Fall Open Enrollment Starts Oct 15th ~ Tips to Prepare & Protect Yourself from Fraud

Fall Open Enrollment Starts Oct 15th ~ Tips to Prepare & Protect Yourself from Fraud

Fall Open Enrollment starts on Oct 15th and is the time of year when you can switch your Medicare health and drug coverage. Below are 3 points to guide you in reviewing your Medicare coverage and options AND tips to protect yourself from fraud. These points are taken from the Medicare Minutes program.

Point 1: Understand your current coverage and how it may change to help protect yourself against Medicare fraud.

If you choose not to act, membership in your Medicare plan—whether Original Medicare or a Medicare Advantage plan—automatically renews each year (unless you’re in a non-renewing MA plan — see our website section When Medicare Advantage Plans Terminate Coverage). Understanding your current coverage will enable you to make an informed decision about your coverage for 2015 and help you detect Medicare fraud. At the end of September, you should have received mail from your current plan about its 2015 coverage. This should have included information about changes to your plan’s list of covered drugs (formulary), health benefits, and/or premium costs. Plans are allowed to change their cost and coverage rules each year, so it’s important for you to read mail from your plan to see if there are any changes that affect you. If you did not receive this information, call your plan to request it. Keep the mail you receive from your plan and reference it throughout the year. It is a form of Medicare fraud if a plan promises coverage for services, items or drugs that it does not intend to cover – so review and keep your mail to protect yourself.

Point 2: Match your needs with the appropriate health or drug choice.

Fall Open Enrollment lasts from October 15 to December 7. For most people, it’s the only time of year to switch your Medicare coverage. Any changes you make during this time will take effect on January 1, 2015. Plans can change their cost and coverage rules annually, so the plan that worked best for you in 2014 may not be the plan that will work best for you in 2015. Even if you are satisfied with your current coverage, you should look at other Medicare options in your area to see whether you can meet your current health care needs at a lower cost. Comparing plans during Open Enrollment and understanding your options will enable you to better detect Medicare fraud when you hear or see something against the rules.

Before comparing your options, make a list of health care providers you see, prescription drugs you take, and pharmacies you use. When comparing plans, look first at whether the plan covers all the drugs you take and/or has all of your doctors in its network. Then look at the plan costs (premiums, deductible, and copays) and check the plan’s star rating. Keep in mind that a plan that works well for your friend or relative may not work well for you.

Point 3: Watch out for Medicare fraud.

One of the most important ways to protect yourself from fraud is never giving out your personal information – including your Medicare or Social Security number – to anyone other than a trusted health care professional. If you do, someone may use it fraudulently. Fraudulent use of a Medicare or Social Security number includes enrolling you in a plan you don’t want during Fall Open Enrollment.

During Fall Open Enrollment, you should also watch out for Medicare marketing fraud. All plans are allowed to send you mail. However, plans are not allowed to call you without your permission, unless the call is from an insurance company you currently use. All plans (including your current plan) are never allowed to e-mail or visit you in person without your permission. Giving out your number and address to a plan at a presentation or health fair gives the plan permission to follow up with you. However, a plan cannot enroll you in its product without your permission. If you suspect fraud – whether it is marketing or another form – you should call our California Senior Medicare Patrol (SMP) hotline at 855-613-7080.

Remember to Take Action: Only provide your phone number or address if you want a plan to follow up with more information. If you do not want a plan to contact you for marketing reasons, do not give them permission to do so. Report any suspected fraud to our SMP at 855-613-7080.

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.