Dear Marci,

I’ve been receiving a lot of mail lately from Medicare Advantage plans, with information about joining their plan. I’m not sure that I want to switch my coverage, and I would rather that these plans do not contact me. Are there any rules that Medicare Advantage plans have to follow when marketing their plans?

– Joel (Chicago, IL)

Yes, there are guidelines that insurance companies have to follow when marketing their Medicare Advantage orPart D plans to you. These guidelines are meant to prevent plans from misleading you about how much a plan costs or what it covers. Understanding the ways that insurance companies are allowed to contact you will help you to spot Medicare marketing fraud.

Remember, both Medicare Advantage plans are stand-alone Part D plans are always run by private insurance companies. Insurance companies are allowed to mail you marketing materials without your permission. They also can place advertisements on the radio, in the newspaper, and on television. However, insurance companies and brokers must get your permission before directly calling, emailing or visiting for an appointment. Cold calls are not allowed. A broker cannot visit you in your home or nursing home unless you request that they do so. You can schedule an appointment to meet with a plan representative, and meet them in either your home or a public place such as a library or coffee shop.

In health care settings, plan representatives can provide sales information in common areas like conference rooms, cafeterias, or community rooms; they cannot provide plan information in hospital or doctor’s waiting rooms. Representatives also cannot approach you in public areas such as parking lots or malls.

If you put your name and contact information on a list at a promotional or marketing event, this may give the plan permission to contact you. Be wary of providing contact information if you are not interested in follow-up contact from the plan. A plan cannot insist that you provide any information if you are attending a promotional or marketing event.

In addition, plans cannot call you and imply that they are calling on behalf of Medicare; Medicare will never ask these insurance companies to contact you. No one from Medicare or a private plan should call you asking for private information, such as your Social Security number, Medicare number, or a bank account number. If someone does call asking for your personal information, it is fraud. Do not share this information with people besides your doctors and health care providers.

Finally, insurance companies and brokers cannot offer gifts for signing up for a plan. They can give small gifts worth $15 or less only if they are made available to everyone, not just people with Medicare. These gifts cannot be given as a reward for signing up for a plan. Gifts cannot be benefits, such as a free checkup or health care procedure. At promotional or marketing events, the insurance company can offer light snacks or refreshments. They cannot provide a full meal, or market their plans in places where free meals are served, such as senior centers.

If you suspect that an insurance company has broken any of these rules, you can contact 800-Medicare toreport the issue. You also can call the Office of the Inspector General at 800-447-8477 to report fraud. It is helpful to write down as many details as possible, such as names, dates, and locations. Medicare will not use your name without your permission when investigating fraud. Remember, in many cases, Medicare will be unable to investigate fraud without your help so always report suspected fraud.

-Marci