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MSBC Media PlayerMedia Center
MSBCOC | Christian Seniors
Senior Citizens May Avoid Medicare Marketing Fraud by Knowing the Rules
Medicare Rights Center
Medicare private plans must follow certain rules and
you should know what is allowed.
With a huge market to exploit - about 36 million senior citizens on Medicare - the hucksters stay busy, according to congressional reports. The Medicare Rights Center has produced some tips for older Americans on the rules that must be followed to market these plans. Sales people who violate these rules should be suspect.
People with Medicare can receive their health care benefits in one of three ways:
- Original Medicare (the traditional fee-for-service coverage from the federal government);
- Original Medicare with supplemental insurance (such as a Medigap or retiree plan); or
- a Medicare private health plan, also known as a "Medicare Advantage" plan.
Prescription drug coverage (Part D) is available either through stand-alone drug plans (PDPs) that work with Original Medicare (and a few private health plans), or as part of Medicare private health plan benefits packages.
The companies that sell Medicare private health and drug plans must follow certain rules when promoting their products. The guidelines are meant to prevent plans from deceiving you through marketing materials or through someone representing the plan - about what the plan offers and how much it costs. That is called marketing fraud.
Plans can market their plan through direct mail and radio, television and print advertisements. Agents can even visit your home, but only if you have invited them.
Medicare private plans, however, must follow certain rules. By knowing what is and is not allowed, you can protect yourself from falling victim to marketing fraud.
Remember these tips on what plans cannot do:
- enroll you over the telephone if they called you. If you would like to enroll, you should call the plan back yourself;
- ask for your financial or personal information if they call you. Beware if you are asked for your Social Security or Medicare number or your bank information;
- request payment over the telephone;
- visit you in your home or nursing home room without an invitation. You can ask the plan to send someone to your house, but they cannot just knock on your door uninvited;
- provide gifts or prizes worth more than $15 to encourage you to enroll. Gifts or prizes that are worth more than $15 must be made available to the general public, not just to people with Medicare);
- disregard the National Do-Not-Call Registry and "do not call again" requests. Plans must comply with federal and state consumer protection laws for telemarketing. You can register online for the National Do-Not-Call Registry or by calling from the number you wish to register.
- send you unsolicited e-mails. You must have specifically requested information in order for a plan to e-mail you;
- compare their plan to another plan by name in advertising materials;
- include the term "Medicare Endorsed" or suggest that it is a preferred Medicare drug plan. Plans can use "Medicare" in their names as long as it follows the plan name (for example, the Acme Medicare Plan) and the usage does not suggest Medicare endorses that particular plan above any other Medicare plan;
- use information that they have obtained from you to market non-health-related products and services without your written consent. Plans cannot use information about you (such as your name and address) that they got by providing you Medicare services to try to sell you other products, like auto insurance.
To learn more about Medicare private health and drug plans, and how you can protect yourself from marketing fraud, log on to Medicare Interactive Counselor at www.medicareinteractive.org.
Medicare Interactive Counselor is a resource provided by the Medicare Rights Center, which claims to be the largest independent source of health care information and assistance in the United States for people with Medicare.
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