CASE Study I:
I received a phone call the other day from “Pat,” one of my Medicare clients. Pat and her husband have been my clients for years. She indicated that someone called her claiming to be from Medicare and wanted to sell her a Medicare (supplemental) Plan.
She listened to the person for a while but also knew that Medicare does not offer “supplemental plans”. Sure, there are Medicare supplemental plans that Oak Crest Insurance Services provides that are issued by private insurance carriers, but Medicare does not offer these supplemental insurance plans.
Pat listened for a while and asked the person again, “Do you work for Medicare” to which the person answered “yes”. The person further wanted to ask my client about the Medicare (supplemental) plan that she was on.
Pat eventually went on to say that she already had an agent that lined her up with a supplemental & prescription drug plan. With that statement, the person on the line “hung up”. Busted.
For Pat, she knew that this person who claimed to be from Medicare was in fact a phone scammer trying to take advantage of her.
Pat knew from the meetings that I had with her that there was only the following type of plans that work with Medicare:
· Supplemental (MediGAP) plans.
· Prescriptions Drug Plans.
· Medicare Advantage Plans often referred to as Part C.
All of the above plans are offered by private insurance carriers competing for your business.
What Pat did not know (because she didn’t qualify), is that there are a few other types of plans that are available for Medicare beneficiaries as follows:
· 1876 Cost Plans.
· PACE Plans.
· DSNP Medicare Advantage Plans.
This was not the first time that Pat informed me that someone tried to get information from her, threatening her identity, or tried stealing funds from her account.
Case Study II:
Another client of mine is turning 65 this October. He informed me that in the month of April, about 5 months prior to when he will be on Medicare, he was receiving around 25 calls per day for about two to three weeks from people wanting to sign him up for Medicare. Some were telling him they were with Medicare (which is illegal), and most were from out of state yet somehow had a local area code phone number.
After a few days, he had to stop answering his phone and only take the messages from his family and friends. He also had to email his family and friends telling him that, if they wanted to talk to him, they would have to email first, then he would call them back.
If you are looking for a reliable source on Medicare Supplemental Plan or Advantage Plans, contact the agents at Oak Crest Insurance Services. (248) 554-333nine
Case Study III:
About every 3rd day, I get a “Robot” phone call. It appears that the most recent trend over the last few years is a robot call that initiates a call. I received a call the other day from a robot voice claiming that they could provide me with a health insurance plan in the middle of the year. I am not sure how they got my name because, as a health insurance agent, I help people with the selection process of picking a health insurance plan. More importantly, I know that the major health insurance carriers cannot issue a policy in mid-year unless one of the following conditions is met:
· Loss of credible coverage (ie from an employer).
· COBRA coverage is ending.
· Birth of a child or adoption.
· Marriage or Divorce.
· Moving to a territory that your current health insurance carrier do not cover (ie moving out of state).
· Aging off of parent plan -typically at age 26.
· Death in the family.
These are a few of the principle valid reasons of how a person can get a health insurance plan mid-year. An insurance agent or carrier does not have a private agreement with the government that would allow them to offer a health insurance plan at “any” time of the year when none of the above-mentioned conditions are met. The government has specific rules that allow a person to get health insurance in mid-year. All agents (or agencies) go through annual trainings that go over these regulations set forth either by the state insurance commissionaire or the federal government.
The robot telephone call is committing an illegal activity by indicating that they have access to major medical plans for “anyone” at mid-year.
The only time that “any” person can get a major medical plan is during open enrollment which takes place from November 1 thru December 15 of each year, which therefore has an effective date of January 1. To make an appointment for open enrollment click here.
About the Author: David Banet is a Licensed Insurance Counselor (Health & Life) and licensed in life, property and casualty insurance that helps people and small businesses with their health, life, business and retirement needs with insurance products. He has written over 100 articles on insurance. David is a family man residing in southeast Michigan, and is licensed in Michigan, Ohio, Florida, Illinois, Indiana, Pennsylvania and Tennessee.
He is an independent broker which means that he represents many insurance carriers. There is no charge to enroll in a health insurance plan for his services.
David has given several educational seminars on Medicare Basics in the neighboring community.
