New Medicare Advantage Marketing Rules Will Help People Make More Informed Healthcare Choices, Allsup Says

Main Category: Medicare / Medicaid / SCHIP
Article Date: 20 Nov 2008 - 4:00 PST

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Medicare beneficiaries trying to sort through their healthcare options for 2009 should welcome new rules designed to protect them against overly aggressive marketing tactics by some insurance companies and their agents, according to Allsup, a leading provider of Social Security disability, financial and healthcare-related services to people with disabilities.

"People need information to make an informed choice, but they need that information to be unbiased, complete and straightforward," said Paul Gada, personal financial planning director and product manager for Allsup Medicare Advisor SMservice, which helps people with disabilities choose the best, most affordable Medicare plan to meet their specific needs.

The new regulations, issued by the Centers for Medicare & Medicaid Services (CMS), became effective Oct. 1. They prohibit telemarketing and other unsolicited sales contacts by Medicare Advantage insurance companies or their agents to Medicare beneficiaries. The rules also ban financial incentives that could encourage agents to move beneficiaries from one plan to another in order to make bigger commissions.

Additionally, last week, the CMS issued revised compensation guidelines for agents and brokers selling Medicare Advantage options, further safeguarding plan participants from potentially overaggressive sales tactics.

Overall, CMS reports that the vast majority of Medicare beneficiaries are pleased with their Medicare Advantage plans. These regulations are designed to ensure that all beneficiaries have the same experience, and the CMS is beefing up enforcement through surveillance. During last year's open enrollment, the CMS required three organizations to take corrective steps and suspended another organization's marketing activities.

Having the option to use a Medicare Advantage program vs. traditional Medicare has been a great benefit to a number of people, with about 10.1 million individuals now enrolled in Medicare Advantage plans compared to just 5.3 million five years ago, according to the Henry J. Kaiser Family Foundation.These plans, at a minimum, cover everything offered by traditional Medicare Parts A and B (hospital and outpatient services). They also may offer additional benefits not covered by traditional Medicare such as dental care or prescription drug programs. Out-of-pocket costs also are likely to be less with a Medicare Advantage plan than if using traditional Medicare and a Medigap policy. Additionally, Medicare Advantage plans generally must cover pre-existing conditions, something Medigap is not required to do.

"People need to be cautious in distinguishing between the poor behavior of some of the insurance agents and the potential benefit Medicare Advantage plans could have in improving their healthcare and making it more affordable," said Gada. "These new regulations help address poor behavior. But despite the new protections, the best defense against predatory practices still is making certain you are relying on information from an unbiased and trusted source."

About Allsup

Allsup, Belleville, Ill., is a leading nationwide provider of financial and healthcare related services to people with disabilities. Founded in 1984, Allsup has helped more than 100,000 people receive their entitled Social Security Disability Insurance and Medicare benefits. Allsup employs more than 500 professionals who deliver services directly to consumers and their families, or through their employers and long-term disability insurancecarriers.

The Allsup Medicare Advisor service provides customized, objective support to help individuals with disabilities navigate the complexities of Medicare and Medicare Advantage programs, analyze the best plan coverage and provider options based on individual preferences, better understand healthcare cost information, and simplify the confusing process of enrolling in a Medicare Advantage plan.

The information provided is not intended as a substitute for legal or other professional services. Legal or other expert assistance should be sought before making any decision that may affect your situation.

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