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BEACON Senior News - Western Colorado

Opinion: Confused about Medicare?

Jan 27, 2023 10:13AM ● By Janet Trautwein

Medicare’s annual enrollment period just ended, and it was all but impossible to miss the commercials featuring celebrities pitching Medicare Advantage plans to seniors. 

Hall of Fame quarterback Joe Namath told seniors they can get extra Medicare benefits by calling a 1-800 number. Actor Jimmie Walker advised them to “call now” to check whether they’re eligible for plans that could be “Dyn-O-Mite.” William Shatner implored them to get the benefits they deserve.

The ads are enticing—and sometimes misleading. Centers for Medicare and Medicaid Services (CMS) received over 41,000 consumer complaints about misleading Medicare marketing tactics last year, a 165% increase from 2020.

In response to complaints, CMS recently issued more stringent requirements for companies advertising on behalf of Advantage, the privately administered plans that are an alternative to traditional Medicare, and Part D prescription drug plans.

But more oversight is sorely needed. The new CMS marketing rule may end up depriving seniors of access to licensed to “third party” Medicare-certified independent agents and brokers who can help with enrollment. 

The Department of Health and Human Services (HHS) must press pause on the new rule.

Persuading seniors to sign up for Medicare Advantage and Part D is big business. Seniors have understandably grown frustrated, as some don’t realize until after they’ve enrolled that their current doctor isn’t in their new insurance plan’s network, or that the extra “benefits they deserve” aren’t actually available in their region. 

That CMS reforms are all well-intentioned, but part of the rule could swiftly undo any progress in the fight against unscrupulous marketing tactics by bad actors. 

The rule expands the definition of third-party marketing organizations to include local agents and brokers. There’s been little clear guidance from HHS about what actually constitutes an enrollment call. So many agents and brokers, who often spend hours exploring a beneficiary’s unique circumstances and combing through potential plans for the best fit, are preparing to record every conversation they have with clients.

That requires equipment that can record and store hours-long audio files for years at a time and do so securely, to comply with federal privacy laws. 

That’s cost-prohibitive for many small agencies and brokerages. Further, some seniors don’t want their enrollment calls recorded, given that they touch on personal information.

Seniors who have relied on agents and brokers for decades now face the prospect of having to sign up for Medicare without their expert counsel.

Federal officials can stop that from happening by pausing implementation of the rule and developing new reforms that protect seniors from bad actors without jeopardizing access to agents and brokers.

Medicare’s annual enrollment is October 15-December 7, but those approaching 65 have a window to sign up around their birthday. HHS can ensure seniors have the ability to enroll in plans that best fit their needs and budget. But it has to act NOW! 

This article originally appeared in the South Florida Sun Sentinel. 

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