The Medicare Open Enrollment Period is a time when dishonest salespeople will try to get vulnerable seniors to buy insurance without understanding exactly what they're purchasing. Some real-life examples:

  • An insurance agent visited a senior living residence and went door-to-door trying to sell seniors Medicare Advantage plans.
  • A salesman parked his company van in a grocery store parking lot, set up a table and gave away free t-shirts and mugs to seniors who signed up for a Medicare Advantage plan.

Both of these tactics are not only dishonest but also illegal, says Fred Riccardi, director of programs and outreach for the Medicare Rights Center, a non-profit organization that helps people understand the Medicare system.

The Open Enrollment Period in 2016 could be especially confusing, given that it may partially coincide with the enrollment period for the Health Insurance Marketplace. Be aware that Medicare beneficiaries are not allowed to enroll in a Marketplace plan and it is against the law for someone who knows that you receive Medicare to try and sell you a Marketplace plan.

The best way to avoid being taken advantage of, according to Mr. Riccardi is for seniors and their families to "always be cautious and arm themselves with as much information as possible before buying a plan."

  1. Don't feel pressured to buy anything on the spot.
    If an agent tries to rush you, be suspicious! Tell the agent you need more time.
  2. Never sign anything you don't understand.
    Don't sign anything unless you know what you're signing. Read what you are asked to sign before you sign it. Never sign a blank application form.
  3. Don't give permission if you don't want calls.
    It is illegal for agents to "cold call" without your permission. If you haven't requested a call, hang up. If you meet an insurance agent at an event, don't sign a "request a contact form" unless you want someone to call you.
  4. Ask clear questions.
    If you make an appoint to discuss Medigap, it is illegal for an agent to try to "up-sell" you to a Medicare Advantage Plan. Be sure you understand what exactly the insurance agent is offering. Ask the direct question: "What type of policy is this? Is it a Medigap or Medicare Advantage?"
  5. Know what you're buying.
    A Medicare Advantage Plan is different than a Medigap policy. It changes the way you receive your healthcare coverage. It may be very difficult or even impossible to "undo" your selection later.
  6. Ask for a summary of benefits.
    Also known as Evidence of Coverage, this document is available for your review before purchasing an insurance plan. It includes information on what is covered, premiums, co-pays, and what prescription drugs are covered.
  7. Know who you're dealing with.
    Make sure the agent is licensed. You can verify an agent's status with your state's department of insurance. However, be aware that there is no such thing as an "official Medicare agent." Medicare does not have sales agents. An insurance salesman cannot represent themselves as a representative of Medicare, nor can they say they are endorsed by Medicare.
  8. Be wary of extras.
    If you listen to a presentation on Medicare Advantage plans or a prescription drug plan, keep in mind that an agent who tries to sell any insurance beyond those plans (such as long-term care insurance, or a Medicare Advantage plan when you have only requested information on Medigap plans) is acting illegally.
  9. Talk to your doctor.
    Make sure your doctor accepts any plan you are considering. If your doctor isn't "in-network" for a Medicare Advantage Plan, you will have to change doctors.
  10. Keep records.
    Do not pay cash. Always pay by check or money order so you have a clear record of payment. Make checks payable only to the insurance company or insurance agency, not an individual agent. Insist on a receipt. Get the name and address of the agent and the insurance company and know how to contact them if you need help.

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