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Officials urge caution in Medicare plan changes

The scene often begins innocent enough with a knock on the dooror the ringing of a telephone leading to a man who identifieshimself as a Medicare representative.

The “representative” then launches into a convoluted explanationof how the Medicare recipient can benefit by switching coverageplans.

However, state officials are warning Mississippians thatpossible Medicare scams are becoming more prevalent – andbolder.

“There is no Medicare or Medicaid representative that is goingto come to anyone’s door to sell insurance – ever. That is thebottom line,” said Francis Rullan, director of communications forthe Mississippi Medicaid Division. “Nor will they ever call you onthe telephone to sell you a policy.”

Rullan said his office, and that of Insurance CommissionerGeorge Dale, are seeing more complaints of people “masquerading asMedicare or Medicaid employees and intimidating the elderly intothinking they must sign up for this or that.”

“While there are many good agents who provide a valuableservice, some are taking advantage of our seniors and otherMedicare recipients, preying on some of the most vulnerablecitizens in our state,” Dale said in a recent press releaseaddressing the scams.

The danger, Rullan said, is that many appear legitimate, butthey could also be misleading.

“They may be viable plans, but the beneficiaries may already begetting these benefits from Medicaid or Medicare, and they’ll losethose (by signing up under the new plan),” he said.

Some insurance agents are using a variety of confusing anddeceptive sales practices to sell Medicare-related Part C and Dplans. According to the complaints, some Medicare recipients arebeing enrolled in these plans without fully understanding thepolicy’s terms, and in some cases, without even knowing they havebeen enrolled.

In a particularly serious case, Dale wrote that the MississippiInsurance Department (MID) investigators found several recipientshad no knowledge of being enrolled in a Medicare Part C plan, andhad never had any contact with the agent responsible for enrollingthem. It is believed by MID that the recipient’s personalinformation was obtained fraudulently and was used on the planenrollment forms in violation of several laws.

“The number of calls we receive is growing daily,” Dalewrote.

Some agents, Rullan said, rely on intimidation after deceivingand confusing their “mark.”

“They will say they have do this, or they have to do this now inorder to secure their benefits. No, they don’t,” he said. “Theydon’t have to sign anything that day.”

Scenarios that are proving to be of particular favorites to theagents using abusive sales practices include:

* The agent will actually claim to be from Medicare. In manyinstances, the agent will present a red, white and blue card thatlooks like a Medicare recipient’s card.

* The agent will have the Medicare recipient fill out “Requestfor More Information” form, when in fact the form is actually anenrollment form for whatever Part C or D plan the agent isselling.

* The agent will ask the Medicare recipient to sign a formclaiming he needs proof he visited the person to show hissupervisor.

* The agent assures the Medicare recipient that enrollment willnot affect their Medicare coverage.

“While this may be true in some portion of Medicare plans, MIDis finding that the recipient has been completely disenrolled fromMedicare Part A and B,” according to Dale’s release. “Often therecipient discovers this fact when a health care provider informsthem that Medicare has declined to pay a charge.”

Rullan recommended people call their local regional Medicaidoffice before signing any paperwork at their home. The nearestoffice can be located by calling 1-800-421-2408.

People who believe they have fallen victim to a Medicare scamare urged to call MID at 1-800-562-2957.