As highlighted in a recent Washington Post Article, The Centers for Medicare and Medicaid Services (CMS) are taking more steps to protect eligible enrollees from misleading marketing campaigns and scams during this Annual Enrollment Period.  

As more baby boomers qualify for Medicare, the Medicare-eligible population continues to grow at an impressive rate. Sadly, some organizations and call centers work to enroll as many people as they can in particular Medicare plans, despite taking little or no time to get to know the person and their needs. Why? To make more money faster. Whether or not they enroll someone in the right coverage based on their unique needs, the company will receive a commission for the enrollment.  

CMS is recognizing that to increase profits, some bad actors are saying and doing whatever they can to entice and persuade customers to enroll in plans, even if the plan is not a good fit. “I’m glad to see CMS working to crack down on less than ethical sales tactics,” says Alissa Morris, Comptroller and Executive Leader for Compliance at Advocate Health Advisors. “What’s most important is for Medicare enrollees not to let anyone pressure them into a decision, especially when it’s someone they’ve never met and don’t know if they can trust.”  

Beware of bait and switch marketing tactics 

A practice that CMS is working to combat is Medicare-related sales organizations advertising high-dollar savings and specific benefits that would compel people to contact the company. Sadly, the savings and benefits some campaigns highlight are only available to a slim percentage of people who reply.  

These campaigns are designed to get callers on the phone first, and then use high-pressure sales tactics to talk them into switching plans, even if that switch may not be in their best interests. Often, the plans callers enroll in are made to sound more attractive than their current one, with lower or $0 premiums and/or $0 out-of-pocket costs.  

But later, enrollees make concerning discoveries about their new coverage. They often find their preferred doctor(s) do not accept their new coverage; or that important prescription drugs are significantly more expensive, or not covered at all. 

Important steps to protect yourself 

While CMS efforts will help protect Medicare enrollees, there are also important steps they should take to protect themselves. To ensure any Medicare plan change is an advantageous one, enrollees should do the following: 

  • Remember that plan cost is only one of several key factors to consider when selecting and enrolling in any Medicare Plan. 
  • Whether your meeting is in person or over the phone, insist that your agent checks to see if your preferred doctors and prescriptions are covered by the plan you’re considering. This is an easy search for any licensed agent to conduct and should be a part of any enrollment decision. 
  • Be patient. Agents should take time to get to know you, understand what is most important to you, and explore the options available to you and that meet your specific healthcare needs. If an agent is putting pressure on you to decide, there are others who would be happy to help.  

Local, licensed agents who listen 

“We believe there is important value in meeting clients where they are, both physically and figuratively,” shares Morris. “Advocate has built a strong network of licensed insurance agents who work and live in the same communities as the Medicare-eligible people they serve. Advocate’s agents provide expert advice and trustworthy guidance to members of their communities by listening.”  

Local Advocate agents are trained to listen to clients—to get to know them, their unique life circumstances, what they like about their current health coverage and what they might like to change. Once this information is gathered Advocate agents search for plan that meet their needs. The agent then validates that potentially good-fit plans include the client’s preferred doctors and prescriptions. Finally, they work with the client to consider the good-fit options and identify the best-fit plan based on both their needs and wants.  

Advocate’s agents focus on serving clients’ needs in the long-term, not on just making a sale.