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Medicare Guide 2023: Complaints Soar for Medicare Advantage’s Misleading Marketing; how to protect yourself

They’re the TV stars of a bygone era, a heroic quarterback, starship captain and sitcom sensation.

Joe Namath, William Shatner and Jimmie JJ Walker have returned to TV screens in recent years, working as pitchers and urging older viewers to call in to see if they qualify for additional Medicare benefits and security payments. more important social.

Consumer watchdogs say the ads are grossly misleading, making promises the company behind them often can’t deliver. The ads — and similar marketing pitches — coincided with an increase in complaints about Medicare Advantage marketing, which jumped 165% last year.

Medicare Advantage plans provide health insurance through a private insurer instead of the government, bundling preventive care, hospitalization coverage, and usually including prescription drug benefits. Federal authorities this year imposed new marketing rules aimed at cracking down on misleading claims by requiring advertisers to disclose that certain Medicare Advantage plans may not be available everywhere and requiring them to record certain sales calls.

Medicare beneficiary advocates and members of Congress say more is needed. They blame private equity-backed insurance companies that they say are trying to win over Medicare Advantage customers with advertising bluster instead of better insurance plans.

“Insurance companies are always trying to come up with new ways to trick older people into buying their product,” said U.S. Sen. Ron Wyden, D-Oregon.

Misleading TV ads are just one of the many risks Medicare beneficiaries face this time of year. There is a separate threat from would-be scammers trying to take advantage of the open sign-up period that runs until December 7 to trick consumers into signing up for services that could prove costly or to steal their number. health insurance.

“Medicare fraud is extremely prevalent because it’s unfortunately quite easy to carry out,” warns Kathy Stokes, director of fraud prevention at AARP.

Scammers can use stolen health insurance numbers to submit bogus bills, or they can trick recipients into ordering expensive equipment that doesn’t meet their needs and may not be fully covered by their plans.

Thus, Stokes and other consumer advocates encourage Medicare beneficiaries to be extremely careful when responding to letters and advertisements they see on television and online, and never to share Medicare numbers with anyone. other than their health care provider or insurance company.

“They’re so good at making their pitch look like it’s coming from Medicare or a legitimate Medicare subsidiary,” Stokes said.

If you think you’ve shared your Medicare number with someone you shouldn’t have, or if you’ve been tricked into signing up for a Medicare Advantage plan you didn’t really want, tell Medicare right away.

And if you have questions about the legitimacy of a plan or need help determining what’s real and what’s a scam, contact your National Health Insurance Assistance Program (SHIP) for acquire help. (In Oregon, it’s called SHIBA.)

“They can direct you to someone who can actually help you,” Stokes said.

Tigard Medicare insurance broker Lisa Lettenmaier said she had always received calls about advertisements customers were seeing on television, but she said the past year had been particularly egregious.

“I spent a lot of time having the same conversation with my clients saying, ‘Yeah, that’s too good to be true,'” Lettenmaier said.

Some TV ads have made general promises that really only apply to a small subset of recipients, she said. Other customers have received mail designed to look official using urgent phrases like “second opinion” and “final opinion” in hopes of enticing recipients. If seniors respond by asking for more information, Lettenmaier said marketers interpret that as an invitation to keep rushing them to sign up for their plans.

“When you get cold calls, when you get senders, just be aware of what it is,” she said.

Last summer, Wyden sent a letter to state insurance agencies across the country seeking data on false or misleading advertising. That’s information the senator plans to use to pressure federal regulators to implement tougher protections for consumers.

“Bad actors keep finding ways to leverage the program, to make a quick buck on vulnerable people,” Wyden said. “So I think the data is going to back up this misleading marketing issue and these numbers that show complaints are increasing are accurate.”

The goal, Wyden said, is to create a marketplace for Medicare Advantage that rewards insurance companies that deal honestly with consumers and offer plans that deliver real value.

“If you can get a good reputation in the senior community, it’s very beneficial for you economically. So there are plans that try to do good and do well,” Wyden said. “But I think bad actors should always be eliminated.”

Tips for Avoiding Medicare Scams

Guidance from Medicare, Oregon Department of Human Services, and AARP.

  • Protect your Medicare number and Medicare card. Do not share them with anyone other than your healthcare provider or Medicare Advantage plan. You do not need to provide your Medicare number to receive plan information.
  • Beware of advertisements for free services or products in exchange for your Medicare number and cold calls from people claiming to be Medicare and want your number.
  • Carefully review your Medicare Summary Notice to make sure the health claims listed are legitimate.
  • If you’re looking for a plan based on a TV ad or letter, check with Medicare Plan Finder on Medicare.gov to make sure it’s a legitimate plan.
  • Report suspected scams to Medicare at 800-633-4227 or 877-772-3379 for Medicare Part D prescription drug issues.
  • Contact your state Health Insurance Assistance Program (SHIP) for assistance in navigating legitimate Medicare Advantage plans.
  • Contact AARP’s Fraud Watch Network at 877-908-3360 if you think you’ve been the victim of fraud or need help determining if an offer is legitimate.

-Mike Rogoway | mrogoway@oregonian.com

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