A couple picks a plan based off of Medicare costs after seeing a Medicare Advantage ad

Buyer Beware: Misleading Ads for Medicare Advantage Plans

Navigating Medicare and understanding the many plan options available can be hard. What can make this process even harder, are the misleading and deceptive sales strategies insurance companies use to sell Medicare Advantage and Medicare Part D prescription drug plans.

It is important to be able to identify misleading Medicare Advantage and drug plan ads so that you don’t sign up for a plan that won’t work for you.

Understand Medicare Costs

One way that insurance companies confuse consumers is by claiming that their Medicare Advantage plans cost $0.

While it can be true that the plan costs $0 more than the Part B premium of Medicare, people don’t understand that they still have to pay their Part B premium.

This year the Part B premium is $174.70 a month for most people. So, people buy the plan thinking that the premium is free, but instead, they will have to pay the $174.70 each month.

Also, the deductibles, co-insurance, and out-of-pocket maximums are based on the plan you choose. So, people should check twice when considering a plan advertised as costing $0!

How are Medicare Consumers Protected?

The Centers for Medicare & Medicaid Services (CMS) is the agency that oversees Medicare. CMS has proposed rules to keep insurance companies from using misleading ads. For example, CMS advises people to be careful of ads that:

  • Suggest benefits are available to all who sign up, when only some individuals actually qualify.
  • Mention benefits that are not available in the service area where they are advertised.
  • Claim unrealistic savings, such as $9,600 in drug savings, which apply only in rare circumstances.
  • Market plans without naming a specific plan.
  • Display the official Medicare name, membership card, or logo without CMS approval.
  • Pretend to be from Medicare, which does not make unsolicited sales calls to people.
  • Contact you if you’re an Advantage or drug plan member and you told the plan not to notify you about other health insurance products.

What Can I Do if I Picked the Wrong Plan?

If you believe you chose a plan based on misleading information and now wish to change plans, you can contact CMS or your State Health Insurance Assistance program at www.shiphelp.org or 877-839-2675.

If you are in a position where you signed up for a Medicare Advantage plan that isn’t working for you, there is a one time a year option to change your plan.

The Medicare Advantage Special Enrollment Period allows people who have a Medicare Advantage plan to either pick a different Medicare Advantage plan, or to move to Original Medicare. This period runs from January 1 to March 31.

To learn more about your Medicare options, read our Quick Guide to Medicare, or watch our webinar recording on Medicare 101.

Learn more about Medicare.

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Monica Bryant