During Medicare’s Annual Election Period, commonly known as the Medicare Open Enrollment Period (OEP) (Oct. 15 through Dec. 7),you can make changes to you Medicare coverage. If you have original Medicare, you can compare and change prescription drug plans (Part D) and Medigap plans.
You can also decide if, instead of original Medicare, you want to sign up for a Medicare Advantage (MA) plan (Part C).
Unlike original Medicare, Medicare Advantage and Part D plans are administered, marketed, and sold by private insurance companies. During OEP, these companies are actively promoting their plans through television ads, social media ads, radio ads, text messages, phone calls, and mailings. In an attempt to get your interest, the ads may intentionally or unintentionally mislead you into thinking one plan is better for you than another.
It’s important to understand what brokers and agents from these private insurance companies are and aren’t allowed to do so you aren’t misled, and you’ll be prepared if an insurance agent or broker tries to enroll you in a Medicare plan that isn’t right for you.
Nicole Liebau, SMP Resource Center Strategic Partnership and Engagement Director
Older adults (and caregivers) watch out for agents who:
- Start a discussion about other insurance products, like life insurance annuities, if your meeting was scheduled to discuss Medicare Part C or Part D.
- Set their own time limits for you to sign up for a plan. You have until Dec. 7 to enroll, and there are no extra benefits for signing up early.
- Pressure you or even threaten to take away your benefits if you do not sign up for their plan.
- Offer you gifts if you do agree to sign up for their plan.
- Approach you in public and try to sell you a plan.
- Suggest that Medicare endorses or prefers their plan.
- Discuss Medicare products you did not ask to talk about when you filled out a scope of appointment form.
- Ask for your personal information or try to sell you a plan at an educational exhibit.
How to avoid unwanted enrollment in a Medicare plan
According to the Senior Medicare Patrol Center (SMP), you can protect yourself by:
- Keeping your Medicare information private. Only share it with your trusted doctors or other health care providers.
- Double-checking what you're told. Before signing up for a Medicare plan, confirm all details an insurance agent shares with you.
- Getting it in writing. Always ask for written information so you have proof and can review it carefully.
- Checking with your doctors. Call your preferred providers to be sure they're part of a plan's network before you enroll.1
Should I report Medicare fraud?
Yes—you should report potential Medicare marketing violations and/or misleading marketing concerns if you see these red flags:
- You received unsolicited phone calls or text messages. Plans must provide you with the option to opt out of communications. It must be done annually and in writing.
- A company represents itself as coming from or sent by Medicare, Social Security, or Medicaid.
- You received information such as leaflets, flyers, door hangers, etc., on your car or at your residence from a company you did not have an appointment with.
- An agent returns uninvited to your residence after missing an appointment with you earlier.
- You signed up for a plan after being told that certain prescriptions or services were covered. But after reviewing your Explanation of Benefits (EOB), you found they were not covered by the plan and you will have to pay out of pocket.
- You were told you could keep your Medigap (or supplemental) plan when you signed up for a Medicare Advantage plan. In reality, you cannot have both a Medigap plan and a Medicare Advantage plan.
For more information on potential Medicare marketing violations and misleading marketing, visit the Senior Medicare Patrol website. If you suspect Medicare fraud, errors, or abuse, follow these steps outlined by SMP.
"Medicare Open Enrollment brings a surge of aggressive marketing, and some of it crosses the line into misleading or fraudulent tactics," explains Ryan Ramsey, NCOA Associate Director of Health Coverage and Benefits. “Be cautious of anyone who pressures you for immediate decisions, asks for your personal information unsolicited, or makes promises about benefits that seem too good to be true."
Who can help me choose the right Medicare plan?
Comparing plans and knowing what is best for you can be overwhelming. And since Medicare fraud and abuse is a reality, it can be hard to know who really has your best interests in mind. That’s why NCOA is here to point you in the right direction with resources for free, unbiased Medicare advice.
One way to get reliable help comparing Medicare plans is to call Medicare directly at 1-800-MEDICARE (1-800-633-4227) or start a live chat with a Medicare representative.
You can also contact your State Health Insurance Assistance Program (SHIP). These programs are located in all U.S. states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. Find your local SHIP here.
Sources
1. Senior Medicare Patrol Center. Misleading Marketing & Marketing Violations Tip Sheet.
