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Victim of a Medicare Scam? You May Not Know About It Until January.

Updated: Feb 22, 2023

In a previous blog, we talked about some precautions you can take to avoid becoming a victim of an unauthorized Medicare assignment of a Medicare Advantage plan. It happens every year but what you may not know if how it is done and what can happen after you are a victim.

Here is a scenario that can happen to anyone. You get a phone call from a local agent or from an agent representing multiple insurance carriers. Many times, these calls are from a faceless person who is not local to your area but part of a large telemarketing company. The person on the phone sounds pleasant but a little pushy. He may make you feel that you are missing out on something you should have or make you feel a false sense of urgency.

You listen to what he has to say and then he asks you for your Medicare Beneficiary Number or your date of birth or other identifier that at the time seems benign and a part of a regular process “to look up your eligibility in your area”. They ask for your zip code but they called you, remember? At the end of the conversation, you say “No, I’m not interested but thank you anyway”.

Two weeks later, you get information in the mail from an insurance carrier that is not the one you have your Medicare Advantage plan. You begin to wonder what is going on so you call the insurance company and ask them what is going on. Apparently, someone has placed you on a Medicare Advantage plan without your permission and you want someone to get you back on your plan. You get upset with the insurance company and tell them to terminate that plan. You think that’s all you have to do, right? Wrong.

First, make sure that you obtain the termination in writing. If the insurance carrier does not respond to your termination request you have the right to hang up and call Medicare directly at 1-800-MEDICARE. Tell them you discovered that you have been placed on a plan without your permission. Tell them that you do not want this plan and want to stay on your current plan (if that’s the case). They will help you with that.

However, things can go wrong and although Medicare makes sure you are not on that “new” plan, you may revert back to straight Medicare, in some cases without a prescription drug plan. But there is more that you can do. You can call your current insurance plan, the one you didn’t want to leave or the one you wanted for the new year, and tell them exactly what happened and that you have already called Medicare about it. The insurance carrier can make sure that they can have your plan renewed (if renewable), cross-walked into the new plan, or to choose another.

But what if this happens after December 7th? Do the same thing. Make sure Medicare and your insurance carriers knows what happened. They can work together to make sure you have no lapse in coverage or that your newly chosen plan is active for January. If the Medicare Advantage situation cannot be rectified, it is possible you may have to revert back to original Medicare.

This happens all the time. The best thing you can do during this time of year is to not answer your phone if you don’t recognize the number. If you are waiting for a phone call from an insurance carrier, they will leave a callback number.

Watch out for those agents who say “I represent [insert insurance carrier name here]”. Ask them who else they represent? Ask them what agency they work for. Ask them for their license number for your state and their call back number, to give you time to look it up. Keep a paper and pen nearby so that you can make notes. When talking to someone on the phone, we all have a tendency to focus on what they are saying and not on finding a pad and pen to write with!

This is good information for you to know and not generally known. Please share it with others in which you are acquainted. Being armed with this information will help you protect yourself if an application is submitted to Medicare on your behalf without your knowledge or consent.

Of course, if you need any assistance in getting your Medicare Advantage or Medicare Supplement in order, please give us a call prior to December 7th if you are current Medicare member. If you are not a current Medicare member but will be eligible soon, please call us so we can walk you through the process.

Have a Happy Holiday Season.


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