Most Medicare enrollees have suffered phone calls, commercials, and mailings trying to entice them into switching plans, but how do you know when these offerings are legitimate? If you are feeling pressured into joining a plan, it is important to remember that many insurance agents and brokers may receive a large fee for securing your enrollment. It is important to recognize when a health insurance company or a health insurance advisor may not have your best interests in mind. The widespread privatization of Medicare benefits can lead some seniors, or disabled individuals, to experience Medicare fraud.
Medicare has many regulations about how plans are allowed to market to possible enrollees. You are most likely being misled by an insurance agent if they say you:
· Must sign up for a Medicare Advantage plan to get Medicare drug coverage (do not offer a part D as an alternative)
· Will pay a higher Medicare part B premium unless you sign up for a particular plan
· Must invite a plan representative to your home to get more information or enroll in the plan
· Can switch back to Original Medicare at any time if you are dissatisfied, without providing information about enrollment period restrictions
· Will receive additional benefits that are actually Medicare-covered services
· Will receive additional benefits, such as dental or vision, that is actually covered by other insurance you already have or are already eligible for (such as Medicaid)
· Will lose your Medicaid benefits unless you sign up for a certain plan
You should never feel pressured to join any plan. If you are uncertain as to whether you are receiving accurate information from a health insurance agent, verify any marketing information by calling the plan directly. Be certain to confirm whether the plan will provide drug coverage, have your providers (doctors, hospitals, and pharmacies) in their network, and does, in fact, offer additional benefits, such as vision or dental. If you feel that you have experienced marketing violations, be sure to save all documented proof, such as marketing materials, business cards, and voicemails.
When making health insurance decisions, it is important to consult with an expert that you trust, whether that is your elder law attorney’s office, health insurance broker, or SHIP counselor. Contact your Senior Medicare Patrol (SMP) if you feel that you may be experiencing Medicare fraud by clicking here or calling 877-808-2468.
