Avoid the “Bad Apples” When Choosing Your Medicare Coverage for 2017

Avoid the “Bad Apples” When Choosing Your Medicare Coverage for 2017

Headlines on 2017 Medicare changes bombard the news, and advertisements and notices on Medicare coverage options for the new year flood into beneficiary mailboxes across the country. This phenomena is just part of Medicare’s Annual Election Period (AEP), also known as fall open enrollment, which runs from Oct 15 – Dec 7. During the AEP, beneficiaries can review their current coverage and plan changes for the coming year and make a change. Beneficiaries can switch their Medicare Advantage plan and/or Part D coverage, and/or return to Original Medicare.

Yet so much information floating around in the news and mail, also creates a ripe environment for confusion, fraud and scams. This means that if you have Medicare, you need to keep an eye out for people trying to rip you off. Crooks are out trying to get your Medicare number, financial information or health insurance number to steal your identity or trick you into buying something you don’t need. And some “bad apple” insurance agents may try to sell you a Medicare plan that makes them money and cheats you out of benefits you really need.

Don’t let anyone trick you into making a bad decision. Take the time every year for a “check-up” on your Medicare choices during Open Enrollment. You can call your local Health Insurance Counseling and Advocacy Program (HICAP) to review and understand your choices at 1-800-434-0222. HICAP offers free, individual, unbiased counseling on Medicare and other health insurance related issues. Also, if you come across any such scams, report them to our California Senior Medicare Patrol at 1-855-613-7080. Make sure you talk with your health care provider before making changes as well.

Here are some things to consider when choosing a plan:

  1. The type of coverage you need. Does the plan let you see the doctors you want and go to the hospital you want? Does the drug plan cover the medicines you now take?
  2. The cost of the plan. Prices are different. Compare costs. Find out if you can get help paying for the plan if you have a low income through the Part D Extra Help program.
  3. The location. Can you go to the pharmacy you like? Is it close to your home?
  4. You are not alone. Get help from family, from the Medicare website or from your local Health Insurance Counseling and Advocacy Program (HICAP).

Learn tips on how to protect yourself during open enrollment season:

Below is an excerpt of tips from the California Department of Insurance’s recent consumer alert on how to protect yourself from the burgeoning scams that grow during Medicare’s open enrollment each year:

  • Medicare does not have official sales representatives: Don’t believe a salesperson who claims to be a Medicare representative. Medicare does not send “representatives” to solicit your business.
  • Unsolicited sales calls are prohibited: Federal regulations prohibit unsolicited telephone calls, door- to-door visits, emails and other forms of sales without your permission. If you have not requested that someone contact you it may be a scam.
  • Guard your personal information: Never give out personal information such as your Social Security number, bank account numbers, or credit card information over the telephone. Verify that the person you are dealing with has proper authority to act on behalf of the plan before you provide your Medicare number.
  • Keep a record of who you speak with and the information that you provide to that person.
  • Beware of cross-selling: Cross-selling occurs when a salesperson approaches you for one purpose but then tries to sell you something else. This could lead to an unplanned purchase of a product that may not be in your best interest. Salespeople may not market health care–related products (such as annuities, life insurance, etc.) during a Medicare Advantage or Part D sales activity.
  • Take your time: Don’t feel pressured to make a quick decision. Be sure that you understand the details of a plan before you enroll. Verify copayment amounts and whether your medical providers participate in the plan that you are considering.
  • You don’t have to make a change: If you are satisfied that your current plan will meet your needs for the coming year, you don’t need to change plans. Confirm the details of your current plan before making a switch.
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.