Abusive Medicare Insurance Sales Practices Spreading
Seniors Urged to be Vigilant in Selecting Program
From: Office of the State Insurance Commissioner Filed 4/11/07
Commissioner George Dale today announced that the Mississippi Insurance
Department (MID) is joining State Senator Terry Burton (Lauderdale,
Newton, Scott Counties) and Colonel Don Taylor and the Mississippi
Department of Human Services (MDHS) in alerting Mississippi's senior
citizens to be aware that abusive sales practices relating to Medicare
Insurance, first reported late last year, are spreading rapidly throughout
According to complaints, some Medicare recipients are being enrolled in
these plans without fully understanding their terms, and in some cases,
without even knowing they have been enrolled. All Medicare recipients and
their family members are urged to be vigilant when selecting a Medicare
Part C or Part D plan, and if an agent uses abusive sales practices, to
contact the MID immediately.
"My office is receiving calls daily from seniors who have been victims. It
is unacceptable to have these individuals preying on some of the most
vulnerable citizens in the state. I want people to know that the
exploitation of our senior citizens by these unscrupulous sales people and
the companies that condone such exploitation will not be tolerated. Every
effort will be made to stop those practices and protect our seniors," said
Although the Medicare Program is under federal regulation, Commissioner
Dale is concerned with reports that some agents are continuing to use a
variety of confusing and deceptive sales practices to sell Medicare-
related Part C and D Plans.
"From the calls we continue to receive we're learning that the problem we
first recognized in the northern part of the state is now spreading
further and further south. We are finding that some individuals preying
on our state's seniors and senior oriented communities are using tactics
that are confusing and downright deceptive and it must be stopped. Abusive
sales practices will not be tolerated by this department. Anyone engaging
in such practices will be subject to severe regulatory action by the MID,
such as suspension or revocation of a license and/or a fine," said
The Commissioner is quick to point out that these plans could be
beneficial to some people and not all agents are engaging in these
deceptive practices. However, he did note that the MID, working with state
and local law enforcement, has successfully revoked the license of one
agent and have a number of others under investigation.
Companies offering Medicare plans are subject, under federal regulation,
to strict marketing guidelines for such plans, which include prior
approval of marketing material. MID will consider any deviation from or
violation of federal Medicare Marketing Guidelines to also be a violation
of the Mississippi Insurance Code.
Among the abusive Medicare Part C and D practices being reported are
door-to-door solicitations. Conducting a door-to-door solicitation or
outreach prior to being invited by a Medicare recipient is prohibited. If
someone comes to your door without you having invited them, do not let
them into your home. Also, do not give that person any information about
yourself or let him or her see any of your personal documents. Especially
do not sign anything for that person.
"The Mississippi Insurance Counseling and Assistance Program (MICAP) of
MDHS's Division of Aging and Adult Services, is designed to answer
seniors' questions about health insurance. Our volunteers are trained to
answer questions, compare policies, organize paperwork, help with claims
and filing appeals on Medicare, Medicaid, supplemental insurance and other
coverage. I would strongly encourage any senior with questions to contact
one of the 10 Area Agencies on Aging offices throughout the state," said
Colonel Don Taylor, Executive Director of MDHS.
Anyone who suspects they have been the victim of abusive Medicare
Insurance sales practices is urged to contact MID as soon as possible at
1-800-562-2957. For any other questions regarding Medicare Part C and D
policies, they should contact MDHS at 1-800-948-3090.
SCENARIOS USED IN ABUSIVE MEDICARE PART C AND D SALES PRACTICES
A number of scenarios are currently being reported to the Mississippi
Insurance Department (MID) as being in use by these agents. Commissioner
George Dale urges all Medicare recipients that if you find yourself in a
similar scenario, such as the ones described below, a red flag should go
up and you should contact the MID immediately. Scenarios that are proving
to be of particular favorites to the agents using abusive sales practices
1). The agent will actually claim to be from Medicare. In many instances,
the agent will present a red, white, and blue card that looks like a
Medicare recipient's card.
2). The agent will have the Medicare recipient fill out a "request for
more information," form, when in fact the "request" form is actually an
enrollment form for whatever Part C or D plan the agent is selling.
3). The agent will ask the Medicare recipient to sign a form "just to show
[my] boss" the agent contacted the recipient.
4). The agent assures the Medicare recipient that enrollment will not
affect his/her Medicare coverage. While this may be true of some portion
of Medicare plans, MID is finding that the recipient no longer receives
benefits under traditional Medicare Part A and B policies. Often the
recipient discovers this fact when a health care provider informs them
that Medicare has declined to pay a charge.
5). The agent tells the Medicare recipient that enrollment in the plan he
or she is selling will not cost anything. Nothing is free. The agent
receives a commission from the sale and premiums will be collected from
6). In a particularly serious case, MID found that several recipients had
no knowledge of being enrolled in a Medicare Part C plan, and had never
had any contact at all with the agent responsible for enrolling them. It
is believed that the recipient's personal information was obtained
fraudulently, and was used on the plan enrollment forms.