Avoid Medicare marketing scams during Medicare's open enrollment

Tuesday, September 20, 2016

Anne Fredrickson
Anne Fredrickson, MHA, MGS, is the project manager for the Ohio Senior Medicare Patrol Project at Pro Seniors

By Anne C. Fredrickson, MHA, MGS, Project Manager, Ohio SMP at Pro Seniors

Medicare open enrollment is October 15 through December 7, annually. During this time, beneficiaries choose their Medicare coverage for the next year.

It’s also a time when Medicare marketing scams occur! In order to know if you’ve been scammed or have encountered predatory sales practices, here is some helpful information about what insurance agents selling Medicare products can and cannot do.

When marketing Medicare products agents can:

  • Distribute information and forms in a retail setting or while participating at a health fair or promotional event.
  • Travel to meet Medicare beneficiaries in their home, provided they have been invited.
  • Provide consumers information about public assistance programs and help individuals apply for government subsidies.

When marketing Medicare products agents cannot:

  • Engage in high-pressure sales tactics.
  • Send unsolicited e-mails.
  • Solicit door-to-door.
  • Use fraudulent or dishonest practices.
  • Collect names, addresses and enrollment applications or conduct sales presentations at health fairs, educational or promotional events.
  • Sell products which are not health-related during a Medicare Advantage or prescription drug plan sales or marketing presentation.
  • Provide meals at promotional and sales events.
  • Sell products in health care settings (doctors’ offices, pharmacies etc.).
  • Make misrepresentations or omit information about a comparative Medicare product to induce a person to buy or change their insurance.

So how can you avoid becoming a victim of predatory sales tactics?

  • Be wary of individuals who claim they work for Medicare. Medicare representatives do not make house calls or solicit beneficiaries by telephone. 
  • Be cautious of individuals selling Medicare products door-to-door. If someone comes to your home without a scheduled appointment, do not let the individual in your home or provide him or her with personal information.
  • Be wary of insurance agents who tell you it’s free to enroll in a Medicare program. Premiums are associated with all Medicare products.
  • Be leery of insurance agents who tell you your enrollment in a Medicare Advantage Plan will not affect your Medicare coverage. When you sign up for a Medicare Advantage Plan you will be removed from your traditional Medicare plan and may incur more expenses in terms of deductibles and co-payments.
  • Do NOT be persuaded by an insurance agent who tries to scare you into believing your Medicare rates are going to increase if you do not switch plans immediately. 

In addition, here are some tips to help you remember how to avoid being a a victim of predatory sales practices.

  • PROTECT your Medicare number. Don’t give out your Medicare, Social Security or bank account numbers.
  • CHECK with the Ohio Department of Insurance, www.insurance.ohio.gov, to see if any consumer complaints have been filed against the company or agent 
  • CONSULT a trusted family member or other advisor to confirm the product meets your needs.
  • VERIFY that your healthcare providers participate in the plan or accept the plan you’re considering.

If you think you’ve been a victim of predatory sales or marketing violations, please report it to: Ohio Senior Medicare Patrol (SMP) at 800-488-6070.

About the Ohio Senior Medicare Patrol

Using a team of volunteers, Ohio SMP helps seniors prevent, detect and report health care fraud, errors and abuse. They do this by:

  • Conducting Outreach and Education
  • Hearing Complaints
  • Recruiting, Training, and Engaging Volunteers

Click here to learn more about Ohio SMP.