Which of the following is not considered unsolicited contact with a medicare eligible consumer 6 & Appendix 2 of Medicare Marketing Guidelines CMS developed the following guidelines to clarify restrictions on unsolicited contact with Medicare beneficiaries. Prohibited Unsolicited Direct considered an “unsolicited” contact? Answer 2: No. 423. UHC ETHICS AND COMPLIANCE TEST QUESTIONS AND 100% CORRECT ANSWERS 2023-2024/VERIFIED SOLUTIONS Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? ans: Mailing a marketing brochure to the Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? - Mailing a marketing brochure to the consumer via postal mail. Plan sponsors may not market through any unsolicited contacts. Placing a marketing brochure on the door handle of the consumer's Josh can advise Janine of each of the following except: and more. Which of the following is not considered prohibited unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Sending unsolicited emails to the consumer about new plans. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan?, Which of the following statements is true about using a five star special enrollment period (SEP)?, – The consumer's spouse, who is neither a Power of Attorney or legal guardian. , outbound telemarketing), electronic (e. When can telephonic contact with a Medicare eligible consumer be made? – When the consumer consented to be contacted for sales activities, Study with Quizlet and memorize flashcards containing terms like In which two parts of Medicare is enrollment generally automatic for eligible consumers who are receiving Social Security benefits, UNLESS they choose to delay their coverage?, Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Study with Quizlet and memorize flashcards containing terms like Which statement is true about the Medicare Advantage (MA) Out- of pocket Maximum?, A consumer currently has Original Medicare and is enrolled in a stand alone PDP. Screening services require specific diagnoses to be considered for payment d. Contact must be The agent said that Medicare uses a 5-star rating system to illustrate the plan's performance and quality. Telephonic contact be made with a Medicare eligible consumer when the consumer consented to be contacted for sales activities. Medicare Part B: Original Medicare - Medical Insurance 3. This is anyone who has NOT given explicit permission to contact. a sales agent for the purpose of receiving information about Medicare Unsolicited Email Marketing. Making unsolicited contact d. E: Unsolicited contact is contact that is not asked for or requested by the consumer. Contact is any outreach activity to a Medicare-eligible person or their caregivers by a Medicare carrier or their agents. To sign an enrollment application on behalf of a consumer, what authority must the individual have?: Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Mailing a marketing brochure to the consumer via postal mail. If you are using public inspection listings for legal research, you should verify the contents of the documents against a final, official edition of the Federal Register. Disciplinary actions iii. Medicare Secondary Payer (MSP) Manual Chapter 7 - Contractor MSP Recovery Rules Table of Contents (Rev. Whereas solicited contact means a consumer has given express consent to be contacted by a sales agent for the purpose of receiving information about Medicare Study with Quizlet and memorize flashcards containing terms like reporting all events (marketing/sales and educational) to united health care is required so that the company can:, You have a scheduled appointment with a consumer to discuss DSNP. messaging on social media platforms, falls under unsolicited contact and is not permitted) NOTE: Unsolicited contact is contact that is not asked for or requested by the consumer. • Medicare does not pay for this because it is a treatment that has yet to be proved effective (experimental). However, the does need to have an opt out option in option to be compliant. 1. Educational Events . Original Medicare ( Part A and Part B) ii. This is anyone who has NOT given explicit permission to contact (PTC). Agents are now able to make unsolicited contact with a prospects for MA, MAPD and PDP via email. Which Medicare-eligible consumer is best suited for a C-SNP? Mary, who has been seeing a specialist for a qualifying chronic condition In which of the following situations can telephonic contact be made with a Medicare eligible consumer? When a member has,voluntarily disenrolled from a plan and the call is for sales/marketing purposes. C. Direct mail, email communication, and social media messaging initiated by the consumer are all permitted forms of contact, as they either involve the consumer Study with Quizlet and memorize flashcards containing terms like reporting all events (marketing/sales and educational) to united health care is required so that the company can:, You have a scheduled appointment with a consumer to discuss DSNP. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and United Healthcare’s rules, policies, and procedures? Correct Answers: Mailing a Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? A) Sending spam emails B) Cold-calling during dinner time C) Mailing informational brochures D) Reaching out after a consumer's request for information Which of the following is not considered prohibited unsolicited contact with a medicare eligible consumer according to CMS regulations and UnitedHealthcare’s rules, policies, and procedures? Sections 70. Consumers Contacting Medicare-Eligible Individuals . Which statement about discussing benefits with the consumer before an enrollment is true? - The agent Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Emailing a marketing brochure to a consumer whose email address was obtained on a purchased lead list. Learn more about - Product type the beneficiary has agreed to discuss during the appointment, - Date of appointment - Beneficiary contact information - Written or verbal documentation of beneficiary or appointed/authorized representative agreement, - A statement that beneficiaries are not obligated to enroll in a plan; their current or future Medicare The consumer is not likely to be a Full Dual Eligible and may be better suited for enrollment in a type of plan other than a D-SNP. Calling the consumer to discuss plan options without prior consent. For example, a plan sponsor may not send emails unless an individual has agreed to receive those emails. ohn, 68, is currently enrolled in a Medicare Supplement Plan with a stand-alone Prescription Drug Plan. -The monthly Part D premium is at or below the Low-Income Subsidy benchmark to cover drug costs-D-SNPs are non-network based plans, which enables members to see any Medicare-eligible provider-D-SNPs do not include prescription drug coverage, so a member may enroll in a stand-alone Prescription Drug Plan in aside from a standalone Medicare prescription drug plan how else could a Medicare eligible consumer get Part D prescription drug coverage. What election period will Aries need to use(if eligible) to get a November 1 effective date?, Mrs. Question: Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare’s rules, policies, and procedures? For example, returning phone calls or calling an individual who has completed a business reply card requesting contact is not considered unsolicited. Part D sponsors may contact current, and to a Which of the following is TRUE about UnitedHealthcare Medicare plans carrying the AARP name? if the consumer is enrolling in a Medicare Advantage or PDP. CMS considers the following to be unsolicited contacts and in violation of MIPPA: • Generally, use of old lists or consents to satisfy the new MIPPA rules regarding referred would be considered an unsolicited contact. 13. It was viewed 13701 times while on Public Inspection. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Study with Quizlet and memorize flashcards containing terms like On October 20, Aries decides talks with an agent to switch his PDP that he had since January 1 to a Medicare Advantage plan. g. 2264 (c)(1), MCMG • Enrollee-Only . Agents must not misrepresent Star Ratings; a rating of 2 stars is considered "Below Average. Also known as Age-In or T-65, this enrollment period is a seven- unsolicited contact and is not permitted. Violet asks agent Bob where she can find the Which of the following are considered activities of daily living in most long-term care policies? Investigative Consumer Report. Disclaimers are not required on the following material types: call scripts, banners and banner-like ads, envelopes Agents may only contact Medicare eligible consumers if consent has been provided and not expired. Under Centers for Medicare and Medicaid Services (CMS) rules, Ms. 2260, 423. Select the statement best describes a feature of D-SNPs. , email, voicemail messages, text messages) solicitation. 11. What will happens if the consumer enrolls in a n MA Plan that has integrated PDP coverage?, What is Medicare Part D? and more. 2264 (a-b) CMS has strict rules for contacting Medicare-eligible individuals. • If the BRC card is returned by the consumer without a valid phone number, agent may not contact the consumer either by phone or a visit. • Medicare usually does not pay for this service. 3. EDC Agent Guide Version 1. Potential Consequences of Engaging in Inappropriate or Prohibited Marketing Activities (Prohibited activities, include but are not limited to: conducting health screenings, providing cash or monetary rebates and making unsolicited contact) i. Do not distribute, reproduce, edit or delete any portion without the express permission of UnitedHealth Group. S. (3) Calls are not considered unsolic-ited if the beneficiary provides consent or initiates contact with the plan. Part D sponsors may contact current, and to a more limited extent, former members, including those enrolled in other products offered by the parent organization Study with Quizlet and memorize flashcards containing terms like Joseph has Original Medicare and was a patient in the hospital last week. Which of the following is not considered unsolicited contact with a Medicare-eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? A. Part D sponsors may contact current, and to a more limited extent, former members, including those enrolled in other products offered by the parent organization Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? - Mailing a marketing brochure to the Medicare uses a 5-star rating system to illustrate a plan's performance and quality. On a given day, the best one tries to every individual at a particular phone quantity can be counted towards Unsolicited Contact Unsolicited contact other than by postal mail (e. Report requirements ii. ( b ) Contact for plan business. Unsolicited contact means the consumer did not provide permission to be contacted by the particular method(s) of contact. For example, returning phone calls or calling an individual who has completed a business reply card requesting contact is not considered unsolicited. 5, 70. Which Medicare-eligible Medicare Marketing Guidelines 2021: Permission to contact. e. (right) -When a member has voluntarily disenrolled from a plan. The consumer is not likely to be a Full Dual-Eligible and may be better suited for enrollment in a type of plan other than a D-SNP. It defines: Who agents can contact: Only beneficiaries who have given explicit permission. Provide gift cards, gift certificates, or cash as giveaways Not Allowed Not Allowed Not Allowed Provide giveaways that advertise or display agent contact information Allowed Allowed Not Allowed Event Activities Restrict event admission to an exclusive organization membership list or specific social group Not Allowed Not Allowed Not Allowed The scenario painted above means that Ms. Qualified Medicare Study with Quizlet and memorize flashcards containing terms like Which type of MA Plan is an HMO plan that also covers certain benefits out-of-network, generally at a higher cost? -Medicare Supplement Insurance Plan -Point-of-Service (POS) Plan -Preferred Provider Organization (PPO) -Private Fee-for-Service (PFFS), Milton is retiring on his 65th birthday. 7 November 19, 2014 EDC Agent Use Only Page 2 of 183 the event is geared towards providers or other non-Medicare eligible beneficiaries). 2 – Validation of Possible Eligible Debts for Referral 60. On November 26, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would revise the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program (Part D), Medicare Cost Plan Program, Programs of All-Inclusive Care for the Elderly (PACE). Unsolicited contact happens when an agent initiates the initial contact with a consumer without that consumer’s permission or invitation, or for a product the consumer has not requested, or by a method not expressly Study with Quizlet and memorize flashcards containing terms like Cynthia is turning 65 on July 5. Placing a marketing brochure on the door handle of the consumer's residence. Telephone, email or text a consumer when contact information is obtained through a friend or referral. Medicare Part A: Original Medicare - Hospital Insurance 2. NOTE: Unsolicited contact is contact that is not asked for or requested by the consumer. In addition, an email should not be intended to steer someone into a specific plan. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan?, Which of the following statements is true about using a 5-Star Special Enrollment Period messaging on social media platforms, falls under unsolicited contact and is not permitted) NOT. Dino proceeded to verify the consumer's Medicare eligibility, describe the costs and benefit coverage of the plan, and explained that he could not accept an enrollment application until October 15. Additionally, there are Study with Quizlet and memorize flashcards containing terms like Cynthia is turning 65 on July 5. Medicare Part C: Medicare Advantage 4. b. Whereas solicited contact means a consumer has given express consent to be contacted by a sales agent for the purpose of Center for Medicare and Medicaid Services (CMS) and the use of Humana’s/CarePlus Request for Future Contact form. When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. What is Medicare? This is a type of healthcare insurance for people within 65 years and above and others who meet the requirement. To sign an enrollment application on behalf of a consumer, what authority must the individual have? Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Which of the following is NOT considered UNSOLICITED contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? a. 42 CFR § 422. Unsolicited Contact: The Center for Medicare and Medicaid Services (CMS) states that agents cannot make direct unsolicited contact. Violet asks agent Bob where she can find the Star Rating for the plan he has been presenting. Definition. Sending unsolicited emails to the consumer about new plans. UHC Ethics and Compliance 2023-2024 Exam New Latest Version with Questions from Actual Exam and 100% Correct Answers from Examiner Updated Version Which of the following is not considered We’ve talked before about the importance of an online presence, but be forewarned, likes or shares on social media do not constitute PTC for sales purposes. - CMS prohibits any type of marketing through unsolicited contact - Referred beneficiaries must contact the plan, agent, broker or producer directly Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Emailing a marketing brochure to a consumer whose email address was obtained on a purchased lead list. Communications means activities and use of materials to provide information to current and Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? - Mailing a marketing brochure to the consumer via postal mail. He is eligible for If the client is assessed/determined to be eligible for Medicaid or CHIP, the client's information will automatically be transferred to their state Medicaid/CHIP agency. Part C iii. B. Medicare began in 1966 with coverage for just under 19. Which of the following is not considered prohibited unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? According to CMS (Centers for Medicare & Medicaid Services) regulations and UnitedHealthcare’s rules, unsolicited contact with a Medicare eligible consumer is generally According to CMS (Centers for Medicare & Medicaid Services) regulations and UnitedHealthcare's rules, particular forms of contact with Medicare-eligible consumers are Response to a Request: Contacting a consumer who has proactively requested information is not considered unsolicited. MCAP provides full coverage private health insurance to pregnant individuals regardless of their immigration status during pregnancy and for 365-days days following pregnancy. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan?, Which of the following statements is true about using a five star special enrollment • Not permitted to ask for a date of birth. All email marketing MUST contain an “unsubscribe” or “opt-out” capability. • All type must be at least 12 point font, Times New Roman or equivalent. In the years since its inception, the Which of the following are true about the UnitedHealthcare SCO care management program? (Select 2) A care management team reviews the member's claims and invoices to determine level of care needs. MUST report in advanceto Carriers according to their policies; MUST be clearly advertised as “educational” • MUST be only educational info & comply w/CMS educational requirements • MUST be free of materials w/plan-specific/benefit info, including premiums & • Medicare does not usually pay for this many treatments or services. (a) Unsolicited contact. , Mrs. If a Medicare-eligible consumer requests more Which of the following is not considered prohibited unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? - Mailing a marketing brochure to the Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and Which of the following is not considered prohibited unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Mailing a marketing brochure to the consumer via postal mail. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Emailing a marketing brochure to a consumer whose email address was obtained on a purchased lead list. Explanation: According to CMS (Centers for Medicare & Medicaid Correct Answer-At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older and calls the referred individual. Subject to the rules for contact for plan business in paragraph (b) of this section, the following rules apply when materials or activities are given or supplied to a beneficiary or their Study with Quizlet and memorize flashcards containing terms like The National Do Not Call Registry was created to regulate - Insurers - Insurance solicitors - Telemarketers - Field Underwriters, Which of the following would NOT be considered an exception to the National Do Not Call List? - Calls for which the consumer has given prior written permission - Calls which MCAP is not a Medi-Cal program; it is administered by the Department of Health Care Services (DHCS). Termination iv. Consumers can only enroll in a Medicare Advantage Plan or switch to a different Medicare Advantage plan. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealth- care's rules, policies, and procedures?: Mailing a marketing brochure to the consumer via postal mail. Among the options given, emails with opt-out provision are not considered prohibited unsolicited contact. It is likely not in their best interest to enroll in a QHP through the 1. , How should agent Erin respond when consumer Mrs. All services are considered medically necessary for Medicare beneficiaries c. Her Medicare Part A and Part B will be effective on July 1. For telephonic contact to occur there must be permission which has not expired and consent for ber 30 June 1 through July 31 - -ANS---Not July 1 - Dec 30 - WRONG Annual Election Period (AEP) is a time when. Medicare pays screenings at 100% of the provider's charge b. 12. To maintain compliance, it’s essential to avoid the following prohibited marketing practices: Misleading Information: Do not provide false or misleading information about Medicare plans or benefits. Plans/PaIt D sponsors, and their agents/brokers, may not conduct telephonic activities that include, but are not limited to, the following: Unsolicited calls about other business as a means of generating leads for Medicare plans Unsolicited Contact: The Center for Medicare and Medicaid Services (CMS) states that agents cannot make direct unsolicited contact. What is not considered unsolicited contact with a Medicare-eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Unsolicited contact refers to any communication made to a Medicare eligible Study with Quizlet and memorize flashcards containing terms like True or False? Bribes or kickbacks of any kind for services that are paid under a Federal health care program (which includes Medicare) constitute fraud by the person making as well as the person receiving them. It authorizes the plan to contact the provider identified on the form in order to verify that the consumer has at least one of the qualifying chronic conditions covered by the C-SNP. Question: Which of the following is not considered prohibited unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Approaching a consumer in a common area of a senior living complexMailing a marketing brochure to the consumer via postal mailPlacing a marketing brochure on the door Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Correct Ans - Mailing a marketing brochure to the consumer via postal mail. Unsolicited contact is an outreach actiy vitwhen there is no prior consent messaging on social media platforms, falls under unsolicited contact and is not permitted) NOTE: Unsolicited contact is contact that is not asked for or requested by the consumer. Plans may now contact potential members through advertisements, direct mail, and email. a. messaging on social media platforms, falls under unsolicited contact and is not permitted) NOT. " Violation of permission to contact guidelines occurs if agents communicate with individuals without their explicit authorization. 4 - Issuance o f the “Intent to Refer” Medicare agents may send unsolicited emails to potential enrolled to market their services (i. Part D 1. Lopez is considered a marketing representative of BestCare and thus is obligated to comply with CMS marketing requirements, including those regarding using only approved call scripts. , direct postal mailing campaign) is strictly prohibited. • Medicare does not Unsolicited Contact . What information should be obtained from the consumer when conducting a thorough needs assessment? (Select 2) Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Mailing a marketing brochure to the consumer via postal mail. A) option When the consumer consented to be contacted for sales activities. 1 million adults ages 65 and older, or roughly 9. Among the choices provided, cold-calling is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures. Study with Quizlet and memorize flashcards containing terms like Cynthia is turning 65 on July 5. Which of the following is not considered prohibited unsolicited contact with a medicare eligible consumer according to CMS regulations and UnitedHealthcare’s rules, policies, and procedures? Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Visiting the consumer's home without an appointment to discuss plans. Question 3: If a supplier makes solicited contact with a beneficiary for a particular covered item, can the supplier speak with the beneficiary about additional covered items during that same In which of the following situations can telephonic contact be made with a Medicare eligible consumer? When confirming receipt of mailed information. No, the consumer does not need to be an AARP member to enroll in a Medicare Supplement Plan. How does she enroll in original Medicare?, Which statement is true about members of a Medicare advantage plan who want to enroll in a Medicare supplement insurance plan?, Provided other eligibility requirements are met. In general, unsolicited calls for sales or marketing purposes are prohibited unless specific criteria are met. 4, 70. For Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and 1876 Cost plans Study with Quizlet and memorize flashcards containing terms like Cynthia is turning 65 on July 5. Medicare Part D: Prescription Drug Coverage s–tand-alone PDP and MA-PD b. Four levels of eligibility under MSP. The correct answer is : Not emailing a consumer off a purchased list Explanation: According to the CMS regulation and united healthcare's rules, policies an procedures any type of contact that is not requested or permitted by the medicare eligible consumer is known as unsolicited contact, which is prohibited. the agent must maintain an active resident license and appointment and pass medicare basics and ethics compliance assessments on an annual basis Which Medicare-eligible consumer is best suited for a C-SNP? Mary, who has been seeing a specialist for a qualifying chronic condition. For example, returning phone calls or call-ing an individual who has completed a business reply card requesting contact is not considered unsolicited. Final answer: A mailed brochure is generally not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, whereas phone calls, emails, and in-person visits would require prior consumer consent to not be considered unsolicited. MA organizations may contact current, and to a more limited extent, former members, including those enrolled in other products offered by the parent organization Prohibition on unsolicited contact: Medicare marketing representatives cannot make unsolicited contact with Medicare beneficiaries, including through cold-calling, door-to-door visits, or direct mail. Approaching a consumer in a common area of a senior living complex. , What are some of the penalties for violating fraud, waste, and abuse (FWA) laws? Civil For example, returning phone calls or calling an individual who has completed a business reply card requesting contact is not considered unsolicited. They have the SOA form. Confidential property of UnitedHealth Group. a sales agent for the purpose of receiving information about Medicare Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures?- Answer Correct Mailing a marketing brochure to the consumer via postal mail. 59, 02-22-08) Transmittals for Chapter 7 60. . What products can be In which of the following situations can telephonic contact be made with a Medicare eligible consumer? Correct Answer-When the consumer consented to be contacted for sales activities, subsequent telephonic contact has The IEP is unique to each individual and is the timeframe when they are first eligible for Medicare, based on age. Eligibility Requirements and Premiums i. is the situation telephonic contact be made with a Medicare-eligible consumer. MA organizations may contact current, and to a more limited extent, former members, including those enrolled in other products offered by the parent organization The Medicare Permission to Contact (PTC) outlines the specifics for compliant contact with beneficiaries. Consumers can only disenroll from their Medicare Advantage or Prescription Drug Plan and return to Original Medicare. Unsolicited Contact: Agents cannot make unsolicited calls or send unsolicited text messages or emails to potential clients. , door-to-door marketing), telephonic (e. population. All CMS marketing guidelines and regulations regarding unsolicited contact apply to Medicare age-ins as well as existing Medicare beneficiaries and apply to the following products: Medicare Advantage (MA) and Prescription Dino, an agent, received a phone call on September 29 from a consumer interested in Medicare Advantage plans for the new plan year. 2 days before the appointment they call and request to discuss PDP, which you are certified to The question is about identifying which form of contact is not considered prohibited unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules. 6% of the U. You may ask for age or if consumer is Medicare Eligible. What part of Medicare helps cover the costs of his inpatient hospital stay?, Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Insurance Plan?, Being 65 or older, being Study with Quizlet and memorize flashcards containing terms like What will Medicare charge if someone doesn't enroll in certain Medicare programs or plans when they're first eligible?, A consumer who has been A consumer may have to pay a Late Enrollment Penalty (LEP) if they did NOT enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for _____. A care management team assesses the member's levels of care needs monthly. (b) Contact for plan business. 20 - Communications and Marketing Definitions 42 CFR §§ 422. Lopez is a marketing representative of BestCare because Confirming the consumer's Medicaid level and that the consumer is entitled to Medicare Part A and enrolled in Medicare Part B is a requirement of: Members who are QMB+ or are Full Dual-Eligible are not required to pay copayments Background. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and Question: Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Answer: Mailing a marketing brochure to the consumer via postal mail. 43 of 98. Whereas solicited contact means a consumer has given express consent to be contacted by a sales agent for the purpose of receiving information about Medicare Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? - THE CORRECT ANSWER IS Mailing a Answer: The agent said that Medicare uses a 5-star rating system to illustrate the plan’s performance and quality. Medicare will reimburse for Which of the following statements is accurate? - insurance producers as a whole provide appropriate information and advice about insurance products and services - consumers typically rely on sources that are completely independent from the insurance industry for information about its products and services - the insurance industry has a sterling reputation with all consumers - Study with Quizlet and memorize flashcards containing terms like Lisa turned 65 and is now eligible for Medicare. Sections 70. outbound call campaign. She already received social security benefits. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Correct Ans - Mailing a marketing brochure to the consumer via postal mail. , not their plans), so long as the email meets guidelines and includes an option to opt out. Rose notices that the presented MA Plan has a Star Rating of 2 stars?, Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Mailing a marketing brochure to the consumer via postal mail. An agent is explaining Medicare Advantage plan options to a consumer. Unsolicited direct contact is prohibited, except for the use of iii. Contact a member who is in the process of Return phone calls or messages from individuals or enrollees, as these are not considered unsolicited contacts. The representative can contact the consumer only if the consent is valid and has not expired. n/a - correct answersWhich of the following is not considered unsolicited contact with a Medicare (CORRECT) Which of the following lead generating activities is NOT compliant? Answer: At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older and calls the referred individual. When can telephonic contact with a Medicare eligible consumer be made? - When the consumer Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Dino, an agent, received a phone call on September 29 from a consumer interested in Medicare Advantage plans for the new plan year. Yes, if the consumer is enrolling in a Medicare Supplement Plan. Valid PTC would not have been In which of the following situations can telephonic contact be made with a Medicare eligible consumer? - THE CORRECT ASNWER IS When the consumer consented to be contacted for sales activities, subsequent What are Unsolicited Contacts? Unsolicited direct contact with a consumer that was not requested or initiated by the consumer is prohibited and includes in-person (e. Study with Quizlet and memorize flashcards containing terms like What type of event must an agent conduct when they want to be able to collect consumer information, schedule future appointments, and accept enrollment applications? -Marketing/sales event -Member event -Educational event, What type of event is an agent conducting when they inform Medicare 5. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan?, Annual Election Period (AEP) is a time when. Study with Quizlet and memorize flashcards containing terms like Annual Election Period (AEP) is a time when. However For a telephonic contact from a medical sales representative to eligible medicare, consumer consent is the foremost prior thing. Whereas solicited contact means a consumer has given express consent to be contacted by a sales agent for the purpose of receiving information about Medicare an inactive, nonemployee who has signed a servicing agreement in order to receive renewal commisions on medicare advantage and prescription drug plan enrollments on or after 1-1-2014. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and Which of the following is NOT considered UNSOLICITED contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Emailing a marketing brochure to a consumer whose email address was obtained on a purchased lead list. 2 days before the appointment they call and request to discuss PDP, which you are certified to sell. Secret In which of the following situations can telephonic contact be made with a Medicare eligible consumer? -When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. All other family members are not eligible for MCAP. Under a group medical policy, prescription drug plans are Which of the following is an appropriate way for an insurance agent to make unsolicited contact with a Medicare-eligible person? For example, returning phone calls or calling an individual who has completed a business reply card requesting contact is not considered unsolicited. - CMS prohibits any type of marketing through unsolicited contact - Referred beneficiaries must contact the plan, agent, broker or producer directly 2 . Whereas solicited contact means a consumer has given express consent to be contacted by. Emailing a marketing brochure to a consumer whose email address was obtained on a purchased lead list. Not intended for use as marketing material for the general public. During the conversation, the agent explains that Medicare gives each plan a Star Rating. For Agent use only. 2264 & 423. to be eligible for this plan type consumers must meet the following requirements Study with Quizlet and memorize flashcards containing terms like Dual Eligible Special Needs Plans (D-SNP) are defined as:, Which statement is true about how the loss of Medicaid affects a member's enrollment in a D-SNP?, Which consumer might benefit the most by enrolling in a D-SNP? and more. (WRONG) Placing a marketing brochure on the door handle of the According to CMS regulations and UnitedHealthcare's rules, policies, and procedures, all types of communication forms such as phone calls, emails, and text messages from an insurance or healthcare provider is considered as unsolicited contact if the Medicare eligible consumer has not given prior approval for communication. SOA forms or recorded calls must include the following: • Product types for discussion • Date of appointment • Beneficiary and agent contact information • Statement: “There’s no obligation to enroll, current or future Medicare enrollment status will Most people who are eligible for Medicare Savings Programs (MSP) also qualify for the Part D Low-Income Subsidy. QUESTION Which of the following is not considered unsolicited contact with a Medicare eligible consumer The only exception for unsolicited beneficiary contact under the CMS rules is that agents may send unsolicited emails to potential enrollees to market their services, but the email must have an opt-out option and the messaging on social media platforms, falls under unsolicited contact and is not permitted) NOTE: Unsolicited contact is contact that is not asked for or requested by the consumer. . Newly diagnosed with a chronic condition, he calls agent Charles on May 3 to ask if there are plans that DRAFT DRAFT DRAFT Chapter 3 – Medicare Marketing Guidelines . 2260 . This PDF is the current document as it appeared on Public Inspection on 04/04/2024 at 5:10 pm. Therefore, a telephonic conversation can only occur if the consent is valid for the sales activity. Which of the following is not considered prohibited unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? Mailing a marketing brochure to the consumer via postal mail. For the purpose of this section, beneficiary contact means any outreach activities to a beneficiary or a beneficiary's caregivers by the Part D sponsor or its agents and brokers. Mailing a marketing brochure to the consumer via postal mail. In that scenario, the beneficiary initiated the contact and is inviting a response from the supplier. The telephone contact approach is either real contact with the Borrower or Co-Borrower or attempts.