Insurance companies have been using improper tactics to sign up seniors for private Medicare plans, according to government officials and advocacy groups. The tactics include going door-to-door, forging signatures, and giving false information. According to an article in the New York Times, enrollment in fee-for service Medicare plans is increasing, but seniors who sign up for these plans often don't understand what they are getting.
These plans, called Medicare Advantage, are offered by private insurers. Fee-for-service Medicare Advantage plans allow patients to visit any physicians or hospitals that will provide treatment based on the conditions set by the insurer. Other Medicare Advantage plans are run on the managed care model. The plans often look attractive because they offer the same basic coverage as original Medicare plus some additional benefits and services that original Medicare doesn't offer, such as vision and dental services. However, a new report by the Medicare Rights Center finds that Medicare Advantage plans actually offer many disadvantages compared to original Medicare. For example, care can actually be more expensive because co-payments may be higher. In addition, seniors who switch from traditional Medicare to Medicare Advantage may find that their doctor does not accept Medicare Advantage plans.
The increased enrollment in Medicare Advantage plans is actually costing the government more, as well. The government pays 19 percent more to fee-for-service Medicare Advantage plans and 12 percent more to all Medicare Advantage plans than it pays for original Medicare.
In April 2007, two insurance agents in Georgia were arrested for defrauding seniors by signing them up for Medicare Advantage plans even though they didn't agree to it, and state insurance commissioners in Kansas, Mississippi, North Carolina, Oklahoma, and Wisconsin are investigating complaints. The insurance industry, however, claims the problems stem from only a few bad actors.
For the New York Times article, click here.
For more on Medicare Advantage, click here.