Time to right Medicare wrongs

The New York State Office for the Aging (NYSOFA) is urging New Yorkers who may have been misled into enrolling in a Medicare Advantage plan that does not meet their needs to change enrollment to another Medicare Advantage plan, a Part D plan or to return to Original Medicare.
“Making the right health care insurance purchase is difficult enough, given the multiple plans and options available,” said Michael J. Burgess, Director of the New York State Office for the Aging. “Misleading individuals during this process is totally unethical and I am glad that the federal government stepped in to correct this wrong.”
Complaints about improper and aggressive marketing of Medicare Advantage plans have grown steadily in New York State this year. Insurance agents who sell to Medicare beneficiaries have used aggressive and misleading sales pitches that also fail to explain how their plans work.
Examples of inappropriate sales tactics that the NYSOFA has seen include sales agents who tell clients that their private-fee-for-service-plan will allow the beneficiary to use “any doctor” or “go to any hospital,” and agents who inform prospective clients that their plan “pays the portion of the medical bill that Medicare does not pay.” Under the terms and conditions of these plans, the doctor or hospital may not actually be a participant, leaving the client without benefits.
In June, the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, announced a Special Enrollment Period (SEP) for individuals enrolled in private plans who think they were misled by sales materials or agents, to switch to other MA plans or original Medicare.
Under pressure from Congress and advocacy groups, United Healthcare, Humana, WellCare, Universal American Financial Corporation, known as American Progressive Insurance in New York State, Coventry, Sterling, and Blue Cross/Blue Shield of Tennessee, signed a voluntary agreement with CMS to suspend marketing of private-fee-for-service plans, but other providers continue to market the PFFS plans.
For local assistance in answering health insurance questions, New Yorkers are urged to call the Health Insurance Information Counseling Assistance Program (HIICAP) Helpline at 1-800-701-0501. New Yorkers who are enrolled in a Medicare Advantage plan and feel they were misled about the plan should call 1-800-MEDICARE to see if they qualify for the SEP.

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