During Medicare’s Annual Election Period, commonly known as the Medicare Open Enrollment Period (OEP), which takes place Oct. 15 through Dec. 7 each year, Medicare beneficiaries can choose the plans that are best for them. Beneficiaries in Original Medicare can compare and change prescription drug plans (Part D) and Medigap plans. They can also decide if, instead of Original Medicare, they would prefer to sign up for a Medicare Advantage (MA) plan (Part C).
During OEP, plans are actively marketing their products through television ads, social media ads, radio ads, text messages, phone calls, and mailings. In an attempt to get your interest, the ads may intentionally or unintentionally mislead you into thinking one plan is better for you than another. Unlike Original Medicare, Part C and Part D plans are administered, marketed, and sold by private insurance companies.
It’s important to understand what brokers and agents from these private insurance companies are and aren’t allowed to do so you aren’t misled, and you’ll be prepared if an insurance agent or broker tries to enroll you in a Medicare plan that isn’t right for you.
Nicole Liebau, SMP Center Director Advisor
Watch out for agents who:
- Start a discussion about other insurance products, like life insurance annuities, if your meeting was scheduled to discuss Medicare Part C or Part D.
- Set their own time limits for you to sign up for a plan. You have until Dec. 7 to enroll, and there are no extra benefits for signing up early.
- Threaten to take away your benefits if you do not sign up for their plan.
- Offer you gifts if you do agree to sign up for their plan.
- Suggest that Medicare endorses or prefers their plan.
- Discuss Medicare products you did not ask to talk about when you filled out a scope of appointment form.
- Ask for your personal information or try to sell you a plan at an educational exhibit.
When to report potential Medicare fraud, errors, or abuse
Report potential Medicare marketing violations and/or misleading marketing concerns if you see these red flags:
- You received unsolicited phone calls or text messages. Plans must provide you with the option to opt out of communications. It must be done annually and in writing.
- A company represents itself as coming from or sent by Medicare, Social Security, or Medicaid.
- You received information such as leaflets, flyers, door hangers, etc., on your car or at your residence from a company you did not have an appointment with.
- An agent returns uninvited to your residence after missing an appointment with you earlier.
- You signed up for a plan after being told that certain prescriptions or services were covered, but after reviewing your Explanation of Benefits (EOB), you found they were not covered by the plan and you will be charged instead.
- You were told you could keep your Medigap (or supplemental) plan when you sign up for a Medicare Advantage plan, when in reality, you cannot have both a Medigap plan and a Medicare Advantage plan.
For more information on potential Medicare marketing violations and misleading marketing, visit the Fraud Schemes website. To report Medicare fraud, errors, or abuse, visit www.smpresource.org or call 1-877-808-2468.
Who can I trust to help me choose the right Medicare plan?
Comparing plans and knowing what is best for you can be overwhelming. And since Medicare fraud and abuse is a reality, it can be hard to know who really has your best interests in mind. That’s why NCOA is here to point you in the right direction with resources for free, unbiased Medicare advice.
One way to get reliable help comparing Medicare plans is by contacting your State Health Insurance Assistance Program (SHIP). These programs are located in all U.S. states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. Find your local SHIP here.
Additionally, NCOA partners with licensed insurance brokers who have been trained and certified in our Medicare Standards of Excellence. These standards hold our partners to the highest expectations in providing consumer advice. These brokers will:
- Explain all your Medicare coverage options without bias—including products not represented by their agency.
- Provide detailed, up-to-date information on Medicare and its various coverages, program requirements, and enrollment dates.
- Recommend plans and products based on your unique health care needs, lifestyle, and budget.
- Explain information in a clear, straightforward manner so that you fully understand the options available to you.
