If a Plan is Engaging in Inappropriate or Misleading Marketing; What Should I Do?Insurance companies selling Medicare private plans must follow certain rules when promoting their products. These rules are meant to prevent plans from presenting misleading information about a plan’s costs or benefits, also known as marketing fraud. Medicare plans are allowed to conduct certain activities. For instance, companies can market their plan through direct mail, radio, television, and print advertisements. Agents can visit your home if you invite them for a marketing appointments. However, insurance agents cannot:

  • Call you if you did not give them permission to do so
  • Visit you in your home, nursing home, or other place of residence without your invitation
  • Ask for your financial or personal information (like your Social Security number, Medicare number, or bank information) if they call you
  • Provide gifts or prizes worth more than $15 to encourage you to enroll (gifts or prizes that are worth more than $15 must be made available to the general public, not just to people with Medicare)
  • Disregard federal and state consumer protection laws for telemarketing, the National Do-Not-Call registry or do-not-call-again requests
  • Market their plans at educational events or in health care settings (except in common areas)
  • Sell you life insurance or other non-health products at the same appointment unless you request information about such products
  • Compare their plan to another plan by name in advertising materials
  • Use the term “Medicare-endorsed” or suggest that their plan is a preferred Medicare plan
  • Imply that they are calling on behalf of Medicare

Additionally, you are being misled if an agent from an insurance company says that you:

  • Must sign up for a Medicare Advantage Plan to get Medicare drug coverage
  • Will pay a higher Part B premium unless you sign up for a certain plan (some plans help pay your Part B premium or charge additional premiums, but your Part B premium will not increase based on your coverage choices)
  • Must invite a plan representative to your home to get information about the plan or to enroll
  • Can switch back to Original Medicare at any time if you are dissatisfied, without providing information about enrollment periods
  • Will receive additional benefits that are actually Medicare-covered services
  • Will receive additional benefits, such as dental or vision, that are actually covered by other insurance you have or are eligible for (such as Medicaid)
  • Will lose your Medicaid benefits unless you sign up for a certain plan

If a plan representative engages in any of these behaviors, save any documented proof of this interaction. You can contact 1-800-MEDICARE, the SMP Resource Center (877-808-2468) or the Inspector General’s fraud hotline (1-800-HHS-TIPS).

Read More: As a Medicare Beneficiary What Other Resources are Available to Me?
Learn About: What is Considered a Grievance?
Return to: Medicare In-Depth

If a Plan is Engaging in Inappropriate or Misleading Marketing; What Should I Do?Insurance companies selling Medicare private plans must follow certain rules when promoting their products. These rules are meant to prevent plans from presenting misleading information about a plan’s costs or benefits, also known as marketing fraud. Medicare plans are allowed to conduct certain activities. For instance, companies can market their plan through direct mail, radio, television, and print advertisements. Agents can visit your home if you invite them for a marketing appointments. However, insurance agents cannot:

  • Call you if you did not give them permission to do so
  • Visit you in your home, nursing home, or other place of residence without your invitation
  • Ask for your financial or personal information (like your Social Security number, Medicare number, or bank information) if they call you
  • Provide gifts or prizes worth more than $15 to encourage you to enroll (gifts or prizes that are worth more than $15 must be made available to the general public, not just to people with Medicare)
  • Disregard federal and state consumer protection laws for telemarketing, the National Do-Not-Call registry or do-not-call-again requests
  • Market their plans at educational events or in health care settings (except in common areas)
  • Sell you life insurance or other non-health products at the same appointment unless you request information about such products
  • Compare their plan to another plan by name in advertising materials
  • Use the term “Medicare-endorsed” or suggest that their plan is a preferred Medicare plan
  • Imply that they are calling on behalf of Medicare

Additionally, you are being misled if an agent from an insurance company says that you:

  • Must sign up for a Medicare Advantage Plan to get Medicare drug coverage
  • Will pay a higher Part B premium unless you sign up for a certain plan (some plans help pay your Part B premium or charge additional premiums, but your Part B premium will not increase based on your coverage choices)
  • Must invite a plan representative to your home to get information about the plan or to enroll
  • Can switch back to Original Medicare at any time if you are dissatisfied, without providing information about enrollment periods
  • Will receive additional benefits that are actually Medicare-covered services
  • Will receive additional benefits, such as dental or vision, that are actually covered by other insurance you have or are eligible for (such as Medicaid)
  • Will lose your Medicaid benefits unless you sign up for a certain plan

If a plan representative engages in any of these behaviors, save any documented proof of this interaction. You can contact 1-800-MEDICARE, the SMP Resource Center (877-808-2468) or the Inspector General’s fraud hotline (1-800-HHS-TIPS).

Read More: As a Medicare Beneficiary What Other Resources are Available to Me?
Learn About: What is Considered a Grievance?
Return to: Medicare In-Depth

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This content was created and copyrighted by the Medicare Rights Center ©2020. Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities. These materials are presented here with support from YourMedicare.com and may not be distributed, modified or edited without Medicare Rights’ consent.

YourMedicare.com takes pride in providing you as much information as possible concerning your Medicare options, but only a health insurance broker licensed to sell Medicare can help you compare your plan options from various insurance companies. When you’re ready, we recommend you discuss your needs with a YourMedicare.com Licensed Sales Agent.