During Medicare’s Open Enrollment Period, you will likely experience more marketing from private Medicare plans, like Medicare Advantage Plans and Part D plans. Companies try to reach consumers in various ways, like television commercials, radio ads, events, mailings, phone calls, and texts. The government has rules, though, to protect you from forceful or misleading marketing. Knowing the rules and red flags can help you make the best choices for yourself during Open Enrollment.

First, let’s look at the marketing rules that these private Medicare health and drug plans must follow.

Remember, these companies are not the government. They just have permission from the government to sell their private Medicare plans to you.

The government says that plans and their representatives cannot:

• Call or email you if you are not enrolled in the company’s plan.
• Call or email you if you have asked them to stop—even if you are enrolled in their plan.
• Visit your home without an appointment.
• Sell you a plan or set up a sales appointment with you while at an educational event. If you share your contact information at an event like this, this often permits plans to contact you later. However, this permission to contact you expires after 12 months.
• Use the Medicare name or CMS logo or imply that they represent Medicare.
• Approach you in public spaces like a mall or parking lot.

On the other hand, plans and representatives must:

• Explain how enrolling in a new plan will affect your current coverage.
• Check that your providers and pharmacies are in the plan’s network before enrolling you.
• Tell you which companies they represent and whether they sell all plans available in your area.
• Schedule an appointment with you no sooner than 48 hours after you agree to the scope of the appointment.

Even if you don’t remember all these specific marketing guidelines, it’s good to remember some of the red flags to watch out for.

For example:

• No one should make you feel pressured or rushed to enroll in their plan.
• No one should make you feel that you could lose your Medicare benefits if you don’t enroll in the plan.
• No one should ask for your Medicare or Social Security numbers just to provide you with information.
• No one should make a cold call to ask you for your Medicare or Social Security information.

Instead, rely on government websites, phone numbers, and offices for information. Your State Health Insurance Assistance Program (SHIP) is government-funded. You can contact them to understand how plans can and cannot market their products to you. Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.

Remember that you should take your time making enrollment decisions. If you feel uncertain or at all rushed, you can tell the plan representative that you need time to think on it and will follow up with them later if you’re interested. Before you sign up for a plan, contact a plan directly to learn about the services it covers and get everything in writing.

If you think you have experienced marketing violations, you should report them.

Keep any documented proof, such as an agent’s business card, marketing materials, emails, or phone call records. You can report marketing violations to 1-800-MEDICARE or to your local State Health Insurance Assistance Program (SHIP). Your local SHIP can help you review the incident, report it to the correct authorities, and continue spotting such red flags. Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.

Finally, protect yourself from unwanted enrollments or identity theft.

No one should ask for your Medicare number, Social Security number, or bank information just to provide you with information. Someone can use your personal information to enroll you in a plan without your permission or to steal your personal information. Remember that plans cannot even request this personal information at an educational event. If you have been enrolled in a plan without your knowledge or because of misleading marketing, you may be able to make changes to your coverage outside of the Open Enrollment Period. Call your local SHIP to see if you qualify and for help making the change. Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.

Still have questions?   

Your SHIP is here for you! You can contact your SHIP for any other Medicare-related questions or concerns you have. SHIP counselors are government funded to provide trusted, unbiased Medicare counseling at no cost to you. (Depending on your state, your SHIP may go by another name.) Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP. 

Supplemental Handout

---

---

Explore more blogs: