Dear Marci,
I am feeling overwhelmed by Medicare plans trying to get me to enroll. Are there rules about how plans are allowed to market to me? What should I do if I think they’re breaking the rules?
-Beatrice (Savannah, GA)
Dear Beatrice,
During Fall Open Enrollment, which runs from October 15 to December 7 each year, Medicare Advantage Plans and Part D prescription drug plans will be marketing to people with Medicare. If you are considering changing your Medicare coverage during Fall Open Enrollment, it is important to verify all marketing information you see through credible sources, like 1-800-MEDICARE, your local State Health Insurance Assistance Program (SHIP), and websites that end in .gov. It is also important to remember the rules that are in place to stop plans from inappropriate marketing, and to know what to do if you think plans are breaking these rules.
Medicare has rules for how plans can contact you in different situations:
- By direct mail, radio, and print advertisements: Plans are allowed to market themselves by any of these means. They cannot, in these advertisements or in any other marketing situation, suggest that they are endorsed or preferred by Medicare. Plan names can include the word Medicare as long as it follows the name of the insurance company (for example, Acme Medicare Plan), and the usage does not suggest that Medicare endorses that particular plan more than any other plan.
- By phone or e-mail: A plan may not call or email you without your permission. They may only give you their contact information if you request it, and if this is the case, you must be the one to call them. If you give your contact information to a plan (like by putting it on a list at an event a plan is hosting), you may be giving them permission to contact you. If you do not wish to receive information about a plan in this way, do not give them your information. Plans must also follow federal and state regulations related to marketing over the phone – they cannot ignore the Do Not Call Registry and do not call again requests, and they cannot call late at night or early in the morning.
- In person: Plan representatives cannot approach you in public places or come to your home or nursing home uninvited. If you go to a plan’s educational or marketing event, or you agree to meet one-on-one with a representative, there are rules they must follow.
- At plan events: Plans can hold educational or marketing events. At educational events, insurance companies cannot hand out marketing materials, plan-specific cost information, or a plan representative’s contact information. At a marketing event, an insurance company can provide information about a specific plan, but they cannot require you to provide contact information, give you a health screening, or create a situation that suggests they only want to enroll healthy people. Plans cannot offer gifts worth more than $15 at either kind of event, and they can only serve meals at educational events, not at marketing events. Additionally, any gifts that plans offer must be available to all attendees, not just those who enroll. Plans cannot offer benefits (such as a free checkup) as gifts.
- At a one-on-one meeting:A plan representative can only schedule a meeting (at your home or in a public place) with your permission. At this meeting, the plan agent or broker is only allowed to talk to the person who has the appointment. Before the meeting, you must formally indicate the topics you would like to discuss, and the plan representative or broker cannot tell you about products or plans that fall outside of that scope, unless you give them further formal permission.
If you think a plan is engaging in a marketing violation, you should save any proof that you have. You can report violations to Medicare by calling 1-800-MEDICARE, or to your Senior Medicare Patrol (SMP) by visiting www.smpresource.org or calling 877-808-2468.
-Marci