HEALTH: Seniors, beware of insurance scams
25 03 08 - 11:12
By JANE GLENN HAAS / McClatchy-Tribune
Have you been hustled and scammed by unscrupulous agents selling bogus contracts for everything from Medicare Advantage plans to prescription-drug plans?
So where do you turn for help?
Kimberly Lankford, personal finance editor for Kiplinger magazine, says the rip-offs are common and the solutions easy to find - if you know where to look.
"There are two levels of fraud to Medicare Advantage, for example," she says.
"It could be a situation where the agent didn't tell you the whole story or that you get your plan switched without knowing."
Q. Let's begin by defining Medicare Advantage plans.
A. They include health maintenance organizations (HMOs), preferred provider plans (PPOs), private fee-for-service plans, Medicare special needs plans and Medicare medical savings plans.
Q. What's the scam?
A. One of the biggest is sales abuse. If you know exactly what you're buying and what it covers, it can be a good deal for people. But there is high pressure from sales agents, who get bigger commissions for signing up people for these plans.
People don't realize all hospitals and doctors are not enrolled in these plans. You really need to be careful. Especially on co-payments. Some have low premiums but may have much higher co-payments than regular plans.
Q. Are these bad products?
A. No, it's just the way they're sold. The key is to look carefully at what is covered. There is no standardization, so what you get from one provider could be different from the next.
Check with www.medicare.gov.
For example, they may cover dental and vision but offer much less than regular policies for services like chemotherapy. You really need to think about what your costs are.
Q. You said some people don't know they've been switched?
A: You might be switched to another plan if you sign something that doesn't even seem like an application.
Q. Let's talk about home health care.
A. Ah, the home health-care hustle. You sign up for discounted home health care services for five or six years. Then when it's needed, you end up not getting what you asked for. Too many people who buy these policies don't know the limitations. This is not like a standard long-term care policy.
Check with your state insurance department if you think you have been defrauded.
Q. Then there's the fake drug discount scam?
A. This is supposed to be cheaper than Medicare Part D (which covers prescription drugs for Medicare patients who do not have drugs covered in their regular Part B plan).
But once again, you may end up finding out the coverage is bogus.
Q. Places to check on authenticity?
A: The Health Insurance Assistance Program is your best bet. Please notify your state insurance department and attorney general if you are scammed.
They can punish these agents.
Q. Are all these agents pushing phony insurance?
A. No, but some are playing on seniors' desire to save medical costs. Get the agent's information, then call the company and ask the company questions. You can get good deals from legitimate companies.