Use Caution When Choosing or Changing Medicare Health Plans

  • Last month, I spoke at the North Dakota Region V Council on Aging. One of the other speakers was a member of the Governor’s Board on Aging. He spoke about long-term care, but he also mentioned his parents and their Medicare coverage, as well as a “Medicare scam.”


    What happens with this scam is that someone will call an elder and tell him or her that they are from Medicare and that Medicare is changing the insurance plan that they are under. Then, of course, they ask for all kinds of private information so they can make the switch. This group of elders was warned that Medicare will never call and say they are changing your plan. It isn’t illegal for a health insurance company to suggest that there are other plans and say that they’d like to talk with you about options. But to claim they are from Medicare – that’s a scam.

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    Another thing that came up in his talk was Medicare Advantage. People need to be very careful with this plan, because many who sign up do not understand what they are getting. I didn’t think too much about it until yesterday, when I received, from the North Dakota Insurance Commissioner’s office, a newsletter which contained the article below:


    “POOLMAN WARNS ABOUT ABUSIVE MEDICARE MARKETING PRACTICES Bismarck, ND – North Dakota Insurance Commissioner Jim Poolman recently warned seniors to be aware of abusive and aggressive sales tactics revolving around the marketing of Medicare Advantage plans. The result of these tactics is that some seniors may feel pressured into purchasing a policy that is not of benefit to them and may replace coverage they already have that is working well for them.

    Poolman said, ‘We have many reports of seniors who have inadvertently signed up for a Medicare Advantage Plan thinking they were buying a Medicare supplement plan. We are also getting a number of complaints on agents who have misled seniors into switching from their Medicare coverage to a Medicare Advantage Plan without their knowledge.’

    Medicare Advantage plans are not traditional Medicare. They are private health plan options approved by Medicare but sold and administered by private insurance companies. Advantage Plans replace Medicare Part A coverage (hospital) and Medicare Part B coverage (medical), and are required to cover medically necessary services. Although Medicare Advantage Plans (also called Part C) are not provided through the federal government, they are still considered part of the Medicare program and companies who sell them must be approved by Medicare.”

    Most states have an Insurance Commissioner or the equivalent. If you or your parents have even a small question about Medicare insurance and all of the options, which are many, call your state Insurance Commissioner’s office. They will be able to help you.


    North Dakota has the Senior Health Insurance Counseling Program (SHIC) which uses trained volunteers to help seniors with these insurance questions. If you go to, you will find State Health Insurance Counseling and Assistance Programs (SHIPs). Just click on your state. You will be taken to your state’s health insurance counseling program, though, as in North Dakota, it may have a different name.


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    The bottom line is, check everything before you switch plans. It’s confusing, so don’t hesitate to get help from your state’s insurance people. And, unless you have placed the call, beware of giving out any personal information over the phone.


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Published On: June 11, 2007