If you market Medicare Advantage or Part D plans, you already know that CMS doesn’t take a light touch with marketing compliance. Every year the rules shift a little — sometimes a lot — and direct mail remains one of the most heavily scrutinized channels, right alongside phone calls and digital ads.
Whether you’re a health plan, a TPMO, or an independent agent, getting the guardrails wrong isn’t just a compliance headache. It can mean six-figure penalties, termination of your selling appointment, or permanent exclusion from Medicare sales altogether.
Here’s a practical, high-level walkthrough of what you need to know before your next direct mail piece goes out the door.
CMS draws a meaningful line between general communications and marketing materials, and where your piece falls determines how much regulatory weight it carries.
Communications are general informational materials — things like a postcard explaining what Medicare is, the differences between Parts A, B, C, and D, or how the Annual Enrollment Period works, with no mention of a specific plan or its benefits.
Marketing materials are the subset that address plan-specific benefits, premiums, cost- sharing, star ratings, or rewards and incentives. If your direct mail piece names a plan, highlights specific coverage, or includes any kind of enrollment prompt, it’s marketing — full stop.
That distinction matters because marketing materials trigger a much stricter set of obligations: filing requirements, mandatory disclaimers, formatting rules, and recordkeeping. A vague “educational” mailer that quietly nudges toward a specific plan
doesn’t get to skip these requirements just because it avoids the word “enroll.”
Any print piece that qualifies as marketing — brochures, flyers, door hangers, postcards — has to be submitted to CMS for review and approval through the Health Plan Management System (HPMS) before it’s mailed. This isn’t optional and it isn’t something you can backfill after the fact. If your mail piece names a plan, its logo, or its benefits, assume it needs to go
through this review process.
This is also true for co-branded materials. If you’re a provider or agency producing something alongside a plan sponsor, the plan sponsor is required to monitor and take responsibility for what you send on their behalf — which means they’ll typically want to
review and approve it too, even before it hits HPMS.
CMS requires specific disclaimer language depending on what your mail piece does and who’s sending it. Two are especially relevant for direct mail:
If you’re an independent agent, agency, or brokerage — and most fall under CMS’s definition of a Third-Party Marketing Organization (TPMO) — your materials need a disclosure along these lines: you don’t represent every plan available in the recipient’s area, and you should state how many organizations and products you do represent. This disclaimer needs to appear not just on mailers, but across your marketing materials, website, emails, and social posts. As of the most recent rule updates, this language no longer has to be read in the first minute of a sales call, but it does still need to appear on print materials, and it must be
included before plan benefits are discussed on a call.
Any time you list a phone number — on a postcard, in a digital ad, or on your website — CMS requires a disclaimer stating that calling the number connects the recipient to a licensed insurance agent. This is a small line, but it’s one of the more commonly missed requirements, especially on mail pieces with a lot of white space pressure and limited room for fine print.
CMS is specific about how things need to look, not just what needs to be said. A few of the most important formatting rules for print:
Plan or organization names must appear in at least 12-point font. This isn’t a suggestion — it’s a hard requirement, and it applies whenever you’re marketing plan-specific benefits.
These formatting details might seem minor next to the bigger filing and disclaimer requirements, but they’re exactly the kind of thing that shows up in compliance audits — and they’re easy to get wrong when a design team is optimizing for visual hierarchy rather than regulatory hierarchy.
A few restrictions worth flagging explicitly, because they’re common pitfalls:
No unauthorized use of a plan’s name, logo, or trademark. If you want to reference a specific Medicare Advantage plan or its branding, you need that company’s prior approval — and in many cases, their own CMS filing covers the piece, not yours
independently.
No fabricated or unapproved plan claims. Referencing benefits, pricing, or plan details that haven’t been filed and approved is treated the same as misrepresenting the plan altogether.
Keep MA content separate from other lines of business. If your agency also sells Medicare Supplement plans or other insurance products, MA marketing materials need to stay distinct — no blending or implying cross-eligibility in ways that could confuse a beneficiary about what they’re being offered.
Beyond the piece itself, CMS expects ongoing oversight of your marketing activity. Plans and TPMOs are required to monitor how their materials are used — including by downstream agents and third-party websites — and to act quickly if something noncompliant slips through. For direct mail specifically, that means keeping records of what was filed, what was approved, when it went out, and to whom, so you can produce a clean audit trail if CMS or a plan sponsor comes asking.
Given how aggressively CMS has expanded oversight into digital and social channels in recent years, it’s a safe bet that print enforcement isn’t loosening up either. If anything, the expectation is that your compliance processes — filing, disclaimers, recordkeeping — are consistent across every channel you use, not just the ones getting the most regulatory
Direct mail might feel like the “old reliable” channel compared to paid social or email, but CMS treats it with exactly the same scrutiny. Before your next piece goes to print:
Determine whether it’s a communication or marketing material based on what it says, not just its format. File it through HPMS if it qualifies as marketing.
Include the TPMO disclaimer and phone number disclaimer where applicable.
Check font size and placement rules for plan and organization names.
Confirm every benefit claim matches the plan’s filed Summary of Benefits.
Get sign-off from the plan sponsor if you’re producing co-branded materials.
Keep a clean paper trail of filings, approvals, and mail dates. None of this replaces a real compliance review. CMS’s Medicare Communications and Marketing Guidelines get revised often enough that language considered safe last Annual Enrollment Period may need updating this year. But if you’re building out a direct mail strategy for Medicare Advantage, this gives you the framework to ask the right questions — and to know what your compliance or legal team should be checking before anything gets mailed.
This post is intended as a general overview and does not constitute legal or compliance advice. Always confirm current requirements against CMS’s official Medicare Communications and Marketing Guidelines and your organization’s compliance team before finalizing marketing materials.