Medicare has been requiring agents and brokers who don’t offer all available coverage to mention that to beneficiaries in a disclaimer read within the first 60 seconds of sales calls. The disclaimer must direct prospective clients to SHIP, Medicare.gov and 1-800-MEDICARE to learn about all options
But the disclaimers will change under new marketing rules from the Centers for Medicare & Medicaid Services (CMS) that take effect in October 2026, right before the start of Medicare’s Annual Open Enrollment (AEP) period for 2027 coverage. The new rules relax some regulations that govern agent and broker interactions with those who want to enroll or change plans.
The new rules allow the disclaimer anytime during a sales call before benefits are discussed. And the disclosures will no longer have to mention SHIP.
You want to prepare a list of key items and questions for agents, brokers and anyone you talk to for assistance. Ask them for answers about plan features that are most important to you, such as:
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Coverage for medications that you take or expect to.
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Whether pharmacies you use are In-Network.
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Verify that your current providers including your Primary Care Physician and specialists are In-Network.
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Verify that your chosen or preferred hospital is also In-Network not just at carrier but at specific plan level.
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That the extra benefits which you most value are offered by the Medicare Advantage plan under consideration.
All of the above items need to be reviewed in order to confirm that you are choosing the best available plan for your individual situation.
