News: 2010 Press Release

Insurance Commissioner Steve Poizner today urged California seniors to protect themselves from agents and brokers who routinely seek to take advantage of seniors.

"As Insurance Commissioner, I want to be sure that California seniors do not become the victims of aggressive or deceptive sales practices which are too common during open enrollment for Medicare Advantage plans and the Medicare Prescription Drug Program," said Commissioner Poizner. "Seniors and their families should arm themselves with as much information as possible, and if anyone has a suspicion that they are being taken advantage of, I urge them to call the Department of Insurance immediately at 800-927-HELP."

There are changes to Medicare this year. Open enrollment for Medicare Advantage plans and the Medicare Prescription Drug Program runs from November 15 - December 31, 2010. Additionally, from January 1 - February 14, 2011 Medicare Advantage enrollees can switch to original Medicare. If you choose to change, you can also enroll in a Medicare prescription drug plan. Between now and the end of the open enrollment period, many insurance agents will engage in vigorous marketing and sales efforts.

Additionally, there are significant changes to Medicare with the Patient Protection and Affordable Care Act (PPACA) that was signed into law in March of this year.

· Preventive care - Beginning in 2011, Medicare beneficiaries will receive free preventive services including diabetes screening, mammograms, some vaccines and colorectal cancer screenings.

· Annual physical exams - Beneficiaries are eligible for a yearly wellness exam to develop or update a personalized prevention plan.

· Medicare Prescription Drug Coverage - some beneficiaries enrolled in Medicare Prescription Drug plans face a gap in coverage often referred to as the "doughnut hole." This is the portion of your annual drug expenditures, when you may be responsible for the costs of all medications. Beginning in 2011, some beneficiaries who enter the "doughnut hole" will get a 50% discount on Medicare-covered brand name drugs and a 7% discount on Medicare-covered generic prescriptions while in the "doughnut hole."

· Medicare Advantage Plans - beginning in 2011, Medicare Advantage plans cannot charge you more than traditional Medicare for chemotherapy, dialysis, skilled nursing care, and other services deemed appropriate. Check with your plan to see if preventive care and wellness improvements to Original Medicare will be available to you.                                                                                

Consumer education is the key to fighting unscrupulous and illegal sales practices. To that end, Commissioner Poizner has reached out to seniors facilities, requesting that administrators and staff join CDI in a statewide effort to protect seniors by posting and distributing useful tips for combating these illegal tactics. By sharing some simple tips, Commissioner Poizner aims to greatly reduce improper Medicare-related sales practices aimed at seniors. 

Commissioner Poizner offers the following tips to help seniors protect themselves against predatory insurance sales practices during open enrollment for Medicare Advantage plans and the Medicare Prescription Drug Program:

· Make Sure They're Licensed: Not all people marketing Medicare Advantage plans are insurance agents. If the person you are dealing with claims to be an insurance agent, contact the California Department of Insurance or visit www.insurance.ca.gov to verify license status. Insurance agents are required to print their license number on all business cards, quotations, and advertisements. Also, verify that the insurance company is licensed to do business in California.  

· Cold Calls Prohibited: Federal regulations prohibit "cold calls" which may take the form of uninvited sales calls, door-to-door visits, unsolicited emails, telephone calls or any other type of sales contact without your express invitation.

· Be Stingy with Personal Information: Never give out personal information such as your Social Security number, bank account numbers or credit card information over the phone. Verify that the person you are dealing with has proper authority to act on behalf of the plan before you provide your Medicare number. This is a good time to seek assistance from a trusted relative, friend or advisor.

· Medicare Has No Official Sales Reps: Be wary of any salesperson who says that he/she is a Medicare representative. Medicare does not send "representatives" to solicit your business. 

· No Marketing in Educational or Care Settings: Federal regulations prohibit the marketing of Medicare products in places where health care is delivered (such as a doctor's office, clinic, or pharmacy counter) or at an educational event.

· No Such Thing as a Free Lunch: Federal regulations prohibit offers of free meals for listening to a sales presentation or for signing up in a particular plan.

· Don't Let Them Oversell You: Federal regulations prohibit selling additional insurance products during any sales or marketing presentation for a Medicare Advantage or Prescription Drug Plan.

· Read and Understand the Plan: Be sure that the plan that you choose matches your needs and that you can continue to see your current health care providers if you wish. It may be very difficult or even impossible to "undo" your selection later. 

· You have rights! Contact the California Department of Insurance at 1-800-927-HELP (4357) or visit our website at www.insurance.ca.gov, if you have any questions about an insurance offer, scheme or agent.

· Additional Info: Information about Medicare is available at 1-800-MEDICARE (1-800-633-4227) or www.medicare.gov or the California Department of Aging Health Insurance Counseling and Advocacy Program (HICAP) at 1-800-434-0222 may be able to assist you.