AG warns of Medicare Advantage plan pitfalls

Tuesday, October 21, 2008

LITTLE ROCK -- Last year, the Attorney General, in partnership with the state's Insurance Commissioner, undertook a public awareness effort to warn Arkansas's Medicare beneficiaries of deceptive marketing practices by Medicare Advantage salespeople.

Recently, the Attorney General's Office has learned that salespeople are going door-to-door in the Helena-West Helena area selling Advantage plans. While there are no reports of deceptive practices at this time, Attorney General Dustin McDaniel issued this consumer alert to encourage vigilance on the part of Arkansas's seniors who may be considering enrolling in a Medicare Advantage plan.

Advantage marketing practices target senior citizens who are trying to select the Medicare prescription drug plan or Medicare Advantage plan that will suit their needs. For certain Medicare beneficiaries, Medicare Advantage plans may provide more drug coverage, fewer out-of-pocket expenses or even more services. These make sense for some Medicare recipients, but not all of them. And some plans, while appropriate for some consumers, are not appropriate for others.

Seniors should be extra cautious when considering a Medicare Advantage plan. Hearings and investigations conducted by Congress have found evidence of misrepresentation and outright fraud on the part of some private insurance agents selling such plans, the attorney general warned. For instance, some Medicare Advantage salespeople make promises that are untrue, including offering eligible enrollees cheap or even free access to prescription drugs, he said.

Additionally, the salespeople may fail to disclose vital information, such as the fact that sometimes coverage cannot be terminated at will and that enrolling in an Advantage plan jeopardizes standard Medicare coverage. Worse yet, some seniors sign up for plans that they later find out that they cannot afford or that their doctors won't accept, McDaniel said.

Consumers considering making any changes to their health care coverage, especially those considering enrolling in a Medicare Advantage plan, should remember the following tips:

* Make sure you read and understand the fine print of all marketing materials and enrollment forms you sign;

* Federal law prohibits the door-to-door marketing of Medicare Advantage plans;

* Contact your current or potential health care provider to see if he or she accepts the Medicare Advantage plan you are considering. You can also contact the Arkansas Insurance Department's Senior Health Insurance Information Program (SHIIP), which provides free one-on-one counseling, education, and information to individuals of all ages with Medicare;

* Don't let your emotions cloud your good judgment. If it sounds too good to be true, it probably is;

* Do not simply rely upon the advice of a salesperson before making important decisions that affect your health coverage. Conduct your own investigation and make sure the plan is suitable to your needs; and

* Contact the AG's office or log on to their Web site to obtain a free copy of the Medicare Advantage Toolkit to learn steps to safeguard your Medicare.

To obtain a copy of the Medicare Advantage Toolkit, call the Attorney General's Office at (800) 482-8982 or log on to the Web site,

To lodge a complaint against a Medicare Advantage plan insurance agent, Arkansans are encouraged to contact SHIIP representatives at (501) 371-2782 or toll-free, statewide at (800) 224-6330. More information can also be found by logging onto the SHIIP Web site, http://insurance.

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