How to Sell Medicare Over the Phone Under CMS Rules

To sell Medicare over the phone, take only calls the beneficiary started or agreed to, then record the Scope of Appointment and read the TPMO disclaimer before you discuss benefits. Record the whole call, and cover CMS's required needs topics and the Pre-Enrollment Checklist before you enroll. Under the CY2027 rules for marketing that began October 1, 2026, there's no 48-hour wait after the SOA, and sales call recordings must be kept for 6 years.

This guide puts each step in order, from permission to contact through enrollment and follow-up, and cites the regulation behind each one. It also covers the TCPA and texting rules that apply when you use a dialer or text leads.

Key takeaways

• Cold calls, robocalls, and unsolicited texts or voicemails to sell Medicare Advantage are prohibited. That includes calls to referrals. A call isn't unsolicited if the beneficiary gave consent or contacted you first.
• For CY2027 marketing beginning October 1, 2026, the 48-hour SOA wait is gone. You still have to agree on and record the SOA before the appointment.
• Say the TPMO disclaimer before you discuss any benefits. The CY2027 rule replaced the old "within the first minute" timing and removed SHIPs from the disclaimer.
• Record marketing and sales calls in full and keep them 6 years. Years 1 to 3 must be audio. Years 4 to 6 can be audio or complete and accurate transcripts. The old 10-year figure no longer applies.
• Before enrolling, fully discuss CMS's needs topics and review the PECL. Then tell the beneficiary where to find the Summary of Benefits and the Star Ratings Document.
• Buying a lead, or scrubbing a list against Do Not Call, doesn't give you permission to call. CMS and TCPA consent rules still apply.

What do you need before you take Medicare sales calls?

Under 42 CFR 422.2274(b), agents and brokers who represent MA organizations must:

• Be licensed and appointed under State law, if State law requires it
• Be trained and tested every year, scoring 85 percent or higher on all forms of testing
• Secure and document a Scope of Appointment before a personal marketing appointment

Whether you need a license in the state where a client lives depends on that state's law. Check with that state's insurance department and your carriers before you take the call.

CMS's definition of a third-party marketing organization (TPMO) in 42 CFR 422.2260 expressly includes independent agents and brokers who are paid to do lead generation, marketing, sales, and enrollment in the chain of enrollment. So the TPMO rules below apply to you.

Do Medicare Supplement calls follow the same rules?

The rules in this guide come from 42 CFR Part 422 subpart V, CMS's Medicare Advantage communication requirements, and from CMS's tip sheet for MA organizations and Medicare drug plan sponsors. They don't settle how Medicare Supplement calls must be handled. For Medigap, ask your state insurance department and your carriers what applies, including whether calls must be recorded.

Who can you call to sell Medicare?

42 CFR 422.2264 prohibits unsolicited telephone solicitation, robocalls, text messages, and voicemail messages. Under 422.2264(a)(3), a call isn't unsolicited if the beneficiary gave consent or started the contact.

When a client wants to refer a friend, give the client your number to pass along, and let the friend call you.

Can you call a T-65 list scrubbed against Do Not Call?

A Do Not Call scrub doesn't turn a cold call into a solicited one. Under 422.2264, only the beneficiary's consent or the beneficiary contacting you does that. A list of people who never asked to hear from you is cold calling, whoever compiled it.

Lead data comes with its own rules. Under 422.2274(g)(3), a TPMO generating leads by phone must tell the beneficiary out loud that their information will go to a licensed agent for future contact. Under 422.2274(g)(4), beginning October 1, 2024, beneficiary data may be shared with another TPMO only with prior express written consent, given through a clear and conspicuous disclosure that lists each entity receiving the data and lets the beneficiary consent to or reject sharing with each one. Ask every vendor for the exact consent language before you buy.

Can you call clients about other lines you sell?

Under 422.2264(b)(1)(iv), calling clients who are enrolled in other products you sell, such as auto or home insurance, counts as plan business. Under (b)(1)(v), unsolicited calls about other lines of business may not be used to generate Medicare leads. Confirm with your carriers how they apply this.

How do you get Medicare prospects to call you?

Because outbound cold contact is off the table, phone sales depend on inbound demand. These channels fit within 422.2264:

1. Mail and print that give your phone number, plus business reply cards that ask whether the person wants a call.
2. Email that includes an opt-out option in every message.
3. Educational events, where CMS's Partner Tip Sheet says SOA forms may now be collected for CY2027. Our guide to educational vs. marketing events covers what's allowed at each.
4. Sales events, where you get attendees' express permission before you call anyone back, and document it.
5. Web forms that ask in plain words for permission to contact the person, by name, at the number they enter.

Once a request comes in, call back quickly. Our speed to lead playbook covers how to do that.

What do the TCPA and texting rules require?

CMS rules decide which Medicare contacts are allowed. FCC TCPA rules add their own consent and opt-out requirements for autodialed, prerecorded, and text contact. You must meet both.

Consent for dialers and prerecorded calls

Under the TCPA, prior express written consent at 47 CFR 64.1200(f)(9) means a signed written agreement authorizing the seller to deliver autodialed or prerecorded telemarketing to a specified number. Electronic signatures are allowed. The agreement must clearly say that signing isn't a condition of purchase.

The FCC's 2023 "one-to-one consent" revision never took effect. The Eleventh Circuit vacated it by mandate on April 30, 2025, and an FCC order effective August 29, 2025 reinstated the prior definition.

Revocation and Do Not Call requests

FCC rules require you to honor a request to revoke consent within a reasonable time, and no later than ten business days after you receive it. The FCC has waived the "revoke all" part of 47 CFR 64.1200(a)(10) until January 31, 2027.

An FCC order circulated in September 2026 for the Commission's September 30, 2026 open meeting would, if adopted as drafted, let callers limit a revocation to the category of informational robocall it responds to, and name exclusive revocation methods. An adopted order would take effect 30 days after Federal Register publication, on a date the FCC announces by Public Notice, and would replace the January 31, 2027 "revoke all" waiver date. We could not confirm its adoption status when this guide was published, so check the FCC's site for whether it was adopted and read the final text before you change your opt-out process.

Under the draft, a revocation made in response to a telemarketing or advertising robocall revokes consent to all future telemarketing robocalls from that caller. Separately, existing FCC rules (47 CFR 64.1200(d)(5)) already apply a do-not-call request to the calling entity and to affiliates the consumer would reasonably expect it to cover.

Texting standards

CTIA's Messaging Principles and Best Practices expect business senders to:

• Get consent before texting
• Document each opt-in, including the timestamp and how consent was given
• Use one opt-in per campaign, and never use rented, sold, or shared opt-in lists
• Honor opt-outs such as STOP, end, unsubscribe, cancel, and quit, and send one final opt-out confirmation

Unsolicited texts to Medicare beneficiaries are prohibited under 422.2264 in any case. For wording ideas once you have consent, see our follow-up text templates.

The Medicare phone call, step by step

This sequence is advice built on the rules cited in each step. Follow your carriers' procedures wherever they add steps.

1. Confirm why the contact is allowed (inbound call, returned call, reply card, or documented consent) and note it.
2. Make sure the call is being recorded, and tell the beneficiary.
3. Agree on and record the Scope of Appointment.
4. Read the TPMO disclaimer before you talk about benefits.
5. Run the needs analysis on CMS's required topics.
6. Compare plans against those needs.
7. Confirm eligibility and the enrollment period.
8. Review the PECL, and tell the beneficiary where to find the Summary of Benefits and the Star Ratings Document.
9. Enroll through your carrier's approved telephonic process.
10. Document everything and agree on how you'll follow up.

Scope of Appointment on a phone call

Under 422.2264(c)(3), a personal marketing appointment is one tailored to an individual or small group, such as a married couple, and it isn't defined by location. A phone appointment counts. Before it starts, you must agree on the SOA with the beneficiary and record it. The SOA must be in writing for in-person appointments. For phone appointments, use the recorded or written format your carriers require.

The CY2027 final rule removed the 48-hour waiting period between completing the SOA and the appointment, along with its two exceptions. CMS's new marketing policies apply to all contract year 2027 marketing and communications beginning October 1, 2026. Plans may now schedule the appointment any time after the SOA is completed, so you can take the SOA at the start of the same recorded call. In the proposed rule, CMS clarified that an audio or audio-visual recording or an electronic record would work as the SOA record for an appointment that isn't in person.

Plans must keep a system confirming that agents complete SOA records for every personal marketing appointment, including telephonic ones (422.2274(c)(9)(ii)). Use the format your carriers require. Our Scope of Appointment guide covers the details.

"Before we talk about any plans, I need to confirm what you'd like to cover today. This call is being recorded. Which types of Medicare plans would you like to discuss? [Beneficiary answers.] Thank you. Just so you know, nothing we discuss obligates you to enroll."

The TPMO disclaimer: exact words and timing

Under 42 CFR 422.2267(e)(41), any TPMO selling for more than one MA organization must say the disclaimer on sales calls before discussing any benefits. If you don't sell for every MA organization in the service area, the wording is:

"We do not offer every plan available in your area. Currently we represent [number] organizations which offer [number] products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."

A different version applies to TPMOs that sell for all organizations, so take that text from the regulation if it fits your situation. The CY2027 rule changed the timing from "within the first minute" to "before benefits are discussed" and removed SHIPs as a listed resource. Retire any script that still mentions SHIPs, and fill in the counts from your current contracts.

Needs analysis: the topics CMS requires

Under 422.2274(c)(12), the following must be fully discussed before an enrollment:

• Whether the beneficiary's current primary care providers and specialists are in network
• Whether their current pharmacy is in network
• Prescription drug coverage and costs, including whether their current prescriptions are covered
• Costs of health care services
• Premiums
• Benefits
• Specific health care needs

As advice, get the full medication list, with doses, and the names of every doctor before you look at plans. Then check each name and drug against each plan you present.

Comparing plans

Show the beneficiary how each plan does on each needs topic, using the carrier's own directories and formulary. Keep the call to health coverage. Under 422.2263(b), you may not cross-sell non-health care products during MA sales activity. You also may not offer cash rebates, meals of any value, or gifts unless they are of nominal value, offered to everyone regardless of whether they enroll, and not cash. For pushback during the comparison, see our objection handling scripts.

Confirm eligibility and the enrollment period

Medicare.gov says joining a Medicare Advantage plan requires both Part A and Part B, while a drug plan requires either Part A or Part B. The person must live in the plan's service area and have their Medicare Number and coverage start dates. Medicare.gov lists other eligibility requirements too, so check that page for the full list. Confirm all of these and the election period before you start an application.

Enrolling by phone

On a telephonic enrollment, 422.2267(e)(4) requires you to review the contents of the Pre-Enrollment Checklist (PECL) with the beneficiary before the enrollment is complete. The PECL covers:

• The Evidence of Coverage, the provider and pharmacy directories, and the formulary
• Premiums, copays, and coinsurance
• Emergency and urgent care coverage
• Plan-type rules
• The effect on current coverage

You must also tell the beneficiary out loud where they can find the Summary of Benefits (422.2267(e)(5)(i)(C)) and the Star Ratings Document (422.2267(e)(13)(ii)(C)).

"Before we finish, I'm going to walk through the Pre-Enrollment Checklist with you. [Review each item.] You can find the Summary of Benefits at [location], and the Star Ratings Document at [location]. Do you have any questions before we submit?"

Which Medicare calls must be recorded, and for how long?

Under current 422.2274(g)(2)(ii), as amended April 6, 2026, all marketing and sales calls must be recorded in their entirety. That includes the audio portion of web-based calls.

CMS's Partner Tip Sheet says plans must now keep these recordings for 6 years, down from 10. Pages still telling you 10 years are out of date. Ask each carrier whether it records calls on its own lines or expects you to provide yours, and how it wants them delivered.

Before you record, check your state's call recording consent law with your compliance team and carrier. As a habit, tell every caller up front that the call is recorded.

When can you market and enroll 2027 plans?

During the MA Open Enrollment Period, which also covers a person's first 3 months of Medicare, coverage starts the first of the month after the plan gets the request. For Special Enrollment Periods, see our Medicare enrollment periods cheat sheet.

Can you call clients after they enroll?

Under 422.2264(a)(3), what matters is consent or who started the contact. As advice, ask on the recorded call whether the client wants you to check in later and how they'd like to be reached, then note the date and their answer. Returning a client's call is never unsolicited. Calls to former enrollees who have disenrolled or are disenrolling are prohibited, except for disenrollment surveys.

When a client asks you to stop calling or texting, honor it promptly, and no later than ten business days after you receive it, as the FCC's revocation rule requires, and block texts as soon as they reply STOP. For year-round service ideas, see our Medicare marketing guidelines guide.

What to document on every Medicare phone sale

Use this checklist (advice) for each beneficiary:

• Basis for contact: inbound call, returned call, reply card, or consent, with the date and how it was given
• TCPA written consent for any autodialed or prerecorded calls, and text opt-ins with timestamp and medium
• SOA record: a recording or electronic record for phone appointments, written for in-person ones
• The full call recording: audio for years 1 to 3, audio or transcript for years 4 to 6
• Notes showing each needs topic was discussed
• PECL review, plus where you said the Summary of Benefits and Star Ratings Document can be found
• Opt-outs and revocations, with the date received and the date honored
• Your current license, appointments, and annual training results

Ask your carriers and compliance team how long to keep consent and opt-out records.

Common mistakes on Medicare phone sales

1. Calling a referral or seminar attendee who never gave permission.
2. Treating a Do Not Call scrub as consent.
3. Leaving voicemails or texts for prospects who didn't ask for contact.
4. Giving the TPMO disclaimer after benefits come up, or using the old version that names SHIPs.
5. Skipping needs topics because the caller already asked for a specific plan.
6. Marketing a non-health product (cross-selling) during MA sales activity, or providing a meal to a potential enrollee.
7. Following retention guidance based on the old 10-year rule.

Where LeadGPT fits in a phone sales workflow

Calls you make or answer in LeadGPT are recorded, and each gets a transcript and an AI summary in the Call Log, where you can play or download it. Confirm with your carriers how they want recordings kept and delivered for the 6-year retention period. When you miss an inbound call, the AI Receptionist takes a message (who needs coverage, their ZIP code, and the best time to reach them) so you can return the call yourself. When a lead texts STOP, LeadGPT blocks every text to that number and sets the lead to Dead. Recording is always on with no announcement, so give any notice your state requires and confirm your process with your compliance team. See the features overview or the interactive demo.

What to do next

1. Update your call script so the SOA comes before the disclaimer and the disclaimer comes before any benefits discussion.
2. Audit every lead source for documented consent and a named-recipient disclosure.
3. Confirm recording, SOA, and enrollment procedures with each carrier.
4. Build the documentation checklist into your client records before AEP volume peaks.

This guide is general information, not legal or compliance advice. Confirm each rule with CMS, your carriers or upline, and your compliance team. You'll find more guides in our sales techniques category, and our editorial policy explains how we research them.