3 Ways to Avoid Scams for Medicare During Open Enrollment

As you are well aware, during the Annual Enrollment Period (AEP), you tend to get bombarded with Medicare ads, news, flyers, calls, and more. It’s not always easy to know what is a scam, who you can trust, or even what is legal when it comes to selling Medicare policies. As you’re trying to determine what health insurance plan is best for you, we encourage you to know the laws surrounding Medicare and always double-check information before making decisions. Here are 3 ways to spot and avoid scams for Medicare.

1. Don’t believe agents who claim to work for Medicare.

There are no Medicare sales representatives. Let us repeat that: there is no such thing as a “Medicare sales rep” or representatives that are “sponsored” or “endorsed” by the federal Medicare program. Typically, the Centers for Medicare and Medicaid Services (CMS) issues all communication in writing, anyway. So if you encounter a knock at your door or a phone call from someone claiming to be an “official Medicare agent,” do not engage in a conversation about your healthcare and, most importantly, don’t give out any personal information.

CMS is only authorized to call you in these situations:
– a Medicare health or drug plan can call you if you’re already a member of the plan. The agent who helped you join can also call you.
– a customer service representative from 1-800-MEDICARE can call you if you’ve called and left a message or a representative said that someone would call you back.

There ARE, however, trusted independent insurance agents who work with a variety of carriers and, as a result, they represent your best interests. Working with an independent agent can make sure you don’t fall through the cracks. When you find the right agent, they will truly advocate for your health and financial needs, asking all the right questions to make sure you are getting the coverage you need, the provider networks you hoped for, and helping you understand the ins and outs of your plan. Not all agents are the same, though. Make sure you work with someone FREE and personalized, like any of our trusted representatives.

2. Look for the fine print.

There are many ads and sales materials for new Medicare products available at a “discounted price.” These well-designed scams for Medicare typically give you a sense of urgency, claiming that the deal only lasts during the open enrollment period. Ads for Medicare Supplement and Medicare Advantage products may promise a range of services for “free” or “at no additional cost.” Some ads may even tell you that you can get money added to your “Medicare check.”

The ads or brochures can be very official-looking, mimicking government documents. Don’t be fooled by appearances; look for the fine print. All sales materials that are not from the federal government are required to include a disclaimer, such as “not endorsed or affiliated with the federal Medicare program.” This disclaimer doesn’t mean they are not trustworthy companies, but it does mean they are not from CMS or the federal Medicare program. So if these particular ads or materials require any personal information (such as your Medicare number, Social Security number, or banking information), or promise a “discounted” policy, be wary of making any choices or handing out any information.

If you’re already enrolled in a plan and are not sure whether materials are legitimate, you can access a full list of the kinds of notifications and information that CMS and your existing plan(s) may send out via mail on the Medicare.gov website

3. Reject unsolicited calls/knocks on the door.

Neither insurance companies nor insurance agents are legally permitted to make unsolicited Medicare-related calls or personal visits. Medicare has given permission to private companies to market and sell Medicare Advantage Plans and Part D prescription drug plans, but there are very clear guidelines they must follow. Sales representatives are not allowed to call/visit you unless you specifically ask them to do so. This could be through submitting your phone or email through an online form or leaving your contact information at a Medicare seminar.

If you do choose to meet with a representative, know this:

  • the agent must document the options you want to learn more about ahead of time
  • the agent cannot sell you life insurance or other non-health products at the same appointment unless you request information about such products
  • the agent can provide you plan materials, explain how the plan works, give you an enrollment application, collect a completed application, and leave business cards for you to pass on to friends and family

Having a trusted advocate on your side can help you avoid these scams for Medicare. If you are in doubt about the materials or calls you received, call your agent. If you don’t have a trusted agent, contact us now. And always report Medicare imposters at 1-800-MEDICARE and  ftc.gov/complaint