Dear Marci,
Last year around this time I started receiving a lot of notices in the mail advertising different health insurance plans for my Medicare coverage. I was overwhelmed by the amount of information I received, and I don’t want to experience that again. How can I sort through these notices and make sure that I am not being taken advantage of? How are insurance companies allowed to market their plans?
– Naomi (Pittsfield, MA)
Dear Naomi,
You are not alone—this is a common concern among beneficiaries. October 15 marks the beginning of Fall Open Enrollment, which is the time during the year when Medicare beneficiaries can make changes to their health care coverage. Starting October 1, Medicare Advantage Plans will start advertising their offerings for next year. While most plans abide by the marketing rules set forth by Medicare, not all plans do. It is important to be aware of these rules and to be on the lookout for other potential red flags so that you can make informed decisions about your Medicare options. Some of Medicare’s marketing rules for plans are:
- Unless you are already a member of a plan or have given permission, plans are not allowed to contact you in any way other than through the mail.
- Plan names cannot suggest that the plan is preferred or endorsed by Medicare.
- Plan representatives cannot approach you in public places, such as parking lots of malls. In health care settings, plans can only advertise in common areas such as cafeterias. They may not advertise in waiting rooms.
- If you schedule a time to speak with an insurance broker about Medicare Advantage options, they cannot try to sell you products other than a Medicare Advantage Plan, such as a life insurance policy.
- Plans cannot offer gifts worth more than $15. Further, they must provide the gift even if you do not sign up for the plan.
In addition to being aware of these rules, you should consider these tips to help avoid becoming the victim of marketing fraud:
- Always verify all information you receive from an insurance plan representative. If a representative says that a particular doctor is in network, you should call the practice to confirm with the doctor.
- Be aware of your right to choose how you receive Medicare coverage. Medicare Advantage Plan representatives should not tell you that Medicare Advantage is your only option.
- If you are feeling pressured, you can tell the plan representative that you will follow up at a later date. This will give you time to make your decisions.
- Use government websites and official sources of information.
- Request translation services when necessary.
The important thing to remember around this time of the year is that it is your right to decide how you would like to receive your benefits. There are many options, and it is important to consider your health care needs in the coming year when making decisions. For more guidance in navigating Fall Open Enrollment, take a look at thesesix tips.
Finally, to report Medicare fraud and abuse, you can contact 800-Medicare or the Office of the Inspector General (OIG) at 800-447-8477. Before calling the OIG, write down as many details as possible, including names, dates, locations, and the care or services received. You can also contact your local Senior Medicare Patrol (SMP) program. To locate your SMP, call 877-898-2468 or visit www.smpresource.org.
– Marci