Marketing Could Mislead Older Adults During Medicare Open Enrollment

By The Senior Medicare Patrol National Resource Center

October 25, 2022

During Medicare’s Annual Election Period, commonly known as Medicare Open Enrollment Period (OEP), which takes place October 15 through December 7 each year, Medicare beneficiaries can choose the Medicare plans that are best for them. Beneficiaries in Original Medicare can compare and change prescription drug plans (Part D) and Medigap plans. They can also decide if, instead of Original Medicare, they would prefer to sign up for a Medicare Advantage (MA) plan (Part C).  

Comparing plans and knowing what is best for you can be overwhelming. You can get free, unbiased help comparing Medicare plans from the State Health Insurance Assistance Programs (SHIPs) that are in all U.S. states, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.

During this period, plans are actively marketing their products through television ads, social media ads, radio ads, and mailings. In an attempt to pique your interest, the ads may intentionally or unintentionally mislead you into thinking one plan is better for you than another. Unlike Original Medicare, Part C and Part D plans are administered, marketed, and sold by private insurance companies. It’s important to understand what brokers and agents from these private insurance companies are and aren’t allowed to do so you’ll be prepared if an insurance agent or representative tries to enroll you in a Medicare plan that isn’t right for you. When you meet or talk with an agent, they cannot:

• Start a discussion about other insurance products, like life insurance annuities, if your meeting was scheduled to discuss Medicare Part C or Part D.
• Set their own time limits for you to sign up for a plan. You have until December 7 to enroll, and there are not any extra benefits for signing up early.
• Threaten to take away your benefits if you do not sign up for their plan.
• Offer you gifts if you do agree to sign up for their plan.
• Suggest that Medicare endorses or prefers their plan.
• Discuss Medicare products you did not ask to talk about when you filled out a scope of appointment form.

Once you have picked the plan that is right for you, be sure you get all the details in writing before signing up. Take your time to read all the information and verify details. For example, before signing up, reach out to your doctors to ensure they are in that plan’s network.

When to report potential fraud, errors, or abuse

Report potential Medicare marketing violations and/or enrollment concerns if you see these red flags:

• You received an unsolicited phone call from a company you have no prior relationship with.
• A company represents itself as coming from or sent by Medicare, Social Security, or Medicaid.
• You received information such as leaflets, flyers, door hangers, etc., on your car or at your residence from a company you did not have an appointment with.
• An agent initiates a discussion about other insurance products, such as life insurance annuities, during a visit or meeting about a Part C or Part D Medicare product.
• An agent returns uninvited to your residence after missing an appointment with them earlier.
• You signed up for a plan after being told by a company that certain prescriptions or services were covered, but after reviewing your Explanation of Benefits (EOB), you found they were not covered by the plan and you will be charged instead.
• You were told you could keep your Medigap (or supplemental) plan when you sign up for a Medicare Advantage plan, when in reality, you cannot have both a Medigap plan and a Medicare Advantage plan.

For more information on potential Medicare marketing violations and enrollment fraud visit our related Fraud Schemes webpage or to report Medicare fraud, errors, or abuse, visit www.smpresource.org or call 1-877-808-2468.