According to Patricia Barry, writing for AARP magazine, the centers for Medicare and Medicaid Services have issued new rules aimed at ensuring that salespeople give honest, accurate information to enrollees. However, the new legislation does not address the underlying issues that gave rise to it in the first place.

This alleged abuse came to light in early 2007 when the insurance commissioners of 37 states reported that thousands of their Medicare constituents had become the prey of unscrupulous marketers who were using illegal or unethical hard-sell tactics to get the elderly to sign up for Medicare Advantage plans. According to the author some of these agents targeted dementia patients, signing them into inappropriate plans, while other convinced uninformed clients that the original Medicare was being permanently shut down and that their only option was to join a Medicare Advantage plan. Still others were led to believe that they were enrolling in a Medicare supplement plan only to find out later that they had actually been enrolled in a full coverage plan that covered all of their medical care at a much larger expense.

One major negative of the Medicare HMO is that they often only cover hospitals and doctors in their network so that if you have emergency or other special needs that are treated elsewhere you may have to fight for coverage or find that you are not covered at all.

To protect yourself from being tricked or pressured you should know the following:

  • It is illegal for a salesperson to come to your home uninvited.
  • For impartial information on your Medicare Insurance options check out or call the Medicare help line at 1-800-633-4227. If you opt to use an insurance agent, try to choose one who is not paid to sell just one plan.
  • Don’t let the agent rush you into making a decision.
  • Do not sign anything before you check out the carrier thoroughly by calling the Medicare help line where you can insert the plan’s name and ID number to learn if Medicare has approved that plan for your area. Additionally, check with your preferred doctor and hospital, etc. to make sure that they will accept this plan.
  • Finally, if you find yourself enrolled in a Medicare plan that does not suit your needs due to misrepresentation by the provider call the Medicare help line and ask to be reenrolled in original Medicare or switched to another Medicare Advantage plan. If you have accumulated medical bills due to this misunderstanding ask to be reenrolled retroactively, so Medicare can pay the bulls at its usual rate.

Be aware that the majority of complaints about marketing abuses have been directed at a new Medicare Advantage product, private-fee-for-service plans. The main advantage of these plans according to representatives is that you can choose any doctor or hospital, anywhere in the country. However, many people have found that many of providers will not accept these plans.

So overall, one must acknowledge that the original Medicare program provides a great service of retirees and if you can supplement it with a gap coverage insurance such as is offered by AARP you will find your needs well met. I for one can attest to the fact that AARP supplemental insurance pays. I had called for enrollment in April to become effective June 1, 2007, but due to a mix up in their office had not received my confirmation as of June 15 when I was taken by ambulance to our nearest hospital. I was hospitalized for 5 days and had surgery. I wondered if AARP would meet their obligation and to their benefit I had no problem with them paying the $10,000 in bills that were not covered by Medicare. While I hope to never need such assistance again I will always be thankful for my choice of AARP for my supplemental insurance.

[tags]Paticia Barry, AARP magazine, AARP insurance, Medicare Advantage Plans, Fee for Service Plans, original Medicare, Medicare, retiree abuse, insurance, supplemental insurance, gap insurance, Medicare HMO[/tags]