spending card allowances. | Allowance amounts cannot be combined with other benefit allowances. Limitations and restrictions may apply. |
Florida D-SNP mailing statements | Marketing & Communications | PY2026 FL D-SNP mailings to enrollees only. | One of four statements verbatim on front of envelope or mailing: (1) 'This is an advertisement.' (2) 'Important DSNP information' (3) 'Health and wellness or prevention information' (4) 'Non-health or non-DSNP related information' |
TPMO disclaimer (agent does not sell all plans) | Marketing | All marketing materials; verbally within first minute of sales call; electronically via email/chat; prominently on TPMO websites. Not required on banners, outdoor ads, envelopes, text messages, social media posts (but required on click-through destination). | We do not offer every plan available in your area. Currently we represent [#] organizations which offer [#] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. |
TPMO disclaimer (agent sells all plans in area) | Marketing | Use when TPMO represents all MA/Part D sponsors in the service area. Same placement requirements as above. | Currently we represent [#] organizations which offer [#] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices. |
Federal contracting statement (FCS) | Marketing | Required on all marketing materials. Exceptions: banners/banner-like ads, outdoor ads, envelopes, text messages, social media posts. | Must include: legal/marketing name of org; plan type (HMO, PPO, PFFS, PDP); statement that org has a Medicare contract; statement that enrollment depends on contract renewal. Example (Devoted): 'Devoted Health is an HMO and/or PPO plan with a Medicare contract. Our D-SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.' |
SSBCI disclaimer | Marketing | Required whenever an SSBCI benefit is mentioned. Must appear on the ad itself (a link is not sufficient). Font/pace must match phone number or contact info for TV, online, social, radio, and outdoor ads. | Must convey: benefit is part of special supplemental benefits; list qualifying chronic condition(s) (all if 5 or fewer; top 5 if more than 5); convey that having a listed condition does not guarantee the benefit—eligibility depends on being a 'chronically ill enrollee' per plan criteria. |
Special enrollment period (SEP) disclaimer | Marketing | Required when advertising outside of AEP. All ROY materials targeting general public must include qualifying language for SEP eligibility. | Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period. |
Star ratings disclaimer | Marketing | Required on any marketing material that references Star Ratings. Exception: small give-away objects (pens, rulers). For space-limited electronic media, acceptable to display when viewer clicks the ad. | Every year, Medicare evaluates plans based on a 5-star rating system. |
Carrier notification (MA org names) | Marketing | Required on all marketing materials. For TV/online/social: read at same pace as phone number or displayed throughout entire ad. For radio: read at same pace as phone number. Exceptions: smaller social media posts and search ads (but required on click-through page). | Names of all MA/Part D organizations being advertised must be clearly displayed. UnitedHealthcare must appear as 'UnitedHealthcare®'. Must be 12-point font, not in fine print. |
Benefits across plans | Marketing | Required when referencing multiple benefits across plans. Use of 'or,' 'and/or,' or a section headline like 'Medicare Advantage plans may include one or more of the following benefits' is also required. | Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. |
Part B premium reduction | Marketing | Required on any material mentioning the Part B premium reduction (give-back) benefit. Humana: 'The Part B Giveback Benefit pays part or all of your Part B premium and the amount may change based on the amount you pay for Part B.' | Without dollar amount: 'Part B Premium Reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower.' With dollar amount: 'The standard Part B premium for [year] is [amount]. Monthly reduction varies and may be subject to processing delays...' |
5-star SEP disclaimer | Marketing | Include whenever a marketing material mentions the potential availability to enroll in a 5-star rated plan. | A 5-star Special Enrollment Period may be used one time between December 8 and November 30 of the following year, provided you meet the plan's enrollment requirements. |
Product endorsements and testimonials | Marketing | Required when using paid endorsers or actor portrayals. Member must be currently enrolled in the plan being endorsed. Cannot use healthcare provider endorsements for compensation. Cannot use negative testimonials about other plans. | Paid endorsement' or 'Paid actor portrayal' as applicable. Devoted adds: 'Real Devoted Health Member' for actual member testimonials. |
Out-of-network / non-contracted provider | Marketing | Required on all materials referencing out-of-network/non-contracted providers. Does not apply to standalone PDP plans. | Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call the Plan's customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. |
Humana preferred pharmacy network | Marketing (Humana) | Required on PY2025-2026 materials for the Humana Premier Rx Plan (PDP) and Humana Value Rx Plan (PDP) only. Not required for other PDPs or MAPD plans. | The Humana Premier RX Plan (PDP) and Humana Value RX Plan (PDP) pharmacy networks include limited lower-cost, preferred pharmacies in [specific states listed]. Lower costs may not be available at the pharmacy you use… |
Telemedicine disclaimer | Marketing & Communications | Required on any material that mentions Telemedicine/Telehealth or Telepsychiatry benefits. | Limitations on telehealth services, also referred to as virtual visits or telemedicine, vary by state. These services are not a substitute for emergency care and are not intended to replace your primary care provider or other providers in your network… |
Prohibited Content & Actions when Marketing Medicare
Category | Prohibited Content & Actions with Examples | Notes / Context |
Language | "Senior" when describing plan eligibility | Use "people with Medicare" or "Medicare beneficiaries" instead |
Language | "Get the money they deserve" / "see what benefits are available to you" | Misleading implication of guaranteed entitlement |
Language | "URGENT!" in large, red, all-caps font or similar high-pressure formatting | Repetitive phrases, oversized or red font communicating false urgency prohibited |
Language | Words creating false urgency: "Act now, or you may lose your benefits!" |
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Language | Fear-inducing language: "beware of plans whose copays could bust your budget" |
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Language | "New" implying new plans released outside AEP when not specifically named |
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Language | "Free" for zero-dollar premium, Part B buydown, LIS, or dual cost-sharing | Use "no additional cost" instead when appropriate |
Language | "Customized," "unique," or "personalized" for Medicare plans |
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Language | "Have Medicare and Medicaid?" as a standalone SEP qualifier outside AEP | No longer a sufficient qualifier under 42 CFR 422.62(b) |
Language | "On Medicare & Medicaid?" without additional qualifying SEP language | Replaced by language like "Aging into Medicare and also have Medicaid?" |
Language | "Unbiased" to describe TPMO services | TPMOs are inherently biased toward plans they contract with |
Language | "Entitled" (except when discussing Original Medicare) |
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Language | "Partnership" or "alliance" when no legal partnership exists | Use "teamed up" or "working together" instead |
Language | "Highly rated" unless referencing CMS Stars Ratings of 4 or 5 stars |
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Language | Superlatives: "best," "top plans," "greatest," "#1," "outstanding" (unsupported) | Must be substantiated with current/prior contract year data |
Language | Absolute language: "every," "all," "guarantee," "promise," "keep your doctor" | Provider networks are subject to change |
Language | "All," "full," "complete," "comprehensive," "unlimited" to describe benefits |
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Language | Pejorative or disparaging language about CMS or any plans |
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Language | Compare/switch language outside AEP targeting those with existing coverage | Implies knowingly targeting already-enrolled beneficiaries |
Language | References to ACA / Healthcare Marketplace / Exchange for Medicare products |
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Language | References to federal programs (MSP, Food Stamps, LIS) to obtain MA/MAPD leads | Seen as bait-and-switch |
Language | Dental marketed beyond "routine" unless more-than-routine coverage is confirmed | Include "routine" if only routine coverage is available |
Language | "Medigap" used extensively in Medicare Supplement materials | Limit use |
Language | "Save $9,000+ on prescriptions" or "save over $7,000" type savings claims | Based on uninsured costs most beneficiaries would never incur |
Language | "Switch and save" or generic "save" implying guaranteed savings | Any savings claim must be based on actual costs a beneficiary would face |
Claims / Comparisons | Named plan comparisons unless properly substantiated |
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Claims / Comparisons | Individual Star Rating measure used to imply overall higher plan rating | Must also include overall Star Rating; identify contract year and "out of 5 stars" |
Claims / Comparisons | 5-star SEP marketed after November 30 if contract did not receive 5 stars for next year |
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Claims / Comparisons | Negative testimonials about other plans or Part D sponsors |
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Claims / Comparisons | Endorsement/testimonial not reflecting actual honest opinion of endorser |
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Claims / Comparisons | Testimonial claiming plan membership without being enrolled at time of creation |
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Claims / Comparisons | Unsupported claims made in endorsements or testimonials | All claims must be substantiated |
Claims / Comparisons | Disparaging Original Medicare | Cannot be compared inaccurately or disparaged |
Claims / Comparisons | Partial carrier listing followed by "and more" | All MA/Part D organization names must be listed; no partial lists |
Benefits | Advertising specific services like "root canals," "hearing aids," "eyeglasses" | Benefits must be at high level only (e.g., "dental," "hearing," "vision") |
Benefits | Advertising benefits not available in the material's service area | Exception: unavoidable reach in local media |
Benefits | Healthy food/SSBCI benefit without declaring SNP audience at outset |
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Benefits | Listing benefits without "or," "and/or," or similar clarifying language | Required to avoid implying all plans cover all listed benefits |
Benefits | Advertising SSBCI benefit without required SSBCI disclaimer | Must list qualifying chronic conditions; disclaimer must match font/pace of phone number in broadcast |
Benefits | Advertising rent as a benefit when UHC does not offer it in any plan | UHC must be excluded from carrier list for benefits it does not offer |
Benefits | Marketing Value-Added Items or Services (VAIS) pre-enrollment | VAIS are not plan benefits and cannot be used as enrollment inducements |
Benefits | "Discounts," "perks," or "extras" suggesting VAIS benefits |
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Benefits | Part B Giveback: using highest dollar amount not available to all | Use lowest available amount; "$[amt] or more" acceptable |
Benefits | Cash, checks in mailboxes, or monetary imagery alongside Part B Giveback | No check is physically issued; must not create false impression |
Benefits | Implying Part B Giveback is immediate | May take one or more payment cycles |
Benefits | Confusing Part B Giveback with Medicare Savings Program | MSPs are government-provided; not plan carrier benefits |
Govt / Identity | U.S. flag imagery very similar to government office imagery |
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Govt / Identity | Red, white, and blue color scheme appearing government-associated | Must include clear "not affiliated with government" disclaimer |
Govt / Identity | "Medicare" in organization name, logo, or URL without "a non-government entity" disclosure | Must appear directly below name/logo |
Govt / Identity | CMS logo or products used in a misleading way |
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Govt / Identity | Medicare card image without prior written CMS authorization | Must obtain CMS email approval and include it in HPMS submission |
Govt / Identity | Materials formatted like official government documents (tax notice format, barcodes, perforated envelopes) |
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Govt / Identity | Official-looking government phrases, seals, or symbols |
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Govt / Identity | Claims that MAO, plans, or TPMO is endorsed by CMS, DHHS, etc. |
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Govt / Identity | Carrier brand name, trademark, or logo in TPMO paid search ad copy |
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Govt / Identity | Carrier logo used to identify Carrier as a represented carrier (vs. affiliation announcement only) | Logo permitted only for affiliation announcements on registered websites or with written permission from Carrier |
Govt / Identity | AI-generated voice/actor without on-screen "AI-generated Voice and Actor" disclosure |
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Govt / Identity | AI used to simulate a real person or celebrity without their express consent |
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Govt / Identity | Provider endorsing or marketing specific MA/PDP plans or a set of plans | Provider must remain objective; no steering toward specific plans |
Govt / Identity | Contracted provider used as spokesperson |
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Govt / Identity | Paid endorsement without "Paid endorsement" or "Paid actor portrayal" disclosure |
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Contact / Consent | Unsolicited door-to-door solicitation without prior appointment |
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Contact / Consent | Approaching beneficiaries in common areas (parking lots, hallways, lobbies) |
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Contact / Consent | Cold calling / outbound solicitation including calls via referral |
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Contact / Consent | Calls to confirm receipt of mailed information |
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Contact / Consent | Calls about other business as a means of generating Medicare leads (bait and switch) |
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Contact / Consent | Unsolicited text messages for marketing purposes | UHC: never permitted even with opt-out; Humana: opt-out required but unsolicited not permitted |
Contact / Consent | Lead forms requiring age, date of birth, or health status information | Only contact information may be required |
Contact / Consent | Requesting Social Security Number on websites | "NEVER permitted" |
Contact / Consent | Sharing beneficiary data with another TPMO without prior express written consent listing each receiving entity | Effective October 1, 2024, per 42 CFR 422.2274(g)(4) |
Contact / Consent | Lead forms collecting info for more than one individual (e.g., two spouse signature fields) |
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Contact / Consent | DOB, gender, tobacco use fields on lead forms unless Medicare Supplement is included (optional only) | Not needed for MA and Part D plans; must be clearly noted as optional |
Contact / Consent | Using sign-in sheets requiring attendees to provide contact info as event prerequisite |
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Contact / Consent | Distributing Scope of Appointment forms at educational events |
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Contact / Consent | Setting up future personal marketing appointments at educational events |
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Contact / Consent | Marketing specific MA/PDP plans or distributing marketing materials at educational events | Educational events must be generic, factual, non-biased only |
Contact / Consent | Knowingly targeting or sending unsolicited materials during MA-OEP (Jan 1–Mar 31) |
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Contact / Consent | Collecting race, ethnicity, SOGI data during enrollment | Race/ethnicity fields must be removed by 1/1/2026 per CMS HPMS memo 5/6/2025 |
Contact / Consent | Marketing new plan year information prior to October 1 |
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Contact / Consent | Gifts in the form of cash, rebates, or cash-equivalent gift cards (Visa, Amex, Walmart, Amazon, etc.) | Nominal gifts limited to $15 total per event; no cash equivalents |
Contact / Consent | Gifts in the form of drug or health benefits (e.g., free checkup) |
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Contact / Consent | Providing meals at sales/marketing events | Light snacks/refreshments only; nothing reasonably considered a meal |
Contact / Consent | Conducting health screenings or health surveys at events | May be perceived as cherry-picking |
Images | Medicare card image without written CMS authorization | Must upload CMS email approval with HPMS submission |
Images | Images of cash, checks in mailboxes, or monetary visuals alongside Part B Giveback benefit | No physical check is issued; must not create false impression |
Images | Government-resembling imagery: U.S. flag similar to government offices, seals, official-looking symbols |
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Images | AI-generated likeness of real person or celebrity without express consent |
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Images | Imagery implying government endorsement or official government origin |
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Tactics | Marketing D-SNP audience outside AEP without also targeting an eligible SEP audience | Per updated dual/LIS SEP rules |
Tactics | Targeting potential enrollees based on income levels (non-D-SNP/C-SNP) |
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Tactics | Targeting based on health status (non-C-SNP) |
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Tactics | Discriminatory activity: targeting higher-income areas, implying plans only for seniors or Medicaid recipients |
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Tactics | Rush or pressure tactics to push beneficiaries into enrolling |
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Tactics | Implying any beneficiary can call to see if they qualify for a SEP | Misleading; only encourage those who actually qualify to call |
Tactics | Marketing materials used differently from the approved/filed HPMS version | Subject to corrective/disciplinary action |
Tactics | Agents recommending specific providers using superlatives ("better care," "best care") |
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Tactics | Agents accepting anything from providers in exchange for steering beneficiaries | Implicates Federal Anti-kickback Statute |