MARKETING SCAMS SUCK SENIORS INTO MEDICARE ADVANTAGE MORASS A NEW REPORT FOUND 9,500 DAILY TV ADS DURING OPEN ENROLLMENT IN 2022, AND 30% OF SENIORS RECEIVED AT LEAST SEVEN PHONE CALLS WEEKLY FROM MARKETERS

Several months ago I wrote about what I called the bad idea behind Medicare Advantage plans, despite their popularity, which is fueled by an unprecedented advertising blitz during each fall's open enrollment period.

"Since its enactment in 1965, Medicare has functioned well with administrative costs far below those of private insurers, who are part and parcel of America's dysfunctional health care industry," I wrote. "Why Congress decided it would be a good idea to let private insurers get their noses under the Medicare tent is testament to the lobbying power that controls so much of Washington."

The column pointed to a Washington Post investigation into how some people on so-called Advantage plans wind up owing medical bills that would have been covered by traditional Medicare. What many enrollees don't realize is that many of the Advantage plans restrict them to approved networks, unlike traditional Medicare, which allows them to see any doctor of their choice.

I added that Physicians for a National Health Program released a report titled "Our Payments Their Profits," showing that insurance companies offering Medicare Advantage plans are overpaid by up to $140 billion a year by Medicare, overpayments that could instead be used to lower premiums for traditional Medicare coverage or, at least, to extend the life of Medicare itself.

Now comes a major report entitled "The Great Medicare Advantage Marketing Scam" by The American Prospect, in cooperation with Health Care uncovered, a website that covers America's health care industry. It explains how for-profit health insurers convince seniors to enroll in private Medicare plans, which currently cover more than half of people eligible for Medicare.

"Seniors face a torrent of Medicare Advantage advertising: an analysis by KFF (Kaiser Family Foundation) found 9,500 daily TV ads during open enrollment in 2022," the report noted. "A recent survey by the Commonwealth Fund found that 30% of seniors received seven or more phone calls weekly from Medicare Advantage marketers during the most recent open enrollment (Oct. 15 to Dec. 7) for 2024 coverage."

The report added: "The marketing for these plans nearly always fails to mention how hard it is to return to traditional Medicare once you are in Medicare Advantage, and that the MA plans have closed provider networks and require prior authorization for medical procedures. Instead, the marketing emphasizes the fringe benefits offered by Medicare Advantage plans like gym memberships."

The article described third-party marketing organizations, which includes brokers that call beneficiaries multiple times a day for days in a row.

Among the prominent third-party marketing organizations, the report noted, is "TogetherHealth," a subsidiary of Benefytt Technologies, which runs those familiar ads featuring former football star Joe Namath.

In August 2022, the Federal Trade Commission forced Benefytt to repay $100 million for fraudulent activities. The month before, the Securities and Exchange Commission levied more than $12 million in fines against Benefytt.

But, the report added, the Center for Medicare and Medicaid Services (CMS), the government agency that administers the health care benefits, continues to allow Benefytt to work as a broker.

David Lipschutz, associate director for the Center for Medicare Advocacy, pointed out that the profits generated by Medicare Advantage plans explains what drives the aggressive and often unethical marketing practices.

"The fact is, there is an increasingly imbalanced playing field between Medicare Advantage and traditional Medicare," he told the American Prospect. "Medicare Advantage is being favored in many ways. Medicare Advantage plans are paid more than what traditional Medicare spends on a given beneficiary. Those factors, combined with the fact that they generate such profits for insurance companies, leads to those companies doing everything they can to maximize enrollment."

In other words, these private insurance companies aren't in it just for the fun.

Lipschutz contended that what adds to the problem is the enormous influence of the health insurance industry in Washington. Health insurers spent more than $33 million lobbying Washington in just the first three quarters of 2023 alone.

"There is no real organized lobby for traditional Medicare, or organized advertising efforts," he told the magazine. "During open enrollment, 80% of Medicare-related ads have to do with Medicare Advantage. We regularly encounter very well-educated and savvy folks who are tripped up by advertising and lured in by the bells and whistles. The deck is stacked against the consumer."

Sheldon Toubman, an attorney with Disability Rights Connecticut, has filed complaints with CMS about the bad marketing practices by the Medicare Advantage industry.

"I have been aware for a long time of basically fraudulent advertising in the MA insurance industry," Toubman told HEALTH CARE un-covered. "There's an overriding misrepresentation - they tell you how great Medicare Advantage is, and never the downsides."

And it's working for the private companies who have been part and parcel of the convoluted health industry that has evolved in the U.S. and leaves millions underinsured and uncovered.

Congress should never allowed this to happen to a successful program that been a lifeline for millions of America's senior citizens.

It's time that it fixes it.