Provider Marketing Guidelines PDF Print E-mail
Medicare patients often look to their community pharmacist to provide them with information regarding their prescription drug coverage options.  

To the extent that a pharmacist can assist a patient in an objective assessment of the patient’s needs, they are encouraged to do so. Pharmacists may engage in discussions with patients when they seek information or advice regarding their Medicare options. Pharmacists may make available and/or distribute plan marketing materials for all plans with which they participate.

However, pharmacists cannot accept enrollment applications or offer inducements to persuade patients to join certain plans, nor can they direct, urge or attempt to persuade patients to enroll in a specific plan. 

Here’s a simple list of CANs and CANNOTs for pharmacists and other health care providers:

Pharmacists and other health care providers CAN:
  • Provide the names of plans with which they contract and/or participate
  • Provide information and assistance in applying for the low-income subsidy
  • Provide objective information on specific plan formularies, based on a particular patient’s medications and health care needs
  • Provide objective information regarding specific plans, such as covered benefits, cost sharing, and utilization management tools
  • Distribute PDP marketing materials, including enrollment application forms 
  • Distribute MA and/or MAPD marketing materials, excluding enrollment application forms
  • Refer their patients to other sources of information, such as the State Health Insurance Assistance Programs, plan marketing representatives, their State Medicaid Office, local Social Security Administration Office, CMS’s Web site at http://www.medicare.gov/, or 1-800-MEDICARE
  • Print out and share information with patients from CMS’s Web site.
  • Use comparative marketing materials comparing plan information created by a non-benefit/service providing third-party 

Pharmacists and other health care providers CANNOT:
  • Direct, urge, or attempt to persuade, any prospective enrollee to enroll in a particular plan or to insure with a particular company based on financial or any other interest of the provider (or subcontractor).
  • Collect enrollment applications
  • Offer inducements to persuade beneficiaries to enroll in a particular plan or organization
  • Health screen when distributing information to patients, as health screening is a prohibited marketing activity
  • Offer anything of value to induce plan enrollees to select them as their provider
  • Expect compensation in consideration for the enrollment of a beneficiary
  • Expect compensation directly or indirectly from the plan for beneficiary enrollment activities