Dear Marci,
I am interested in learning more about Medicare options this year during Fall Open Enrollment, but I’ve heard enrollment fraud is common. What are ways I can avoid enrollment fraud, and what should I do if I think it’s happening?
-Aldis (San Francisco, CA)

Dear Aldis,
You are right that Fall Open Enrollment, which takes place from October 15 to December 7, 2017, is a great opportunity to evaluate your Medicare options. You will be able to decide whether you want to enroll in Original Medicare or a Medicare Advantage Plan. You can also compare Medicare Advantage Plans and Part D drug plans.
You are also right to be wary of enrollment fraud. If you find yourself in one of the following situations, remember that you have rights as a Medicare beneficiary:

• You are being pressured to join a plan. If you are feeling a lot of pressure to join a plan, remember that you have a right to choose how you receive Medicare coverage. You can choose between a Medicare Advantage Plan and Original Medicare, and you can enroll in any Medicare Advantage Plan or Part D plan that is offered in your area. You have the whole length of Fall Open Enrollment to make choices about your health coverage, and you will not receive extra benefits for enrolling early. If a plan representative is pressuring you, or if you just need more time to review your options, tell them that you will follow up with them later to make a decision. You can receive unbiased counseling about your plan options from your State Health Insurance Assistance Program (SHIP). To find and contact your SHIP, visit www.shiptacenter.org or call 877-839-2675.
• You believe you might be receiving false information. Plans cannot falsely represent themselves to get you to enroll. Before making a final choice about your coverage, confirm all the information a plan has given you. For example, if a plan agent tells you that all of your providers are in-network, check with your providers to see if this is true. Whenever possible, rely on information from government websites (website that end in .gov) and emails, seek unbiased counseling from your SHIP, and get information about the full range of plans available in your area by calling 1-800-MEDICARE. Additionally, remember that a plan cannot claim to be endorsed by Medicare or to represent Medicare, and cannot threaten you with the loss of your Medicare benefits if you do not enroll in their plan.
• Someone is asking you for confidential/personal information. Plans do not need to, and should not ask for your Medicare number, Social Security number, or bank information just to provide you with information. Plans should not call you at home to ask for this information, and should not ask you to give it to them at educational events. With this information, a plan can enroll you without your consent. Plans also cannot call you and ask you for a payment over the phone, but rather they have to send a bill. Additionally, know that there will be new cards issued for Medicare beneficiaries starting in 2018, but you do not need to take action or pay anything to get your new card or retain your Medicare benefits. Be wary of situations where people ask for your Medicare information or some form of payment related to this card.

If you find yourself in one of these situations, protect your Medicare and Social Security information and remember that you have the right to make your own decisions about your Medicare coverage. If you believe a plan representative has violated Medicare’s marketing guidelines, or if you think you were enrolled in a plan without your permission, you can contact your Senior Medicare Patrol (SMP). You can find and contact your SMP by visiting www.smpresource.org or calling 877-808-2468.

-Marci

Dear Marci,
I’ve heard that I can make changes to my Medicare coverage during Fall Open Enrollment. Should I look for a new plan? How can I enroll in one if I find one I like?
-Jing (Burlington, VT)

Dear Jing,
If you are considering changing your Medicare coverage, Fall Open Enrollment is the time to do it. Fall Open Enrollment is the period between October 15 and December 7 each year when people can make changes to their Medicare coverage. You can change your Medicare Advantage Plan, change your standalone Part D prescription drug plan, or switch between Medicare Advantage and Original Medicare. Whether or not you are satisfied with your current coverage, you should review your current costs and benefits. Fall Open Enrollment is also a good time to compare your coverage to other available options. Research shows that people can save money by shopping for new plans each year.
If you are thinking of enrolling in a new Medicare Advantage Plan or stand-alone Part D drug plan, you should take the following steps:

1. If you are looking for a new Part D plan, you can use the Plan Finder tool from www.Medicare.gov to compare options in your area. Before you use Plan Finder, make a list of the medications you take, the amount that you currently pay for them, and which pharmacies you like to visit. You will be able to get a sense of which plans cover the medications you need with the lowest costs and fewest coverage restrictions.
2. If you are shopping for a new Medicare Advantage Plan, you can use the Plan Finder tool to compare options in your area. You can also call 1-800-MEDICARE and ask about plans in your area. Once you have a list of your available options, you can visit their websites to learn more.
3. After you have researched plans and found one that you are interested in, call that plan directly to confirm what you learned online. Ask about your doctors and hospitals to check that they are included in your plan’s network. Check also that the plan includes all the drugs you need on its formulary, and that your pharmacies are in the plan’s network. Write down everything about this conversation, including the date of the conversation, who you speak to, and the outcome of the call.
4. Call 1-800-MEDICARE if you decide to enroll in a new plan. This is the best way to protect yourself if there are any problems with enrollment. Write down everything about your call, including the date of the conversation, who you speak to, and any information the Medicare representative gives you during the call. Remember to confirm all the details about your new plan with the plan itself before calling Medicare.

If you need additional help, you can call or visit the website of your State Health Insurance Assistance Program (SHIP). SHIP counselors can help you understand your Medicare coverage options.

-Marci