Some Sales Tactics On Medicare Advantage Plans Break Federal Law
Clayton Davis says the federal law regarding Medicare Advantage plans is clear.
Private companies cannot call people who have not called them first. Agents cannot knock on a door unless the customer asks them to. Agents can only talk about the kind of plan the customer asked about.
Davis, an attorney who contracts with the Southern Alabama Regional Council on Aging to provide free legal services such as Medicare and Medicaid counseling, said the law exists to protect people from ending up on plans that are not appropriate for them.
Davis and SARCOA are busy this time of year helping people figure out what kind of health plan will work best for them.
Jessica Barefield, human resources and media specialist with SARCOA, said the organization has received calls from people complaining about door to door salespeople trying to sell them a plan. Davis has heard reports of agents stopping people in the streets.
"We want people to be aware that it is not legal for people to go door to door selling Medicare plans," Davis said.
According to Medicare.gov, a Medicare Advantage plan is a type of health plan offered by a private company that contracts with Medicare to provide Part A (hospital insurance) and Part B (medical insurance) benefits.
The plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Most of the plans offer prescription drug coverage.
Davis said a lot of fraud occurred before Congress passed the current law. Some agents misrepresented the plans they were selling.
"We had plans that had no network at all, we had unlicensed people coming from other states," he said. "It was legal to call people even if they were on the 'do not call' list and it was legal to knock on their door without an invitation."
Davis said agents were getting as much as $800 per person as commission.
Under current law, agents are supposed to look for suitable plans for people instead of looking after their commission.
"We've had reports of people calling legitimately and interested in a supplement and regular Medicare, and when the agent got there he tried to sell them a PPO or an HMO and that is illegal," Davis said.
The concern is not every Medicare beneficiary is well educated enough about the plans to make an intelligent decision or to understand that somebody may be trying to sell them something they don't need or is not best for them, Davis said.
People can report possible violations by calling his office, Davis & Associates, at 334-671-3990 or SARCOA at 334-793-6843.
"If they report it to us, we can report it to the people who have to enforce it," Davis said.
He said people need to know that they have the right to not be bothered by agents operating illegally.
"We want the market to run right and not have people cheating," Davis said.
EDITORIAL: Opioid treatment for the poor? That could die with Obamacare
After Hurricane Matthew, price of private living on the rise
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News