MedicarePhD: Medicare Marketing Abuse

Due to the just discussed questionable agendas of both companies and agents, marketing abuse is rampant in the sale of most kinds of Medicare related policies. Because the client is older, often disabled, totally confused by the mountains of information, and sometimes just lazy, this group is an ideal candidate for unscrupulous companies and agents. Realize, we at MedicarePhD are not just discussing individuals turning 65, but everyone over that age who can change policies on an annual basis. The sad result of this unethical activity is that a variety of things can transpire---none of them good.

MARKETING ABUSE

COMPANY ABUSE

In general, the individual companies are not as guilty as their agents, primarily because companies are more in the public eye than the agents in the field. However, remember their agendas and “Caveat Emptor”---let the buyer beware.

For example, a study conducted by the Center for Medicare Advocacy for the Kaiser Family Foundation found that almost 75% of Medicare health policy advertising failed to conform to CMS guidelines. CMS (Center for Medicare Services) is the governmental body responsible for administering and regulating the provision of Medicare services.

All too often, however, the CMS relies on the companies to police themselves and of course that is a problem. Fortunately the CMS has become more aggressive fining one major company a million dollars for unethical marketing practices plus ordered two major firms to cease selling policies until they cleaned up their act. Additionally, they are sending in persons to monitor community meetings for abusive practices.

A second company problem is more an act of omission rather than commission. As discussed previously, many companies allow independent agents to market their products, and these agents are simply not well trained in the details of these plans. Furthermore, some companies fail to adequately train even their in-house agents, and once again commissions are the driving force, not what is best for the consumer. To their credit, the company fined $1 million fired 150 agents and reduced their reliance on independent agents according to a study by the CQ Health Beat News.

Another ploy we encountered numerous times was the result of internet searches. When we first decided to create this self-help site, we searched the net for similar endeavors. Almost without exception when we found an informational site, at the end it turned out to be insurance company driven.

Invariably the site was slanted to favor whatever type of policy that company was promoting, but often it is difficult to determine who is behind it. Generally you are given a number to call for further information or asked to “click here” and low and behold, up pops a company’s Medicare Advantage HMO.

AGENT ABUSE

Many agents make these company ploys seem like child’s play. In a laudable effort, the CMS has outlawed the following practices which more often than not lead to exploitation. Medicare Advantage plans and their agents cannot:

In order for you not to fall prey to some of the aforementioned situations, we will take a look at some of the issues you will have to deal with in interacting with these firms and their agents.

• You can no longer go to your long-time family doctor because you did

not realize they are not on the company’s provider list.

• The plan does not have prescription drug coverage.

• The hospital you have to go to is miles away.

• You pay too much when often times you could have obtained a no

premium policy.

• You lose your right to have pre-existing conditions exempted.

• For commission’s sake, you are simply put into the wrong plan

There are a number of other restrictions but the above are the primary ones of which to be aware. And surprise, surprise---many agents act like they have never heard of these restrictions. For a great offering of marketing abuse case studies, go to Medicarerights.org (Medicare Rights Center website) and click on Medicare Private Health Plan Stories. Also the Center for Medicare Advocacy relates on their site many examples of Medicare Advantage plan marketing transgressions.

You are now starting to wonder, is MedicarePhD ever going to tell me how to decide on a Medicare plan? But hold on, let us first brief you on the best and worst methods to educate yourself before you make that final determination.

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How Do I Educate Myself? >>

• Market their plans in any form of medical facility such as hospital,

pharmacy, doctor’s office

• Ask for personal information such as your Medicare Card number,

Social security number, or credit cards

• Discuss any products you did not request---For example, try to sell

you an HMO or PPO when you requested Medigap information

• Cross-sell you---can’t sell you life insurance or annuities when

discussing a Medicare Advantage plan

• Request any payment over the phone or in person---all plans must send

you a bill