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  • Writer's pictureTom Cianflone

Avoid these Medicare Enrollment Scams


medicare enrollment scams

Just like other scams, Medicare enrollment scams are rampant today. Here are three you can easily recognize and avoid with the information I'm about to give you.


Being Pushed into Medicare at Age 65

Mostly everyone is eligible for Medicare at age 65. But that does not mean you have to enroll in Medicare at age 65. From a scamming Medicare agent perspective, unless you are enrolled in Medicare Part A and Part B, they can't sell you anything. So naturally they want you to enroll as early as possible.


But you DO NOT have to enroll in Medicare at age 65 if: You are working past age 65 and are covered by employer group health and your employer has 20 or more employees. Employer group health plans offered by employers with 20 or more employees are considered "creditable coverage" by Medicare, meaning, they offer coverage that is equal to or better than Medicare. This means you can continue on these plans and not switch to Medicare health coverage if it doesn't make sense to do so. Whether it makes sense to keep employer group health or switch to Medicare is a purely financial decision and I can help you compare your options to see if Medicare is a better deal for you or not. If you continue with employer group health, you will have a special enrollment period (SEP) available to you when you decide to leave employer group health that will let you enroll in Medicare after age 65 without a late enrollment penalty.


Being Pushed into a Medicare Advantage Plan without Understanding your Original Medicare Option

If you're talking to an agent about Medicare and the only plans they are showing you are Medicare Advantage plans (aka, Part C plans), leave and leave quickly. When you first enroll in Medicare, you have two options for additional coverage:

  1. Keeping Original Medicare and adding a Medicare Supplement and prescription drug plan (PDP)

  2. Replacing Original Medicare with a Medicare Advantage plan administered by a private carrier (Aetna, UnitedHealthcare, Humana, many others)

Scammer type Medicare agents won't even tell you about your option to remain on Original Medicare because they get paid much more money up front for Medicare Advantage plan enrollments compared to the commissions on Medicare Supplement plans.


Here in South Florida, Medicare Supplement plan premiums are not cheap but are still in reach for many. It's not up to an agent to decide that staying on Original Medicare with a separate Supplement and PDP is something you don't need to know about. You need to know all your options and then make a decision that is right for you depending on your medical and financial situation. This is the most important decision you will make when deciding on additional coverage once you're enrolled in Medicare. It's a decision that will make all the difference in how you experience Medicare. My approach is to educate my clients on all options including the pros and cons of Original Medicare vs Medicare Advantage and then help you make the best decision for you.


Being Duped into Switching Plans During AEP/OEP

All Medicare Advantage plan members can change plans during the annual enrollment period (AEP, October 15 through December 7) and during the open enrollment period (OEP, January 1 through March 31). While the rules for AEP and OEP differ, for the purposes of this post the important thing is that plan members can make a plan change. Scammer Medicare agents know this and are particularly active during these periods. And these are the periods in which you will be bombarded by Medicare ads on TV and through the mail. Their only goal? To get you to doubt the Medicare plan decision you already made and then call an 800 number or to provide contact information via an online form. Once you do that, you've given them what Medicare calls "permission to contact" and the calls and emails will never stop.


Once they have you on the phone, their only goal is to get you to switch plans. Call center agents get paid for the switch, period. They will try to convince you to switch by dangling the "extra benefits" of Medicare Advantage plans before you: allowances for food, gas, utilities, whatever it takes. They may tell you that your doctors are in network for the plan even though they are not. They may tell you that your medications are covered by the plan even though they are not. And once they get you to switch, you won't ever hear from them again. I know that this happens because I get the calls after reality sets in and the plan member realizes they've made a huge mistake.


How to Avoid Medicare Scams

Simple: Don't call 1-800-ANYTHING and don't provide your contact information online. If you get an unsolicited call about Medicare, hang up. Work with a trusted local agent. Contact me anytime if I can be of assistance.

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