Under CMS marketing rules, a TPMO (Third Party Marketing Organization) must include which statement when contacting beneficiaries?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
TPMOs — third party marketing organizations that market Medicare Advantage and Part D plans on behalf of insurers — must state that they are not connected with or endorsed by the federal Medicare program, along with other required disclosures such as the number of organizations and products they represent. The disclaimer prevents beneficiaries from confusing marketing organizations with the government. CMS also prohibits misleading claims about plan benefits and imposes limits on gifts and incentives. CMS applies the same strict rules to calls and appointments: recordings must be kept, unsolicited contact is limited, and marketing materials must not imply that any particular plan is government-endorsed.
Why the other options are wrong
- B) Guaranteeing full coverage with no out-of-pocket costs is a misleading benefit claim that CMS marketing rules prohibit.
- C) Gifts and incentives are permitted only within strict nominal-value limits; offering gifts worth more than $100 regardless of enrollment violates the rules.
- D) Medicare coverage continues while a beneficiary is in a Medicare Advantage plan; that statement is false and prohibited.
Memory hook
TPMOs must wear the badge: 'We are not connected with Medicare.' The disclaimer is mandatory, the guarantee is not.