Not long ago, I wrote about those ubiquitous Part C Medicare Advantage TV ads that show up faster than a telemarketer can dial the phone. Well, the federal government has gotten so many complaints about MA ads that the rules governing them change beginning January 1, 2023.
The Senate Finance Committee called for an investigation in August 2022 after hearing about a large number of Medicare Advantage marketing complaints. The final report, released in November 2022, explored materials submitted by 14 states. It found most of those states tracked an increase in complaints to insurance commissioners from 2020 through 2021. CMS reported more than twice the number of complaints for MA marketing over the same time period. According to the report, “States reported instances of deceptive marketing material, such as mailers that appeared to be official government documents or advertisements that use ‘Medicare’ in the company’s name or branding.”
Another concern was marketing plans to beneficiaries who had dementia or were enrolled in a plan without their consent. Sometimes, beneficiaries had their plans inadvertently switched to one that didn’t cover their doctor.
The investigation also found a frequent source of complaints coming from plan offers to add money back to seniors’ Social Security checks. If a plan buys down Medicare Part B premiums, that could result in a higher payment for seniors that choose those plans. However, brokers and agents are apparently employing the additional benefit to lure beneficiaries into plans even if they don’t lower the Part B premium.
The Centers for Medicare and Medicaid Services is the agency that oversees the Medicare program. The agency is stepping in to stop the confusing language in the ads as well as the pressure tactics used in marketing Part C. The director of CMS’s Medicare Drug and Health Plan Contract Administration Group, Kathryn Coleman says, “We have reviewed thousands of complaints and hundreds of audio calls and have identified numerous issues with information provided to beneficiaries that is confusing, misleading and/or inaccurate.”
As part of the changes, CMS has to pre-approve all new TV ads for Medicare Advantage plans, and existing ads that don’t meet federal guidelines have to be pulled or the ad-buying organization may be subject to compliance action.
Medicare Advantage is one of the two main types of Medicare and is offered by private insurers. The second type, known as Original or Traditional Medicare, provides benefits directly from the federal government.
What should you watch out for when dealing with Medicare Advantage organizations? The nonprofit Medicare Rights Center provides a list. MA brokers and agents are not allowed to:
- Call you or visit without permission.
- Ask for your financial or personal information.
- Offer valuable prizes to incentivize enrollment.
- Pretend or suggest that their plan is preferred or endorsed by the Medicare program.
- Claim you can always switch back to Original Medicare without explaining limited enrollment periods.
- Misconstrue Medicare-covered services as additional benefits.
If you’ve faced any of these tactics or other suspected Medicare marketing fraud, you can report it to 1-800-MEDICARE.