One minute last December, Leslie Montgomery was playing a medieval general plundering a nearby kingdom. Second, she was a retiree drowning in a flood of confusing Medicare sales calls.
The 75-year-old was immersed in her favorite free online game when a banner ad popped up warning her she might be missing out on federal funding. She clicked, and within minutes she received an avalanche of calls about health insurance quotes she never requested.
set of federal regulations It was issued this year to protect consumers like Mr. Montgomery. Following the rapid rise, Complaints about misleading marketing Private Medicare plans and terrible report With support from Senate Democrats, the Biden administration has finalized new rules to curb deceptive Medicare marketing strategies. The reform will face its first major test when Medicare’s open enrollment period begins Oct. 15.
It’s easy to see why Montgomery would be seduced by this type of online advertising.
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greg montgomery
she is one of about 12 million people In the United States, people with medical and social vulnerabilities can receive both Medicare and Medicaid.
She was diagnosed with Parkinson’s disease earlier this year and was soon evicted from her home in an RV park for seniors.
The Phoenix, Arizona, resident currently lives on just $50 a month in disposable income. So, she clicked.
Last December, as insurance brokers called her phone multiple times, Montgomery repeatedly explained that she was interested in providing additional cash from the federal government rather than switching plans.
“And they say, ‘Well, you know. right I bought insurance to get that,” she recalls. As soon as she heard it, she hung up. She didn’t want her new health insurance.
“It’s very frustrating when you think someone is going to help you and then find out that that person is not there to help you,” Montgomery said. “They’re basically there to punish you.”
Too many choices, too little information, and an astonishing level of deception.
Open enrollment, which runs through December 7 of this year, is a once-a-year chance for the nation’s 65 million Medicare beneficiaries to buy higher-quality, lower-cost insurance.
“This is a high-stakes decision that can have very significant health and financial implications for beneficiaries.” Gretchen JacobsonHe is vice chair of the Commonwealth Fund, a private foundation that also conducts health policy research.
Research shows that choosing a flawed plan Overspending among the elderly with limited incomeand even people receive poor quality care or Leaving a life-saving prescription unfilled. Other registration choices users make include: It’s difficult and expensive to undo Down the road.
However, research shows that only about a third of people compare plans during this two-month period each year. Estimate By KFF, a health policy research nonprofit organization.
Shopping for Medicare can be tough.
In addition to traditional Medicare coverage provided by the federal government, the average person can now choose from more than 60 products, including: Medicare plans operated by private insurance companies (known as Medicare Advantage) and Individual prescription drug coverage.
Every fall, millions of Medicare buyers are exposed to information about dozens of these options, but that information is often incomplete and, in some cases, fraudulent.
Private insurance companies and brokers Aired over 640,000 commercials Only on TV last fall. still, 2 out of 3 seniors They still say they want to know more about their options.
“It’s both too much information and too little information at once,” he said. Brandon Wilsonsenior director of consumer advocacy group Community Catalyst.
Paid marketing is heavily biased toward Medicare Advantage. Profits more than double Better than other types of coverage offered by private insurance companies. Nearly 9 out of 10 of his television ads that aired last fall focused on Medicare Advantage. According to KFF.
a new research A study by the Commonwealth Fund also found that deceptive marketing tactics further muddied the waters. Three-quarters of respondents reported receiving unwanted calls, which are prohibited by the federal government. Half said they had received information about specific programs from the government, but the government was not providing such support.
“We were very surprised,” said Jacobson, who led the study. “What was really concerning was that across almost every indicator we asked, people in lower income brackets were consistently reporting these activities more frequently than higher income brackets. ”
Nearly one-third of people living on less than $25,000 a year report being misled by advertising. The same group was twice as likely as higher-income groups to say they felt pressured to switch insurance coverage.
Low-income people who are eligible for both Medicare and Medicaid have even more options: special Medicare Advantage plans. Special support plan with double coverage. These services often include additional benefits, but can add to the confusion.The situation is further complicated this year as many pandemic-era protections kept people enrolled in Medicaid. It’s finished.
New regulations target deceptive advertising, but seniors are left without the help they need
Insurance brokers and agents best source of advice Seniors are trying to navigate this registration maze, but the information they provide is incomplete.
Private insurance companies pay these third-party intermediaries commission They can range from $50 to $762 per sign-up, with other unreported payments to promote a particular plan. Brokers and agents are not legally required to present their customers with all options available in their area.
“Their compensation doesn’t necessarily align with how they want to advise their beneficiaries,” Jacobson said, pointing to the findings. focus group Implemented in cooperation with insurance brokers.
Jacobson said this disconnect is particularly true for low-income customers. Advising a potential customer to stick with traditional Medicare generates little profit for the broker unless the person purchases private insurance to supplement government coverage.
“So when a low-income person talks to a broker, in most cases the only way that broker can make money is by enrolling that person in a Medicare Advantage plan,” Jacobson said.
This means that, like advertisers, people can’t rely on brokers to paint a complete and unvarnished picture of coverage options. The details of Medicare Advantage plans are especially important to consumers. limit people’s access a certain doctor It covers more medicines than traditional Medicare.
“This study highlights the need for more reliable and neutral resources to be made available,” Community Catalyst’s Brandon Wilson said, referring to the new federal study.
Leslie Montgomery was able to tap into one of those resources. help line Operated by a non-profit organization Medicare Rights Center — earlier this year.
Another attractive ad caught her eye, this time on a postcard in a stack of mail, so she decided to hire a professional to place the ad for her.
Trained helpline volunteers helped Ms. Montgomery weigh the benefits of her current insurance against a new plan’s excellent offer of spending $100 a month on vitamins, aspirin, and other over-the-counter items. . She realized it was better to stay there.
According to the Center for Medicare Rights, the number of calls jumps by about one-third before and after open enrollment. Still, people are far more likely to make enrollment decisions themselves or rely on brokers than to use unbiased helplines or federal services. Plan comparison tool.
Recent regulatory changes The Biden administration aims to increase the overall quality and transparency of promotional materials.
New restrictions limit how Medicare’s logo and name can be used. The federal government is also cracking down on misleading promises of cost savings and the use of superlatives like “best” and “most.”
Despite these efforts, many Medicare enrollees remain confused about what is and is not fraud. 90% of seniors A Commonwealth Fund research report says it’s unclear how to file a complaint with the federal government about Medicare marketing.
state health insurance assistance programs It received $55 million this year, less than $1 per Medicare beneficiary. Advocates often argue that more federal funding should go toward programs that provide free one-on-one counseling locally.Experts also want more additions Broker fee reformrequiring reporting of bonus payments, or equalizing sales commissions across all plan types.
Leslie Montgomery still believes in open enrollment as an opportunity for seniors to make the most of their limited funds.
She also knows what a dangerous time it is.
“I research things, and people who don’t do that can really get into a lot of terrible trouble,” Montgomery said.
This story is from the Health Policy Podcast trade off, whose complex care coverage is supported in part by Arnold Ventures. Dan Gorenstein is Tradeoffs’ editor-in-chief and Leslie Walker is the show’s senior reporter and producer. version of this story First appearance.
Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We are affiliated with His NPR stations in the Midwest and surrounding areas, including Missouri’s He KBIA and KCUR, Iowa Public Radio, Ohio’s Ideastream, Kentucky’s He WFPL, and more.
