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     Current Replies for "Medicare tackles marketing abuses"
      Medicare tackles marketing abuses (bigaltherealone)
    Posted: 3:47:56 pm on 5/9/2008 Modified: Never
     

    Courtesy of chicagotribune.com/a>

    Here’s a primer to help you understand the latest regulations proposed by federal regulators for private plans that operate under Medicare.

    The traditional Medicare program remains unchanged and every senior can choose to be in it.

    Instead, the proposed rules target two types of private plans: those that pay for prescription drugs (known as Medicare Part D plans) and those that provide comprehensive benefits (known as Medicare Advantage plans).

    Altogether, 25 million of Medicare’s 44 million members have either Part D or Medicare Advantage coverage.

    In both cases, insurance companies market and manage the plans. The bills are ultimately paid by Medicare, but the private companies run the show.

    That’s where problems have arisen. According to numerous reports, aggressive insurance agents have allegedly duped seniors into buying private Medicare plans they didn’t want or need. In some cases, seniors with dementia have been signed up by unscrupulous agents.

    Some seniors have thought they were enrolling in a Medicare drug plan only to find themselves in a Medicare Advantage plan. Here’s the difference: a Medicare drug plan only applies to prescriptions and leaves your traditional Medicare coverage intact. A Medicare Advantage plan replaces traditional Medicare altogether and usually limits a member’s choice of doctors and hospitals.

    Some agents have reportedly used high pressure tactics to sell multiple products such as annuities or life insurance products to vulnerable seniors. Others have allegedly forged signatures or conducted mass enrollments at seniors centers.

    Congress has held hearings on the alleged Medicare marketing abuses. The insurance industry agreed earlier this year that stricter marketing guidelines are advisable.

    The proposed new federal regulations address many problems, such as cold calls, door-to-door marketing, expensive inducements to seniors to purchase private Medicare plans, sales pitches at health fairs and community clinics, and attempts to push extra products on potential customers.

    They don’t, however, place limits on the commissions that agents get for selling private Medicare plans. High commissions underlie the drive to sign up customers and are fueling Medicare marketing abuses, several critics charge.

    Nor do the proposed regulations give states such as Illinois the power to enforce marketing and sales standards for private Medicare plans. That authority remains vested in the federal government, which doesn’t have the on-the-ground staff to do the job, critics contend.

    In Illinois, hundreds of consumers have contacted the state’s Division of Insurance to complain about agents selling private Medicare plans, according to Susan Hofer, spokeswoman for the division. Two insurance company investigations are outstanding but the state can’t do as much as it would like to force companies to improve practices, according to division director Michael McRaith.

    If you have a complaint about someone who’s marketing a Medicare plan, the state will follow up and investigate, Hofer promised. Call this toll free number: (877) 527-9431.

    If you’re a senior and you want to talk to someone about what kind of insurance is best for you, contact the state’s Senior Health Insurance Program at (800) 548-9034.


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