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Medicare Open Enrollment is prime time for fraud

To The Leader

 

It’s that time of year again. Open enrollment for Medicare Part D and Medicare Advantage plans starts October 15 and runs through December 7.  

It is so important that you review your Medicare Part D plans and your Medicare Advantage plans (if you have one) every year.  Plans change and you want to make sure your prescriptions and doctors (for Advantage Plans) are still in your network.   

The changes you can make during Medicare’s Open Enrollment include:

  • Joining a new Medicare Advantage Plan or Part D prescription drug plan
  • Switching from Original Medicare to a Medicare Advantage Plan
  • Switching from a Medicare Advantage Plan to Original Medicare (with or without a Part D plan)

You should always shop for a new drug plan and Medicare Advantage plan each year to ensure you are getting the best coverage for the best price to suit your needs.  You can shop and compare plans at www.medicare.gov. Get a family member to help if you don’t use the Internet or call the State Health Insurance Assistance Program at 800-252-9240 and speak to a qualified Benefits Counselor.

Medicare Part D Enrollment Scams to look out for:

  • Medicare or a health plan calls and wants to send you a new health card for $299.
  • You receive a call about a refund from last year’s premiums or your drug plan cost.
  • An agent tries to sign you up for plan that you don’t need, isn’t right for you, or doesn’t even exist.
  • Watch out for fake RX cards offering big discounts with little or no benefits.
  • You receive a call offering big discounts on a new health insurance plan

Agent/Broker Prohibited Behaviors

  • Agents may not state they are from Medicare or use the term “Medicare” in a misleading manner.
  • Agents may not approach beneficiaries in public – beneficiaries must approach the agent at public events or healthcare settings
  • Agents are not allowed to conduct marketing or sales activities in healthcare settings except in common areas.  Restricted areas include, but are not limited to exam rooms, hospital patient rooms, dialysis centers and pharmacy counter areas.
  • Agents cannot send unsolicited text messages and leave voicemail messages. However, agents may call or visit beneficiaries who attended a marketing or sales event when prior permission is given and documented.

Tips on how to Stop Fraud During Open Enrollment

  • Medicare will never call or visit. Medicare will only send information via postal mail service.
  • Guard your Medicare card and number like a credit card.
  • Don’t give out your Medicare number except to your doctor or other providers.
  • Don’t let someone push you into making a fast decision.
  • If you receive a call, especially from a number you do not recognize or anyone requesting personal information hang up immediately.
  • Know your health care options.  Get help from your family, the Medicare website or your local State Health Insurance Assistance Program (SHIP).
  • No health care plan is allowed to cold call

If you are unsure about a call or want to check out a company, please call us first at 713-341-6141. If you have any questions or want to report a scam please doesn’t hesitate to call us at the Senior Medicare Patrol at 713-341-6184 or 888-341-6187.  If you would like a presentation to your organization or community about the new Medicare Card and possible scams, please contact the Texas Senior Medicare Patrol.