Medicare’s open enrollment season brings television commercials, junk mail and other forms of marketing of private insurance options that can overwhelm and often mislead older adults into choosing plans that don’t work for them.
In Iowa, for example, a beneficiary called a phone number from a TV commercial he saw advertising Medicare Advantage plans. The representative who answered persuaded the man to enroll in a plan that was not available in his county. The following week, the beneficiary discovered his prescriptions were not covered by his new policy, and he was required to pay out-of-pocket.
This incident was recounted by Iowa’s State Health Insurance Assistance Program to warn residents to be wary of misleading marketing by Medicare Advantage plans, which are private insurance plans offered in place of traditional government-administered Medicare.
Some advertisements would be considered fraud
It’s the time of year for older Americans to be wary of the marketing that is ubiquitous for both Medicare Advantage and Medigap, which is the name given to private plans that supplement traditional Medicare coverage.
In fact, nearly all people 65 and older who responded to a recent survey from the Commonwealth Fund said they received some Medicare plan marketing, mostly through television or online ads; a third received seven or more phone calls every week.
About 11% of respondents said they had enrolled in a plan under the impression that their doctor was covered, only later to learn there were limitations on seeing that doctor or the doctor was not in the plan’s network. And 17% said they had been led by advertisements to believe something about a plan that turned out to be untrue.
“Certain marketing experiences reported in our survey would be considered fraud by federal authorities,” Commonwealth reported, noting that fraud and misleading marketing can confuse people and cause them to enroll in a plan that doesn’t meet their needs.
“No marketer, whether calling on behalf of a plan or a third party, is permitted to ask for — or needs to have — a beneficiary’s Medicare or Social Security number outside the formal plan enrollment process," the report said. "In addition, time-limited, special discounts on Medicare plans do not exist and are not allowed by the Medicare program.”
But 10% of respondents reported being asked for their Medicare or Social Security numbers, and 19% said they were offered time-limited special discounts.
Under rules for the Centers for Medicare and Medicaid Services, marketers may not call beneficiaries unless they agreed to be contacted or have requested the call, and brokers and agents cannot coerce or otherwise pressure beneficiaries into signing up for a plan. But unsolicited calls and emails from plans or plan representatives were commonly reported in the survey, with 74% reporting receiving an unsolicited call from a plan representative.
Medicare marketing complaints increase
The number of beneficiary complaints related to the marketing of Medicare Advantage plans doubled between 2020 and 2021, according to government data.
The Commonwealth Fund survey results dovetail with a report last year from U.S. Sen. Ron Wyden, D-Oregon, chairman of the Finance Committee, who found what he described as “numerous tactics used by insurance companies, brokers, and third party marketers to push seniors to sign up for their plans, including deceptive mail advertisements, misleading claims about increasing Social Security benefits, aggressive in-person marketing tactics, and enrolling beneficiaries, particularly those dually eligible for Medicare and Medicaid, in a new plan without their consent.”
The main reason for all the marketing is the money made by private insurers. Just over half of Medicare beneficiaries are enrolled in Medicare Advantage plans, with under half choosing traditional Medicare. Medicare Advantage can control its costs by limiting beneficiaries to in-network providers, and the plans have been accused of overcharging taxpayers.
A recent report from an advocacy group called Physicians for a National Health Program said “By our estimate, and based on 2022 spending, Medicare Advantage overcharges taxpayers by a minimum of 22% or $88 billion per year, and potentially by up to 35% or $140 billion. By comparison, Part B premiums in 2022 totaled approximately $131 billion, and overall federal spending on Part D drug benefits cost approximately $126 billion. Either of these — or other crucial aspects of Medicare and Medicaid — could be funded entirely by eliminating overcharges in the Medicare Advantage program.”
Help available for overwhelmed beneficiaries
The Commonwealth Fund noted that in 2022, the average beneficiary had more than 40 Medicare Advantage plans, another 60 Part D plans, and many Medigap plans from which to choose. This heavy competition may represent an oversaturated market, with 96% responding to the survey saying when they have too many plan options, they’re more likely to stick with their current plan.
If you need unbiased help with Medicare, you can get it from your State Health Insurance Assistance Program. These representatives don’t stand to make money from your choices and can give advice based on your needs.
Note: A version of this item first appeared in Kiplinger Retirement Report, our popular monthly periodical that covers key concerns of affluent older Americans who are retired or preparing for retirement. Subscribe for retirement advice that’s right on the money.
Elaine Silvestrini has had an extensive career as a newspaper and online journalist, primarily covering legal issues at the Tampa Tribune and the Asbury Park Press in New Jersey. In more recent years, she's written for several marketing, legal and financial websites, including Annuity.org and LegalExaminer.com, and the newsletters Auto Insurance Report and Property Insurance Report.
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