Hard-Sell Tactics Push Medicare Advantage Plans
By: Patricia Barry Source: AARP Bulletin Date Posted: 2007-07-13 15:07:00-04:00
Medicare beneficiaries in at least 37 states have been victims of illegal or unethical hard-sell tactics used to sign them up for private Medicare Advantage health plans—often without their knowledge or without them realizing it would mean leaving the traditional Medicare program—according to state insurance commissioners.
"In the most troubling of these cases, unscrupulous agents have enrolled beneficiaries with dementia into an inappropriate plan," Wisconsin insurance commissioner Sean Dilweg recently told the Senate Aging Committee.
Some seniors said insurance agents had told them Medicare was "closing down" and that they had to join an MA plan to continue health coverage.
Others thought they were buying a plan that covered only prescription drugs, but later found they'd been signed up for an MA plan covering all their medical care. This automatically switched them out of traditional Medicare or, in some cases, caused them to lose retiree health benefits.
"Over the past year we've received hundreds of complaints from our citizens, who have been misled or deceived during a sale," said Oklahoma's insurance commissioner Kim Holland.
The MA program includes managed care plans, which generally restrict choice of doctors and hospitals to those in their networks, and others known as private fee-for-service (PFFS) plans, which theoretically offer more choice of health providers. Enrollment in PFFS plans has risen rapidly over the past 18 months, especially in rural areas. "A majority of beneficiary complaints regarding Medicare Advantage are tied to PFFS plans and the way they are marketed," Abby Block, director of Medicare's Center for Beneficiary Choices, told a House committee last month.
Responding to the complaints, the Centers for Medicare and Medicaid Services (CMS) announced June 15 that seven insurance companies have voluntarily agreed to suspend marketing PFFS plans until they have met new Medicare requirements for training agents and selling plans. "CMS and the plans are stepping up to ensure that deceptive marketing practices end immediately, and that beneficiaries understand what they are purchasing," Leslie V. Norwalk, acting administrator of CMS, said in a statement.
The health insurance industry also announced a new self-imposed code of conduct, but that doesn't satisfy all lawmakers. "We're going to drain this swamp," vowed Sen. Ron Wyden, D-Ore.
Have you been tricked into signing up for a Medicare Advantage plan? If so, the AARP Bulletin would like to hear your story. Please include your name and telephone number. We will not publish your name without your permission.
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