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Know your rights during Medicare Open Enrollment

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During Medicare’s Open Enrollment Period (OEP), which ends December 7, Medicare beneficiaries can choose the plans that are best for them. You can get help comparing Medicare plans from the State Health Insurance Assistance Programs (SHIPs) that are in all U.S. states and territories. It’s also good to understand what sellers are — and aren’t — allowed to do, so you’ll be prepared if an insurance agent or representative tries to enroll you in a Medicare plan that isn’t right for you.

There are limits on how Medicare plans can contact beneficiaries. Medicare plans:

  • Can’t call you if you don’t have a relationship with their company.
  • Can’t send you email if you haven’t agreed to this form of contact.
  • Can’t come to your home to sell Medicare products without an invitation.
  • Can’t leave flyers, door hangers, or leaflets on your car or at your home. However, agents and brokers who have a scheduled appointment with you may leave plan information at your residence if you don’t show up for the appointment.

When you meet or talk with an agent, they:

  • Can’t start a discussion about other insurance products, like life insurance annuities, if your meeting is about Medicare Part C or Part D.
  • Can’t set their own time limits for you to sign up for a plan. You have until December 7 to enroll, and you can’t get any extra benefits for signing up early.
  • Can’t threaten to take away your benefits if you don’t sign up for a plan or offer gifts if you do.
  • Can’t suggest that Medicare endorses or prefers their plan.
  • Can’t discuss Medicare products you didn’t ask to talk about when you filled out a scope of appointment form.

Once you’ve picked the plan that’s right for you, be sure you get all the details in writing before signing up. Take your time to read all information and verify details. For example, reach out to your doctors to ensure they are in that plan’s network.

If a scammer calls

Scammers might call and pretend to be Medicare representatives or agents in an attempt to steal your Medicare number. They can use fake caller identification to impersonate Medicare or another organization you know, so don’t trust the name displayed on your phone’s screen. If anyone calls and asks for your Medicare, Social Security, or bank or credit card information, hang up. A scammer can use your personal information to file false claims, sign you up for a plan to which you didn’t agree, or even steal your identity. A legitimate Medicare employee will always have your Medicare number on file.

For more information about Medicare fraud, errors, or abuse, visit smpresource.org. To report someone pretending to be from Medicare, call 1-800-MEDICARE and visit ReportFraud.ftc.gov.

Blog Topics: 
Health & Fitness

Comments

Thank you for this! I am just now at that age where I am mandated to sign up for Medicare (Part A). I spent several days during my vacation trying to navigate through the mounds of information!

I have no idea what happens to those folks who have trouble deciphering and trying to work through this mess called "Medicare." It's ridiculous.

At 65, we're supposed to be losing our "edge" - yet it almost takes an insurance salesperson to wade through it all. Also, I have an issue with our "government" provided healthcare making us seek out a for-profit entity (insurance company) in order to plug the holes of Part A and Part B.

You can choose to purchase a Medigap or supplemental insurance plan, but the government doesn’t require you to buy additional coverage. A supplemental insurance can help cover the remaining 20% of costs after Medicare has paid.

If you would like to explore other Medicare arrangements, like Medicare Advantage plans that cover different services, now is the time during Medicare's Open Enrollment period. Reach out to your local State Health Insurance Assistance Program (SHIP) by visiting their website and setting up a free and unbiased counseling appointment: shiptacenter.org/about-medicare/regional-ship-location

Thank you so much for this informative information. I have Ben violated, but didn’t realize it until you sent this email. I have received calls, mail, etc, even though I’m on the National Do Not Call, mail, email or text lists. What do we do when there is a violation?

Please report unwanted calls and recorded calls (or "robocalls") to the FTC at www.ReportFraud.FTC.gov.

I'm going to be 65 in May of next year. I'm not suppose to sign up until next year, right? I think it's February (month1) to end of August (month 7) with May being Month 4. So, it's not until NEXT year that I need to think about Open Enrollment...right? In February, I get to think about initial enrollment. Since I'm still working, I can use my employer-provided health care (the employer said so). Can we get a "What to know if you turn 65 soon..." (PLEASE!) and thank you!

You can read how to Get Started with Medicare at Medicare.gov.

What about the recording phone calls from pharmacy I usually use and the MEDICARE supplement insurance company that I signed up for this year. I reported to FTC one time for the pharmacy's corporate office using recording voice messages and kept calling to me asking for the refill of medication. It's been so annoying, and even after reporting it to FTC, the calls have yet to stop. I feel like I do not want to sign up with them for the next year enrollment.

Even when your number is on the Do Not Call registry, a business may leave you a recorded message that's strictly informational. You could call the pharmacy and tell them you don't want to get phone reminders. Some businesses give customers a choice about how they want to be contacted.

I already have my secondary insurance... have for a year and over this past year and especially now I must get 10 to 20 calls a day trying to sell me insurance plus email and regular mail. This is harassments from all the agencies. I block their numbers so they just use another number to call from. THIS IS HARRASSEMENT!!!

You can report those unwanted calls and recorded calls (or "robocalls") to the FTC at www.ReportFraud.FTC.gov.

It is a waste of time to report these calls. They come from fictitious numbers that fool my caller ID into thinking that the call is from a local number (usually one that has been disconnected). They also give me fake company names. The Public Service Commissioner says there is no way to track them down. Just hang up.

Reporting unwanted calls does help the FTC and law enforcement. The FTC analyzes report data and trends to identify illegal callers based on calling patterns.

The FTC takes the phone numbers you report and releases them to the public each business day. This helps phone carriers and others working on call-blocking and call-labelling solutions. Your reports also help law enforcement identify the people behind illegal calls.

This is the best news that I have read since opening enrollment begin. It is like they Medicare are pushing people to enroll in Humana & United Health Care. Thanks for the information. Faye

Jill is so right. I help my parents (87 and 84 years of age now) every year with open enrollment and I am so confused. I can only imagine how hard it is for the elderly that have no one to help them. Our government needs to do something to streamline this issue. And yes, it is not a requirement for them to have the supplemental, but the threats they get about not being able to pay for things without it is ridiculous and should be illegal. Nor, should a person be penalized and have to pay more for coverage at a later date if they don't get a supplement when they first start receiving Medicare benefits. That should be ILLEGAL!! Our government has a long way to go regarding health coverage no matter what party wins the election! I hope someone has a plan that is beneficial to all!!

Good Morning. I turned 67 in September 2020. I started receiving my Social Security when I turned 66 in 2019. However, someone registered me for Medicare Part A, effective September 2018; however, I didn't receive my Medicare card until after I started receiving Social Security in 2019. I didn't want to apply for Medicare Part A&B at this time because I am still working for the State Highway Administration and covered under their Health Insurance Plan. In the meantime, I am receiving dozens of requests to join their insurance plans.

What should I do now that I have been pushed into Medicare Part A?

Should I stay with my current company health insurance? They are also in the process of open enrollment.

I read that I have to apply for Medicare Part B now. Is that correct?

Please help!!

You can get help comparing Medicare plans from the State Health Insurance Assistance Programs (SHIPs) that are in all U.S. states and territories.

Why do plan "Yearly Drug & Premium Cost" amounts change during the enrollment period? And why are they *allowed* to change? Shouldn't they be "locked in" once submitted by the insurance company to the Medicare website? I have been comparing for several weeks and for the SAME PLAN, amounts have changed from week to week within the enrollment period! I have the screenshots to prove it? Why does this happen and why is it allowed?!

You can talk with someone from your State Health Insurance Assistance Programs (SHIP) about that. There are SHIPs in all U.S. states and territories.

How can I resolve a discrepancy between a medication's Tier as reported on the Medicare website and the same medication within the company's formulary? On Medicare.gov, a Plan says a med is a Tier 2 Drug but in their own formulary for the same Plan and the same play year, it shows that it will be a Tier 4 drug. I contacted the Plan, itself, without any satisfaction. Why are the insurance companies allowed to do this - to lure you into selecting by promoting a med as a lower-tiered drug than in their formulary? And once you are in the Plan year, when you purchase the drug, which Tier will "win" when the invoice arrives? Will the member/customer win the dispute with screenshots of the Medicare "advertised" Tier?

You can talk with someone from your State Health Insurance Assistance Programs (SHIP) about that. There are SHIPs in all U.S. states and territories.

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