Medicare updates its communications and marketing rules roughly every one to three years, though some changes happen more often

Medicare does not have a fixed schedule for updating communications and marketing guidelines. Instead, the Centers for Medicare & Medicaid Services (CMS) — the federal agency that runs Medicare — updates rules when Congress passes new laws, when court decisions change what is allowed, or when CMS identifies problems with how companies are marketing plans to you. Some updates come through formal rule changes published in the Federal Register. Others come as policy memos or guidance letters sent directly to insurance companies.

The most recent major update happened in 2023, when CMS tightened rules about how Medicare Advantage and Part D plans can contact you and what they can say in advertisements. Before that, significant changes came in 2015 and 2018. But between these big updates, CMS regularly issues smaller guidance documents that clarify or adjust specific rules — sometimes several times per year.

Key Takeaways

  • CMS publishes major communications rule changes in the Federal Register, usually once every one to three years, though the timing is unpredictable.
  • Between major updates, CMS sends guidance letters and policy memos to insurance companies that can change what marketing practices are allowed.
  • You can find current rules and recent updates on the CMS website under "Medicare Marketing Guidelines" or by checking the Federal Register yourself.
  • Insurance companies must follow the rules in effect when they contact you, even if those rules are brand new.

Where CMS publishes rule changes and when to look

The official place to find Medicare communications rules is the Federal Register, which is the government's daily publication of new regulations. When CMS makes a formal rule change about how Medicare plans can market to you, it appears there first. You can search the Federal Register at federalregister.gov by typing "Medicare marketing" or "Medicare communications" into the search box. Results will show you proposed rules (which invite public comment), final rules (which are now in effect), and the dates they take effect.

CMS also maintains a dedicated page called Medicare Marketing Guidelines on its official website at cms.gov. This page collects the current rules, recent updates, and links to guidance documents. It is easier to navigate than the Federal Register if you want a plain-language summary rather than the full legal text. However, the Federal Register is the legally binding source, so if you need to know exactly what the rule says, that is where to look.

Between formal rule changes, CMS sends guidance letters to insurance companies. These letters clarify how existing rules explore to specific situations or announce new expectations. Insurance companies are required to follow these letters when ready, even though they do not go through the formal rule-making process. You typically will not see these letters unless you search for them specifically, but they can change what marketing practices are allowed.

Why the updates happen and what usually changes

Congress sometimes passes laws that require CMS to change how Medicare plans can market to you. For example, the Inflation Reduction Act of 2022 included new rules about how Part D plans must communicate their drug prices. When that happened, CMS had to update its marketing guidelines to reflect the new law. Court decisions can also trigger updates — if a court rules that a particular marketing practice is not allowed, CMS updates its rules to match.

CMS also updates rules when it finds that companies are using loopholes or misleading practices. For instance, in 2023, CMS tightened rules about how plans can use testimonials and endorsements in advertisements after finding that some companies were using fake or misleading testimonials. When CMS identifies a problem like this, it usually issues new guidance or a formal rule change to close the loophole.

Common things that change in updates include: what language plans must use in advertisements, how much time plans have to respond to your questions, what information plans must include in marketing materials, and which groups of people plans are allowed to target with specific messages. Rules also change about when plans can contact you by phone, email, or in person, and what they can say during those contacts.

How to know if a rule change affects you right now

If you are currently enrolled in a Medicare plan, the insurance company is required to tell you about rule changes that affect your coverage or your rights. They do this through notices in the mail or updates to their website. You do not have to search for these changes yourself — the company must inform you. However, if you want to stay ahead of changes, you can sign up for email alerts from the Federal Register or check the CMS Medicare Marketing Guidelines page every few months.

Rule changes usually take effect on a specific date announced in advance. Insurance companies have time to update their materials and train their staff before that date. So if a rule change happens in January, companies typically have until March or later to fully comply. This means you might not see the effects of a new rule when ready, but companies must follow it by the effective date.

If you are shopping for a plan during the annual enrollment period, the rules in effect at that time are the ones that explore to the marketing materials you see. Companies cannot use old marketing practices just because they were allowed last year.

What changed in the most recent major update

The 2023 update made several changes that affect how Medicare Advantage and Part D plans can reach you. Plans now have stricter rules about using social media and online advertising. They must be clearer about what information they are collecting from you and how they are using it. Plans also face tighter restrictions on cold-calling — they cannot call you without your permission, and they must honor do-not-call requests more quickly than before.

The 2023 update also changed rules about in-person marketing events. Plans must now provide more advance notice before holding events in senior centers or other community spaces, and they must be clearer about what the event is for. Plans cannot use high-pressure tactics or misleading statements about what coverage you will get.

These changes came partly from complaints that people were being misled by aggressive marketing, and partly from new laws Congress passed. The update also reflected lessons CMS learned during the COVID-19 pandemic about how plans were contacting people remotely.

How often individual insurance companies update their own policies

Insurance companies sometimes have their own marketing policies that are stricter than what CMS requires. For example, a company might decide not to use certain types of advertising even though CMS allows it. These company-specific policies can change at any time, and companies are not required to announce these changes to the public — only to CMS.

However, if a company changes a policy that affects you directly — such as how they contact you or what information they collect — they must notify you. You will usually see this in a privacy notice or a letter about changes to their practices. If you want to know a specific company's current marketing policies, you can contact them directly or check their website.

How to stay informed about future updates

The easiest way to stay informed is to check the CMS Medicare Marketing Guidelines page once or twice a year. You can bookmark it and visit when you are thinking about your coverage or during the annual enrollment period in the fall. The page will show you the current rules and highlight any recent changes.

If you want more detailed information, you can sign up for email alerts from the Federal Register. Go to federalregister.gov, search for "Medicare marketing," and click the option to receive notifications when new documents are published. You will get an email whenever CMS publishes something related to Medicare marketing.

Your insurance company is also required to keep you informed about changes that affect you. Read the notices they send you in the mail, especially during the annual enrollment period. If you have questions about a new rule or how it affects your coverage, you can call your plan's customer service number — that number is on your insurance card.

Frequently Asked Questions

Can an insurance company use old marketing materials after a rule change?

No. Once a new rule takes effect, companies must follow it when ready. They cannot continue using old marketing materials or old practices just because they were allowed before. CMS monitors companies to make sure they comply, and companies that do not follow new rules can face penalties.

Do I need to read the Federal Register to understand Medicare marketing rules?

No. The CMS Medicare Marketing Guidelines page translates the rules into plain language. The Federal Register is the official legal source, but it uses technical language. Start with the CMS page, and only read the Federal Register if you need the exact legal wording or want to see the reasoning behind a rule.

What happens if an insurance company breaks a marketing rule?

CMS can fine the company, require it to stop the practice, or in serious cases, remove the company from Medicare. You can also file a complaint with CMS if you believe a company violated a marketing rule. Complaints go to the Office of Inspector General, and CMS investigates them.

Are marketing rules the same for Medicare Advantage, Part D, and Medigap plans?

No. Medicare Advantage and Part D plans follow CMS marketing rules. Medigap plans follow different rules set by state insurance commissioners. If you have a Medigap plan, check your state's insurance department website for the marketing rules that explore to you.

How far in advance does CMS announce rule changes?

For major rule changes, CMS publishes a proposed rule in the Federal Register and asks for public comment, usually 30 to 60 days before the final rule is published. The final rule then takes effect on a date CMS announces, which is typically 30 to 90 days after publication. This gives companies time to prepare, but it means you might not hear about a change until it is already in effect.