Buyer Beware: Medicare Open Enrollment Brings Out Scammers & Con Artists

Every year, Medicare’s “Open Enrollment” period runs from October 15 – December 7.  During this time, Medicare enrollees can switch their Medicare health plans and prescription drug coverage to plans that better meet their needs. That includes changing from traditional Medicare coverage to a Medicare Advantage plan (or vice versa). The private Medicare Advantage providers want your business and aren’t shy about asking for it, so be prepared for phone calls, direct mail, emails, online ads, and even personal visits from insurance agents.

But buyer beware: scammers and identity thieves are definitely in the mix, and aggressively pursue their targets. Know the warning signs before you divulge any personal information.

Take Advantage of Open Enrollment

It’s important to look at your coverage every year because providers are allowed to change the costs and coverage limitations every year.  If you don’t stay on top of changes, you could accidentally lock yourself into a plan that doesn’t cover necessary medications or forces you to switch doctors. You may also find a plan that costs less. In 2016, a Kaiser Foundation study reported that 78% of people stayed in their current plans during Open enrollment, but many of those who switched to new plans enjoyed cost savings:

Medicare Advantage enrollees who switch plans reap some benefits by shifting to plans with lower average premiums ($17.51 per month lower, on average) and lower out-of-pocket limits ($401 lower, on average) than they would have paid had they remained in the same plan.

According to a recent New York Times article, one reason people stick with their current coverage is the difficulty of shopping for plans: all the options and fine print just seem overwhelming. This year, Medicare launched its new, redesigned Medicare Plan Finder web site, but the updated received criticism for its lack of detailed information on health care providers covered by competing Medicare Advantage plans.

“Some plans give customers access to online search tools to look up a particular doctor or hospital,” Ms. Neuman said. “Others send out a PDF of a big, fat directory that you can look through.” Directories often can be outdated or contain errors, studies have found. So it makes sense to ask your doctors and other providers directly if they participate in any plan you are considering.

Remember that Medicare authorized new rules and coverages in 2019 that can help seniors age in place and save money. Changes included coverage for in-home care and coverage for seniors in assisted living facilities. Not all plans offer these new benefits.  That’s another reason you should review coverage options every year and look for better deals!

Beware of Common Medicare Identity Theft & Fraud Schemes

Scammers know that many people are confused by all the options, and they’re ready to “help!”

Help themselves, that is – at your expense.  Here’s how they do it.

• Impersonation: While you can request a call if you have a problem/question, Medicare never calls you uninvited and asks for personal information. Scam callers, however, may use official sounding names like “Medicare Benefit Center” or “Medicare Enrollment Center” and even spoof caller id numbers to make it look like an “official” call.
• Threats: Some callers try to scare enrollees by threatening benefit reductions or even revocation of benefits if the victim doesn’t supply personal information immediately. They may say you owe for a specific service or benefit, or even have to pay a fine. Medicare will always bill you directly; they don’t place collection calls.
• New Medicare number. Medicare is in the process of issuing every enrollee a new “Medicare number.”  That’s because it previously used social security numbers, and there were many security problems with that. This process happens automatically and should be complete by the end of 2019.  You don’t have to request a new number and certainly don’t have to pay to get one, but scammers may try to convince you to give them your current information and warn you that you’ll lose your benefits if you don’t comply.
• Fake Refunds and/or Freebies: You may receive notification that you’re eligible for extra benefits or “freebies” like health screenings, scooters, home safety equipment, etc. All you have to do is supply your personal information and Medicare number. Be very careful: these scams often involve Medicare fraud, which is a serious problem – and a crime. The scammer takes your information and bills Medicare for services you didn’t actually receive.  Medicare offers guidance about how to spot and report fraud.

Get Information From an Unbiased Source

During Open enrollment, you’re also likely to receive numerous calls from perfectly legitimate insurance agents.  There’s nothing wrong with talking with them – as long as you realize that they usually have a specific plan in mind for you already.

It’s always better to learn about coverage options and benefits from an unbiased source. Here are several:

• Medicare insurance brokers are independent agents who represent multiple insurance companies. Learn more about how to choose a Medicare insurance broker.
• Medicare Questionnaire from the National Council on Aging is a short online form that can help you connect to resources and research Medicare plans. It can also refer you to a local advisor who will work with you personally to find the best plan.
• SHIPs (State Health Insurance Assistance Programs) operate in all 50 states, with funding provided through grants from the Centers for Medicare and Medicaid (CMS). SHIPs provide free, in-depth, unbiased, one-on-one health insurance counseling and assistance to Medicare beneficiaries, their families, and caregivers.

Remember: Medicare Open Enrollment begins October 15 and closes December 7 each year. Start researching your options early to find the best plan for your needs.

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