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In this episode we review key CMS regulations agents must follow to stay compliant during Medicare sales. Bonus? These steps also help educate and inform your clients!

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Contact the Agent Survival Guide Podcast! Email us [email protected] or call 1-717-562-7211 and leave a voicemail.

Resources:

Fact vs. Fiction: Examining the Medicare Part B Premium Giveback

Formularies & Covered Drugs – Knight School Training

How to Check Medicare Extra Help Eligibility for Your Client

How to Help Clients Avoid Medicare Late Enrollment Penalties

How to Help Your Clients Get the Most Out of Their Medicare Advantage Plans

Insurance Agents as TPMOs: What CMS Compliance Regulations Mean for You

Medicare Grievances & How Insurance Agents Can (Try To) Prevent Them

MA & PDP Compliant Sales Checklist PDF Download

SNPs: The Secret to Surviving Lock-in

The 2026 Medicare Part D Redesign Updates Agents Should Know

The Beginner’s Guide to C-SNPs

The Beginner’s Guide to D-SNPs

The Difference Between Medicare & Medicaid: What That Means for Insurance Agents

What Agents Can’t Say During Medicare Sales Appointments

What to Know About SOAs in Medicare Health and Prescription Drug Plan Sales

References:

“Agent and Broker Training & Testing Guidelines.” CMS.Gov, Centers for Medicare & Medicaid Services,

https://www.cms.gov/files/document/cy2025-agent-broker-training-testing-guidelines.pdf. Accessed 14 Oct 2025.

“Agent and Broker Training & Testing Guidelines.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/cy2026agentbrokertrainingtestingguidelinespdf.pdf. Accessed 15 Oct. 2025.

“Costs.” Medicare, www.medicare.gov/basics/costs/medicare-costs. Accessed 14 Oct. 2025.

“Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F).” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/newsroom/fact-sheets/contract-year-2025-medicare-advantage-and-part-d-final-rule-cms-4205-f. Accessed 14 Oct. 2025.

“Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F).” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/newsroom/fact-sheets/contract-year-2026-policy-and-technical-changes-medicare-advantage-program-medicare-prescription-final. Accessed 15 Oct. 2025.

“Emergency Department Services.” Medicare.Gov, Medicare, www.medicare.gov/coverage/emergency-department-services. Accessed 14 Oct. 2025.

“Medicare Communications and Marketing Guidelines (MCMG) Date: 02/09/2022.” CMS.Gov, Centers for Medicare & Medicaid Services, www.cms.gov/files/document/medicare-communications-marketing-guidelines-2-9-2022.pdf. Accessed 14 Oct. 2025.

Seladi-Schulman, Jill. “Medicare IRMAA: What Is It and When Does It Apply?” Healthline, Healthline Media, 22 Apr. 2025, www.healthline.com/health/medicare/what-is-irmaa.

“Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments.” Federalregister.Gov, Federal Register, www.federalregister.gov/documents/2024/07/31/2024-14828/medicare-and-medicaid-programs-cy-2025-payment-policies-under-the-physician-fee-schedule-and-other. Accessed 14 Oct. 2025.

“Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.” FederalRegister.Gov, Federal Register, www.federalregister.gov/documents/2025/04/15/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare. Accessed 15 Oct. 2025.

“Out-of-Pocket Maximum/Limit.” HealthCare.Gov, www.healthcare.gov/glossary/out-of-pocket-maximum-limit/. Accessed 14 Oct. 2025.

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