Medicare Advantage Plans / Fraudulent enrollment
I have been searching the web today concerning fraudulent and/or unethical enrollments into Medicare Advantage plans.
I am a claims rep for a Medicare Beneficiary Customer Contact Center. I receive calls on a daily basis from seniors who have been conned into signing up for Medicare Advantage plans by unscrupulous insurance agents.
I hear a variety of stories. People are being told that the agent is offering better prescription drug coverage at no cost to the beneficiary, that they are being offered a supplemental policy, that their Medicare card is no longer valid, and the senior better take this policy if they want to have any health coverage at all.
In one case last week, a man was told he could sign up for additional drug coverage for free. This man is illiterate, so could not read the policy. Since the agent was sitting in the doctor's waiting room, he trusted her. Turned out he signed up for a PFFS plan which his doctor doesn't accept. His doctor ordered several tests that day, and the man is facing a huge bill which he cannot pay.
In another case, a couple was signed up for a PFFS plan only to discover that the nearest hospital which accepted the plan was over 160 miles away.
I am only a couple of years away from being on Medicare myself, have family members on Medicare, and this is really making me MAD!!! I want to know who is investigating this kind of abuse of our senior citizens. I'm in the mood to get proactive. Can you direct me to agencies or organizations who are trying to combat this?
Thank you for your consideration,
Rev Charles Deck