Healthcare Lead Routing and Distribution

A healthcare lead is not a generic form submit. It carries sensitive health information, it sits under federal and state health-data privacy rules, and it is almost always being sold into an outreach workflow that triggers TCPA. The moment the lead references Medicare Advantage, the Centers for Medicare and Medicaid Services Marketing Guidelines (MARx) apply on top, with extra rules for lead vendors, scope-of-appointment forms, and prohibited outreach patterns. Get any layer wrong and the exposure is regulatory, not just commercial.

The concrete operator problems look like this. Sensitive health information must be encrypted at rest and in transit, and every access to it must be logged. TCPA one-to-one consent under FCC 23-107 means the consumer has to name the specific buyer at opt-in, so a generic partner page that sells to fifteen carriers without naming them is no longer compliant. Medicare Advantage adds MARx restrictions on how lead vendors generate and distribute traffic, plus scope-of-appointment requirements before an agent can discuss plan options. ACA, dental, and Medicare Supplement all require state-specific agent licensure. Calling-hour rules follow the prospect zip, not the buyer zip. A router that does not reason about any of this hands the operator a liability in the shape of a CRM.

Lead Router was built for operators who sell into this environment. The same routing engine that handles auto, solar, and home services is pre-wired with the compliance controls healthcare demands, and the control surface is designed so the compliance team and the revenue team are looking at the same record.

• Medicare Advantage (MA). Plan year, state, zip, Part A and Part B effective date, scope-of-appointment confirmation, MARx-aware contract rules, carrier licensure by state.
• Medicare Supplement (Medigap). Plan letter interest, tobacco status, current plan, underwriting window, state-based pricing rules, agent appointment filters per carrier.
• Medicare Part D. Prescription intent, current drug list, formulary preference, standalone versus MA-PD, plan year, AEP and SEP timing rules.
• ACA on-marketplace. Household income, household size, subsidy eligibility, state exchange versus HealthCare.gov, agent NPN, special enrollment qualifying event.
• ACA off-marketplace and short-term medical. Non-subsidy plan interest, STM duration rules by state, association health plan eligibility, underwriting questions.
• Dental, vision, and supplemental. Standalone dental and vision, accident, cancer, hospital indemnity, critical illness. Often cross-sold with MA and ACA, routed on separate contracts to prevent cap contamination.
• Senior final expense. Health-adjacent. Age band, tobacco status, coverage amount, state appointment rules. Routed alongside Medicare on the same engine so the same consumer can feed two product waterfalls with one intake.

Lead Router is built security-first. Data at rest uses AES-256-GCM, data in transit uses TLS 1.2 or higher, tenant data is isolated at the query layer, role-based access controls scope who can see sensitive health-related lead data, and every read, write, and export is audit logged.

TCPA one-to-one consent under FCC 23-107 is enforced at the contract level. A buyer that was not explicitly disclosed on the consent string at opt-in cannot win the lead, regardless of price or priority. Full policy detail lives on the TCPA compliance page.