State Insurance Commissioner Warns Seniors of Medicare Scams
From: State Insurance Commission   Filed 12/20/06 GCN

Commissioner of Insurance George Dale today cautioned Mississippi senior citizens that, according to complaints received by the Mississippi Insurance Department (MID), some agents are using a variety of confusing and deceptive sales practices to sell Medicare-related Part C and D plans. According to the 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.

Dale urged all Medicare recipients and their family members to be vigilant when selecting a Medicare Part C or Part D plan and if an agent uses abusive sales practices, to contact the Mississippi Insurance Department immediately. He also reassured all Medicare recipients that the MID is working closely with state and local law enforcement agencies to identify and locate agents and companies using abusive sales practices. The investigations have already resulted in the revocation of the license of one agent, while a number of other investigations are on-going.

"While there are many good agents who provide a valuable service, some are taking advantage of our seniors and other Medicare recipients, preying on some of the most vulnerable citizens in our state.  These citizens are particularly susceptible to abusive sales practices. This Department is mindful of how confusing and difficult it must be for the many Mississippi Medicare Part C and D recipients trying to select a plan from the various coverages that are offered. 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 Dale.

Companies offering Medicare plans are subject primarily to federal regulation. In particular, there are 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 to the MID 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. Contact MID immediately or have a family member do so.
                                           
"The number of calls we receive is growing daily.  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," Dale said. Dale is quick to point out, however, that these plans could be beneficial to some people, and not all agents are engaging in these deceptive practices.

Anyone who suspects they have been the victim of one of these Medicare scams is urged to contact MID as soon as possible at 1-800-562-2957.

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 include:

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 has been completely disenrolled from Medicare Part A and B. 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 policy holders.

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.