Finding the best private Medicare drug or health insurance among dozens of options is difficult enough without adding misleading sales tactics to the mix.
Still, federal officials say complaints are increasing from seniors who are tricked into buying guidelines – without their consent or lured by questionable information – who may not include their medications or their doctors. In response to that
The agency also revised the rules to make it easier for beneficiaries to escape plans they didn’t sign up or enroll in, only to find that promised benefits didn’t exist or they couldn’t see their providers.
The problems particularly arise during Medicare’s open enrollment phase that began
The person on the phone said she needed Heimer’s Medicare number to make sure it was correct for the new card she was going to receive. When Heimer hesitated, the woman said: “We don’t ask for anything
“I can’t believe it, but I gave her my card number,” said Heimer. Then the caller asked questions about her medical history and offered to send her a saliva test “absolutely free”. Heimer became suspicious and hung up. She contacted the 1-800-MEDICARE hotline to get a new Medicare number and called the AARP Fraud Watch Network Helpline and the
But later that morning the phone rang again and this time the caller ID showed a number that matched the Medicare toll-free helpline. When she answered, she recognized the voice of the same woman.
“You are not from Medicare,” Heimer told her.
“Yes, yes, yes, that’s us,” the woman insisted. Heimer hung up again.
It’s only been two weeks since Heimer gave her Medicare number to a stranger and nothing has gone wrong so far. But armed with that number, scammers could bill Medicare for services and medical care that beneficiaries never receive, and the scammers could enroll seniors for a Medicare benefit or drug plan without their knowledge.
Nationwide, the Senior Medical Patrol sent 74% more cases to CMS and the Inspector General of Health and Human Services for investigation in the first nine months of this year than in all of 2020
And last month, CMS officials warned the private insurance companies that sell Medicare Advantage and drug plans that federal regulations prohibit fraudulent sales practices.
Coleman reminded companies that they are “responsible and accountable for their marketing materials and activities, including marketing conducted on behalf of an MA plan” by salespeople. Companies that violate state marketing rules can face a fine and / or suspension of registration. However, a CMS spokesperson was unable to provide any examples of the recent violations or their penalties.
When beneficiaries discover a problem beforehand
Year, unless you are eligible for one of the rare exceptions to the rule.
For the first time this year, CMS has created another remedy.
Officials can grant a “special registration period” to people who wish to abandon their plan because of fraudulent sales tactics. These include “situations where a beneficiary claims, verbally or in writing, that their inclusion in an MA or Part D plan was based on misleading or incorrect information … their knowledge,” according to the Medicare Managed Care Manual.
“This is a really important beneficiary safety valve that clearly goes beyond the limited ability to change plans when someone feels the buyer’s remorse,” said
The possibility of leaving also exists if a significant number of insured persons do not have access to the doctors or hospitals that should be part of the provider network.
Still, the scams continue across the country, experts say.
A misleading television commercial in the
In August, a
Reeg said another senior received a call from a salesperson with bad news stating that she did not receive all of the Medicare benefits to which she was entitled. The beneficiary provided her Medicare number and other information, but did not know that the caller was enrolling her on a Medicare Advantage plan. She found out about this during her visit to the doctor, who did not accept her new insurance.
Heimer’s impostor was persistent. When the stranger tried to reach her a third time, Heimer said, the caller ID showed the phone number of another local hospital. She told the woman she had the calls to CMS, the AARP Fraud Watch Network Helpline and the