Arkansas Democrat Gazette - Berry to Seniors: Beware of Shady Medicare Advantage Salesmen

Op-Ed

A new scam is threatening America's seniors. Several elderly Americans across northeastern Arkansas have notified local officials of unethical tactics some Medicare Advantage salespeople are using to push seniors into enrolling in these plans. For some people, these Medicare Advantage plans fit all of their medical needs. Unfortunately, others are finding that their new insurance plan does not allow them to get the care they have depended on for years.

Originally Medicare Advantage plans were created to provide seniors with another option than traditional Medicare. Freedom of choice among health care plans is an American value that I proudly support. The problem here is not Medicare Advantage itself. The problem is that Medicare recipients are allegedly being taken advantage of by those who are misrepresenting themselves and using illegal sales tactics to coerce seniors into signing up for these policies. In many cases, seniors are unaware that their doctors will not accept their new plan and find they are unable to receive medical care when they need it most.

Arkansas seniors have reported rogue salesmen have contacted them by phone or in person, claiming to be Medicare or Social Security employees. They urge seniors to purchase a Medicare Advantage plan immediately, or face losing their Medicare coverage. Others found they were unintentionally enrolled in a plan because they signed up for more information, or filled out a "sign-in sheet" at a local health fair.

The First Congressional District offices have fielded over 200 calls in recent months from seniors and family members of seniors who have fallen victim to these shady sales tactics. These kinds of sales techniques have become a problem in places other than Arkansas. Cases are now being reported across the country, catching the attention of insurance commissioners and health care administrators across the country.

Under most circumstances, these sales tactics are prohibited by state law as unfair or deceptive practices and would be investigated and controlled by state regulators and the state regulatory agency. However, since the Medicare Modernization Act of 2003, state regulators have lost most of their regulatory authority over Medicare Advantage plans except for licensure and solvency.

Many seniors, who have never been in a situation like this, do not know that they should report the incidents to the State Insurance Commission. As a result, countless cases remain undocumented. In addition, the Centers for Medicare and Medicaid Services have been unable and unwilling to take action. In the meantime, seniors are left to their own defenses against unethical practices.

To curtail these abuses, the House of Representatives recently passed the CHAMP Act, which aims to protect seniors from abusive marketing. This Act will limit unethical marketing activities, ensure seniors are educated about their options, set standards for agent training, and limit commissions. The CHAMP Act also give states the oversight and enforcement tools they need to hold agents, brokers and plans accountable for wrongdoing.

In the meantime, I urge any senior who is considering a Medicare Advantage plan to read the fine print and research all of the details before signing up for the plan. Below is some information to keep in mind should you consider enrolling in the plan:

Tips:

* Medicare will never contact you directly or dispatch representatives to your residence unless you request a meeting
* If you have questions, call your current or potential provider for clarification.
* You can also contact the Arkansas Insurance Department's Senior Health Insurance Information Program (SHIIP) for free one-on-one counseling, education, and information. They can be reached at (501) 371-2782 or toll-free, statewide at (800) 224-6330. More information can also be found on the SHIIP Web site: http://insurance.arkansas.gov/seniors/divpage.htm

Make sure the plan is the right choice for you, not the Medicare Advantage salesman who will mostly likely benefit from the commission. I urge all seniors who are considering enrolling in this plan to take every precaution available. As with any major purchase, its buyer beware, and the Medicare Advantage plan is no exception.

Marion Berry of Gillett represents Arkansas' 1st Congressional District and is a member of the House Appropriations and Budget committees.

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