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5 Illegal Insurance Practices During Medicare Open Enrollment

Insurance agents are prohibited by law from using aggressive or deceptive sales practices to lure seniors into buying insurance policies…but that doesn't mean it doesn't happen.

Fred Riccardi, director of programs and outreach for the Medicare Rights Center (, a non-profit organization that helps people understand the Medicare system, says seniors and their families should be aware of what agents can and can't do, so they can spot dishonest practices right away.

During his years counseling Medicare beneficiaries, Mr. Riccardi saw that while the majority don't break the rules, some salespeople use dishonest, misleading or illegal sales tactics.

Here are some things insurance agents cannot do:

No cold calling. Agents cannot go door-to-door or call you at home, unless you've given them prior permission to do so.

No official Medicare sales reps. Be wary of any salesperson who says that he/she is a Medicare representative. Medicare does not send "representatives" to solicit your business. Private insurance companies sell Medigap and Medicare Advantage and are not official representatives or endorsed by Medicare.

No marketing in care or educational settings. Medicare products cannot be marketed in places where health care is delivered (such as a doctor's office, clinic, or pharmacy counter) or at an educational event. Although insurance agents can participate in an event, they cannot directly enroll you in a plan at that event.

No such thing as a free lunch. Federal regulations prohibit offers of free meals for listening to a sales presentation or for signing up in a particular plan. Gifts can't have a value of more than $15.

No overselling. Federal regulations prohibit selling additional insurance products during sales or marketing presentations.For example, if a senior requests information on Medigap, an insurance agent can't recommend a Medicare Advantage plan instead.

What to do about it.

Seniors do have rights. If you have been approached by a salesperson who acts inappropriately or aggressively, or if you've been enrolled into an insurance plan against your will, call 1-800-Medicare and file a complaint. Also, file a grievance with your state department of insurance.

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