In 2008, the Centers for Medicare and Medicaid Services (CMS) adopted new rules to crack down on predatory sales practices in the Medicare Advantage industry, an enormous field that sells government-subsidized private health insurance plans that are an alternative to traditional Medicare. While the changes helped trim complaints of fraudulent practices to Medicare by almost half, there are still widespread problems, according to a CMS study based on a secret-shopper survey of 1,900 Advantage marketing events. And, if you happen to get sold an Advantage plan that does not work for you, the implications could be serious as you may end up not being able to see your current doctor or get the save drug or health coverage you had with Medicare.
Typical shady practices include:
- Misinformation about what an Advantage plan covers (65% of complaints are related to this problem).
- Soliciting meetings with Medicare beneficiaries, typically the elderly, to “discuss their Medicare plan” without clearly identifying themselves as someone selling an alternative to Medicare.
How can you battle these tactics? Medicare offers several ideas: