During Medicare Open Enrollment (Oct. 15-Dec. 7), ads for Medicare Advantage plans 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 private insurance carriers are and aren’t allowed to do. That way, you’ll be prepared if someone tries to enroll you in a Medicare plan that isn’t right for you.
NCOA partners only with licensed brokers who meet our Standards of Excellence. That means you can be sure you’re receiving practical, unbiased advice on choosing a Medicare plan.
During Medicare’s Annual Election Period, commonly known as the Medicare Open Enrollment Period (OEP), which takes place Oct. 15 through Dec. 7 each year, Medicare beneficiaries can choose the Medicare plans that are best for them. Beneficiaries in Original Medicare can compare and change prescription drug plans (Part D) and Medigap plans. They can also decide if, instead of Original Medicare, they would prefer to sign up for a Medicare Advantage (MA) plan (Part C).
During this period, plans are actively marketing their products through television ads, social media ads, radio ads, and mailings. In an attempt to pique your interest, the ads may intentionally or unintentionally mislead you into thinking one plan is better for you than another. Unlike Original Medicare, Part C and Part D plans are administered, marketed, and sold by private insurance companies.
It’s important to understand what brokers and agents from these private insurance companies are and aren’t allowed to do so you’ll be prepared if an insurance agent or representative tries to enroll you in a Medicare plan that isn’t right for you.
When you meet or talk with an agent, they cannot:
- 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.
- 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.
- 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.
Once you have picked the plan that is right for you, be sure you get all the details in writing before signing up. Take your time to read all the information and verify details. For example, before signing up, reach out to your doctors to ensure they are in that plan’s network.
When to report potential Medicare fraud, errors, or abuse
Report potential Medicare marketing violations and/or enrollment concerns if you see these red flags:
- You received an unsolicited phone call from a company you have no prior relationship with.
- 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 initiates a discussion about other insurance products, such as life insurance annuities, during a visit or meeting about a Part C or Part D Medicare product.
- An agent returns uninvited to your residence after missing an appointment with you earlier.
- You signed up for a plan after being told by a company 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 be charged instead.
- You were told you could keep your Medigap (or supplemental) plan when you sign up for a Medicare Advantage plan, when in reality, you cannot have both a Medigap plan and a Medicare Advantage plan.
For more information on potential Medicare marketing violations and enrollment fraud, visit the Fraud Schemes website. To report Medicare fraud, errors, or abuse, visit www.smpresource.org or call 1-877-808-2468.
Who can I trust to help me choose the right Medicare plan?
Comparing plans and knowing what is best for you can be overwhelming. And since Medicare fraud 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 by contacting 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.
Additionally, our free Age Well Planner tool can connect you with a Medicare enrollment specialist. NCOA only partners with licensed insurance brokers who have been trained and certified in our Medicare Standards of Excellence. These standards hold our partners to the highest expectations in providing consumer advice. These brokers will:
- Explain all your Medicare coverage options without bias—including products not represented by their agency.
- Provide detailed, up-to-date information on Medicare and its various coverages, program requirements, and enrollment dates.
- Recommend plans and products based on your unique health care needs, lifestyle, and budget.
- Explain information in a clear, straightforward manner so that you fully understand the options available to you.
Medicare enrollment guidance through Age Well Planner is 100% free and confidential. This service is available in multiple languages and for people who are hearing impaired.
Ready to get started? Visit Age Well Planner now.