Bill Pellegrini

The Medicare Insurance Industry: Stopping and Reporting Predatory Practices

On the last day of AEP, a P&A client walked into our office asking for help with his insurance.  He had been getting hammered night and day by call centers trying to sell him a new plan or getting him to switch his plan to a new carrier.

At 86, our client was concerned about maintaining his coverage with his Medicare Supplement plan.  His biggest fear was he would be left without coverage.  When he received two enrollment letters from two major carriers, for Medicare Advantage plans, he came straight down to the P&A office for assistance.

Our client relied on us to help him and as a result it alerted us to aggressive predatory practices being implemented by insurance call centers in our industry.  While we don’t necessarily think of a Medicare call center as a place where elders will be exploited, we’re witnessing clients being harassed at a minimum with incessant phone calls, followed by aggressive call center agents being incented to sell specific plans.

These call centers are calling without a “permission to contact.”  We all know that “unsolicited contact” is not permitted per CMS compliance.  One strategy to skirt the compliance issue is to call for Medicare Supplements, then transition to Medicare Advantage. The call centers use well crafted wording to get the response they want from the beneficiary, often times resulting in an enrollment that was unintended by the beneficiary.

And while the agent is excited about the commission, they just made by selling a certain plan, the prospect is left confused and wondering what they just signed up for not realizing that the taped phone call just obligated them.

Clutter Control

Seniors are the easiest targets for financial predators – more than any other demographic.

A recent study from the Georgia Institute of Technology found that older people struggle to remember important details because their brains can’t resist the irrelevant “stuff” they soak up subconsciously. Over time, the brain becomes cluttered, containing both relevant and irrelevant information.  The senior brain has more trouble than younger brains with “clutter control,” or sorting out what is important in their brains from what is not important.

Cluttering of the brain, and the resulting loss of confidence about selecting the correct memories, is a significant reason why older people are more susceptible to manipulation by predators. Additionally, as brains age, they undergo physiological changes that diminish older people’s ability to assess the trustworthiness of potential predators.  Not to mention Dementia and Alzheimer’s can also start to impact the senior brain.

The crime of Elder Financial Abuse has grown to a multibillion-dollar industry and will only grow worse without everyone’s focused action.  Predatory practices in the Medicare industry is a growing concern.

Senior vulnerability represents an inevitable scientific fact.  Many of our seniors need aggressive, consistent, and effective help protecting them from the in-person, telephone, and computer crooks, swindlers, and predators who target them daily.

As independent insurance agents, we are exposed to some of the most vulnerable parts of our clients lives; the prescriptions they take, the diseases they’re managing, the doctors they see and how much they can afford.  We make the hard calls to the carriers and providers on their behalf and we help protect them.  Looking out for predatory practices in our own industry is the only way we’re going to help combat this assault on our seniors.

You can report this activity by:

  • Calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
  • Call the Office of Inspector General directly at 1-800‑HHS‑TIPS (1-800‑447‑8477, or TTY 800‑377‑4950).
  • File an online report with the Office of Inspector General.

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