This file is historical in nature. Links and contact information may be outdated and no longer valid.
November 23, 2009
Consumer Tips for the 2009 Medicare Enrollment Period
AUSTIN – It's that time of year again. The annual enrollment period for Medicare Advantage health insurance plans and Medicare Part D prescription drug plans begins November 15 and ends December 31, 2009.
Private companies that contract with the federal Centers for Medicare and Medicaid Services (CMS) offer Medicare Advantage and Medicare Part D drug plans. The plans change each year, and it's up to each beneficiary to choose whether to change or keep the plan for the upcoming year.
CMS adopted rules to guide sales practices and to protect consumers from improper marketing activities. According to the rules that went into effect October 1, 2008, individuals who contact you about any type of private Medicare coverage:
- Must be licensed by the state.
- May not make unsolicited contacts, including door-to-door sales, cold calls or approaching you in a parking lot.
- Must have an appointment in advance before coming to your home.
- Must arrange with you in advance the type of products that will be discussed during a scheduled sales appointment. They may not attempt to sell you other types of insurance coverage other than the type agreed upon in advance.
- May not try to sell you non-health care related products (like a life insurance policy or an annuity) during a sales or marketing presentation of a Medicare plan.
- May not attempt to sell you a plan in a doctor’s office or in a pharmacy.
- May not attempt to sell you a plan at an educational event.
- May not offer you free meals at promotional or sales events.
- May not offer you gifts or other promotional items with a value greater than $15.
Remember: While these plans may be a good deal for some people, they’re not right for everyone. TDI cautions consumers to consider carefully before making any changes to their Medicare coverage. You should have received a notice from your Medicare Advantage or Medicare prescription drug plan that details the changes in benefits and costs to your plan for 2010. Review these changes carefully.
Here are some tips to help you protect yourself:
Verify that the salesperson and company are licensed. It is illegal to sell insurance in Texas without a license. To verify a license, visit the TDI website at www.tdi.state.tx.us or call TDI’s Consumer Help Line at 1-800-252-3439.
Before joining a plan, always personally confirm with your doctor and other providers that they will accept the plan. Don’t take a salesperson’s word for it.
Don’t buy anything from a salesperson who comes to your home uninvited.
Be cautious if you’re not dealing with a trusted agent whom you’ve worked with before. Don’t be fooled if a salesperson claims to be with Medicare or Social Security, even if he or she shows you an official-looking identification card.
Be careful about giving out your Medicare number or other personal information. An unethical salesperson can use this information to remove you from original Medicare and enroll you in a Medicare Advantage plan without your knowledge.
Don’t sign anything you haven’t read and don’t fully understand.
Don’t believe a salesperson or agent who tells you that a Medicare Advantage plan won’t affect your original Medicare coverage. If you enroll in a Medicare Advantage plan, it will provide your health coverage instead of original Medicare. Some salespeople may try to tell you that Medicare Advantage plans are Medicare supplement insurance (commonly known as Medigap). They’re not. Medicare supplement plans fill in the “gaps” by paying some of the costs that original Medicare won’t pay. Medicare Advantage, however, entirely replaces your original Medicare coverage. Your Medigap policy only works with original Medicare.
Take your time to decide. Don’t buy anything from a salesperson who tries to pressure you into making a quick decision. Medicare offers online tools to help you learn about your options and find a plan that’s right for you. Visit the Medicare website at www.medicare.gov or call the Medicare Help Line at 1-800-633-4227.
When meeting with salespeople, ask questions about things you don’t understand. Take notes. Write down the salesperson’s name, address, phone number, and anything he or she told you. It’s a good idea to have a trusted friend or family member with you when you talk to the salesperson.
Before you enroll in a Medicare drug plan, call your pharmacy to make sure the plan covers the prescriptions you take. Visit www.medicare.gov for more information about the Medicare prescription drug benefit and the plans available to you.
Help fight Medicare fraud
If you believe you were misled or pressured into enrolling in a Medicare Advantage plan, or were enrolled in a plan without your knowledge, you have several options. Call the Medicare Help Line at 1-800-633-4227 and explain what happened. Ask to re-enroll in original Medicare or to switch to another plan that better meets your needs. Also, call the plan – not the agent – and report the problem.
Report fraud or other agent misconduct to TDI. TDI is aggressively pursuing disciplinary action against agents who mislead or deceive people to sell Medicare Advantage plans. We need your help to gather information to protect you and other potential fraud victims. To report fraud or misconduct and to file a complaint, visit the TDI website at www.tdi.state.tx.us.
For more information or assistance
If you have questions or need help with an insurance question, call TDI’s Consumer Help Line at 1-800-252-3439.
Area Agency on Aging (AAA) offices statewide can provide one-on-one assistance to people with insurance questions or issues. To speak with an AAA benefits counselor, call 1-800-252-9240. Your call will be routed to the AAA office nearest you.
For more information contact:
Last updated: 04/25/2011
This file is historical in nature. Links and contact information may be outdated and no longer valid.
