October 11, 2026. Medicare's Annual Enrollment Period opens on October 15 and runs to December 7, and every agency selling Medicare Advantage or Part D plans is about to get more inbound calls, web leads and callback requests than its licensed agents can answer. An AI voice agent can take a large share of that load, but the CMS marketing rules draw hard lines around it. It can answer inbound calls, return calls a beneficiary asked for, qualify the caller and book a licensed agent. It cannot cold call, it must deliver the third-party marketing disclaimer before any benefit is discussed, every marketing and sales call must be recorded and kept for six years, and the TCPA's consent rules apply on top because an AI-generated voice is an artificial voice. This guide lays out the rules as they stand for the 2026 AEP, including what the Contract Year 2027 rule changed, and how we build compliant AI calling for insurance agencies.
The rule text below is the current eCFR version of 42 CFR Part 422, Subpart V, which governs Medicare Advantage marketing (Part D has parallel rules in Part 423), read 11 October 2026. Medicare Supplement plans are regulated by the states and are not covered here. This is a map of the rules, not legal or compliance advice, and the carriers you contract with may impose stricter requirements.
Key numbers
| Item | Number |
|---|---|
| 2026 Annual Enrollment Period (42 CFR 422.62(a)(2)) | October 15 to December 7 |
| Marketing of next year's plans may begin (42 CFR 422.2263(a)) | October 1 |
| Unsolicited calls, robocalls, texts and voicemails (42 CFR 422.2264(a)(2)(iv)) | Prohibited |
| Retention of marketing and sales call recordings (audio for the first 3 years) | 6 years |
| TPMO disclaimer timing on sales calls (42 CFR 422.2267(e)(41)(ii)) | Before any benefits are discussed |
| Scope of Appointment validity (42 CFR 422.2264(c)(3)) | 12 months |
| 48-hour Scope of Appointment wait (CY2027 final rule, effective June 1, 2026) | Removed |
| Sharing beneficiary data with another TPMO (per entity, since October 1, 2024) | Prior express written consent |
42 CFR 422.62, 422.2263, 422.2264, 422.2267 and 422.2274 (eCFR current text), Federal Register 2026-06600 (April 6, 2026), FCC-24-17 and 47 CFR 64.1200, all read 11 October 2026.
The AEP calendar
- October 1: plans and their agents may begin marketing the following year's plans (42 CFR 422.2263(a)).
- October 15 to December 7: the annual coordinated election period, when beneficiaries can switch between Original Medicare and Medicare Advantage plans or between plans, for coverage starting January 1 (42 CFR 422.62(a)(2)).
Cold calling is out, whatever the list looks like
The beneficiary contact rules apply to plans and to the agents and brokers working for them. If the contact is unsolicited, they may not "Use telephone solicitation (that is, cold calling), robocalls, text messages, or voicemail messages", and the regulation names the usual workarounds as included: calls based on referrals, calls to former members, calls to people who attended a sales event without giving express permission to be contacted, and calls to confirm that mailed information arrived (42 CFR 422.2264(a)(2)(iv)). An AI agent dialing a purchased list of turning-65 prospects is a robocall and a cold call at the same time.
Plans may also not make unsolicited calls about other lines of business as a way to generate Medicare leads (422.2264(b)(1)(v)), which closes the "we were just calling about your auto policy" route.
When a call is not unsolicited
The same section says calls are not unsolicited "if the beneficiary provides consent or initiates contact with the plan", and gives returning a phone call or calling someone who completed a business reply card requesting contact as examples (422.2264(a)(3)). That is the AI agent's lane: inbound calls, callbacks to people who asked, and follow-ups to web forms and reply cards that request contact. Plans may also call their own current members about plan business, provided members are told at least once a year, in writing, that they can opt out of those calls (422.2264(b)).
The TCPA sits on top. The FCC confirmed in February 2024 that AI-generated voices are artificial voices (FCC-24-17), so calls to cell phones need prior express consent and calls that market need prior express written consent (47 CFR 64.1200). A web form that captures a Medicare inquiry should therefore carry TCPA consent language that covers AI voice calls, in addition to the request for contact that CMS cares about.
What the agent must say and record
Three requirements shape the script and the infrastructure:
- The TPMO disclaimer, before benefits. A third-party marketing organization that sells for more than one Medicare Advantage organization must convey the standardized disclaimer verbally "during sales calls prior to the discussion of any benefits". If you do not sell every plan in the area, the current text reads: "We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options." (42 CFR 422.2267(e)(41)). Agencies that sell every plan in the area use a shorter version set out in the same paragraph.
- Lead-generation disclosures. When a TPMO generates leads, it must tell the beneficiary on the phone that their information will be provided to a licensed agent for future contact, and must disclose when it is transferring them to a licensed agent who can enroll them (42 CFR 422.2274(g)(3)). An AI qualifier that warm-transfers to an agent needs both lines in its script.
- Full recordings, kept six years. All marketing and sales calls, including the audio of web-based calls, must be recorded and retained in their entirety for at least six years: audio for the first three years, then audio or complete and accurate transcripts for years four to six (422.2274(g)(2)(ii)). Check that your voice platform's recording retention, and your storage costs, can meet that.
Since October 1, 2024, a TPMO may also share a beneficiary's data with another TPMO only with prior express written consent obtained through a clear disclosure that lists each receiving entity and lets the beneficiary accept or reject each one (422.2274(g)(4)). If your AI agent hands leads to partner agencies, that consent has to exist before the handoff.
Scope of Appointment after the Contract Year 2027 rule
Before a personal marketing appointment, the plan or agent must agree upon and record the Scope of Appointment with the beneficiary, in writing if the appointment is in person; the scope, a business reply card or a request for information is valid for 12 months (422.2264(c)(3)). What changed this year is the waiting period. CMS's Contract Year 2027 final rule, published April 6, 2026 and effective June 1, removed the requirement that 48 hours pass between completing the Scope of Appointment and the appointment itself, while keeping the advance agreement (Federal Register 2026-06600). For an AI-assisted flow, that means the agent can capture and record the scope on the same call and hand off to a licensed agent who can proceed, provided the scope is documented first.
Where AI fits, and where a licensed agent must take over
The AI agent's job is front-of-house: answering, returning requested calls, confirming the caller's details and interests, delivering the required disclosures, recording the scope, and booking or transferring to a licensed agent. Discussing specific plan benefits in a sales context, recommending plans and enrolling are generally licensed activities under state insurance law. Keep the agent out of them, the same way we keep lending agents out of quoting in your AI agent can call your mortgage leads but cannot quote them.
A compliant AEP call flow
- Inbound call, or a callback to a request with documented consent and the TCPA language that covers AI voice.
- Recording starts with the call and is stored for six years.
- The agent identifies the business and, if it is an AI, says so where state law requires it.
- The TPMO disclaimer is read before any plan or benefit is mentioned.
- Qualification questions, then the Scope of Appointment, recorded.
- Disclosure that the caller is being transferred to a licensed agent who can enroll them, then a warm transfer or a booked appointment.
- Opt-out requests logged and honored, for both the TCPA and the plan's own calling lists.
The bottom line
AEP is the season when an AI agent pays for itself, because inbound volume and callback requests spike while licensed capacity does not. The rules let it work every call a beneficiary started or asked for, and none that they did not. Build the disclaimer, the disclosures and six-year recording into the platform before October 15, not after the first complaint. Our insurance AI calling setup and TCPA-compliant calling stack are designed around these requirements, and our comparison of what AI calling platforms enforce covers the dialer side.
Frequently Asked Questions
No. CMS rules for Medicare Advantage and Part D prohibit unsolicited telephone solicitation, robocalls, text messages and voicemail messages, including calls based on referrals and calls to former members. Calls are allowed when the beneficiary initiated contact or gave consent, such as returning their call or following up a business reply card that requested contact.
October 15 to December 7, 2026, for coverage starting January 1, 2027. Plans and their agents may begin marketing the 2027 plans on October 1.
It is standardized text required by 42 CFR 422.2267(e)(41) for third-party marketing organizations selling for more than one Medicare Advantage organization. On sales calls it must be conveyed verbally before any benefits are discussed. The version for agencies that do not sell every plan in the area says they do not offer every plan available, how many organizations and plans they represent, and to contact Medicare.gov or 1-800-MEDICARE for all options.
Yes. All marketing and sales calls must be recorded and retained in their entirety for at least six years, in audio for the first three years and in audio or complete and accurate transcripts for years four to six, under 42 CFR 422.2274(g)(2)(ii).
No. The Contract Year 2027 final rule, published April 6, 2026 and effective June 1, 2026, removed the 48-hour waiting period between completing the Scope of Appointment and the personal marketing appointment. The scope must still be agreed upon and recorded before the appointment, in writing for in-person meetings.
Yes. The FCC confirmed in February 2024 that AI-generated voices are artificial voices, so AI calls to cell phones need prior express consent, and marketing calls need prior express written consent, in addition to the CMS rules.