With Medicare’s Open Enrollment just around the corner (Oct 15 – Dec 7), beneficiaries, their families, and caregivers across the country are bracing for the annual onslaught of advertisements, marketing and solicitations regarding Medicare Advantage, Medigap and Part D prescription drug plans. Many find the tsunami of information and marketing confusing, overwhelming and misleading, as found in a new Commonwealth Fund survey. This survey helped glean beneficiary experiences with marketing outreach from these private plans.
Here’s the highlights of what the survey found, as summarized by Medicare Rights Center:
- Plan marketing is often overwhelming. Nearly all beneficiaries saw advertisements and received phone calls, mailings, and emails on a weekly basis. Some experienced even more. Every day, over 75% saw TV or online ads, while 33% received phone calls.
- Fraudulent tactics endure. Many respondents reported Medicare marketing that runs afoul of federal rules, including communications from “Medicare” promoting a specific plan (51%) and unsolicited calls from plans and brokers (74%). Few know what to do about it. About one in five survey participants said they did not know how to file a complaint about Medicare marketing and didn’t think they could figure out how.
- Harmful marketing practices disproportionately target and impact lower-income beneficiaries. Of the 14% of people who stayed on the phone after an unsolicited marketing call, nearly one in three lived on $25,000 or less per year. They were also more likely than those with higher incomes (defined as $50,000 or more) to be asked their Social Security or Medicare numbers outside the enrollment process (22% vs. 6%) and to feel pressured by an insurance broker or agent (21% vs 7%).
- Misleading marketing is widespread. Across all income groups, similar shares of beneficiaries (11% to 12%) chose plans because they believed their doctor to be “in network,” only to discover otherwise post-enrollment. However, lower income respondents were more likely to report seeing, reading, or receiving advertising information that was later found to be untrue (28% vs. 15%).
- All reported seeing, reading, or receiving advertising information that was later found to be untrue (28% vs. 15%).
- Growing plan numbers further complicate beneficiary decisions. Most respondents (96%) said that when they have too many plan options, they are more likely to stick with their current plan than switch.
- But these underlying choices may be sub-optimal. Most of the survey participants turned to friends and family (27%) and insurance brokers or agents (22%) for enrollment advice. But less than half knew there were barriers to switching from MA to Original Medicare with a Medigap, suggesting these and other strategies are inadequate.
- Beneficiaries need clear, comprehensive, and unbiased enrollment assistance. More than one in three said they would like to know more about out-of-pocket costs and benefits of their coverage options, and one in four said that they would like more one-on-one help to make their coverage decision.
These survey results highlight and align with the growing number of misleading marketing complaints reported to Medicare. According to the Centers for Medicare and Medicaid Services (CMS), Medicare received almost 40,000 complaints from beneficiaries about the marketing of plans in 2021, up from about 5,700 in 2017. These complaints included beneficiaries being enrolled without any contact with a health plan, cross-selling and misleading information about provider networks, reimbursements, benefits and premiums.
In addition to the misleading marketing and fraudulent enrollment tactics, the number of plan choices continue to grow. For 2023, the average beneficiary had access to 43 plans, over twice as many as in 2018. Yet this increase in plan choice, leads to more confusion and overwhelm. With too much to review and compare, many people don’t. This often results in staying in their current plan without investigating other more optimal options, and can inadvertently lead people to unnecessarily pay higher costs and/or lose access to preferred providers (i.e., if their current plan changes the providers in its network).
Last year, the Biden Administration took some actions in response to the rise in misleading marketing complaints to: restrict use of the Medicare name, prohibit ads that don’t mention a specific plan, and ban sales presentations immediately following educational events. These actions are important and a start, yet more must be done. Such actions include: restoring consumer protections that were recently weakened, enforcing guidelines for the marketing of supplemental benefits, strengthening plan and marketing materials oversight, and promoting and growing the State Health Insurance Assistance Programs (SHIPs) that provide free, individual and unbiased assistance with Medicare.
Beneficiaries, families and their caregivers who have questions about Medicare, their coverage options during Open Enrollment and more, can contact their local Health Insurance Counseling Program (HICAP) at 1-800-434-0222 – HICAP is California’s SHIP program.
Also, people who come across misleading marketing and/or fraudulent enrollment tactics can report this to our California Senior Medicare Patrol at 1-855-613-7080. See our new Novella, “Older Adults & Medicare Health Plans” available in English and Spanish. This tool gives a good summary of what health plans and their agents cannot do, how to spot enrollment fraud and where to report it.