On a typical work day, I receive several robocalls from Medicare Advantage (MA) plans wanting to ask “a few simple questions” to see if I qualify. I usually just hang up, but recently I was particularly cranky about being interrupted. So I told the robo-voice I did not have Medicare Part A or B, which should have disqualified me from enrolling in an MA plan.
“Sounds like you qualify!” the robo-voice chirped anyway. “Stay on the line to talk with one of our MA experts!”
Then a few weeks ago — in the heart of MA recruiting season due to the Oct. 1-Dec. 7 MA open enrollment period — I accompanied my elderly parents on a trip to see extended family.
“This Is a Limited-Time Offer!”
During the trip, I was occasionally in my hotel room during daylight hours. So I had a front-row seat for the MA commercials now littering daytime TV.
The formulaic commercials featured…
• Smiling, active seniors with few discernible disabilities or health conditions (though one actor portrayed a senior in a housedress and comically oversized glasses).
• Graphics in bright red and yellow, text written in capital letters, and exclamation points everywhere.
• Warnings about limited opportunities: DON’T MISS OUT! THE CLOCK IS TICKING!
• Enthusiastic, incomplete promises lacking details, but with plausible deniability: “Our Medicare Advantage plan could offer you benefits not offered by traditional Medicare!”
•Reminders that talking with an MA expert is FREE!! (And so is the phone call!!)
MA plans also mail letters in official-looking envelopes with seals and logos that look as if they represent government agencies such as CMS. My parents were nearly ensnared by an MA letter they thought was a notice from Medicare. And they’re not the only ones confused by these tactics.
KFF (formerly Kaiser Family Foundation) reviewed more than 1,200 different TV commercials that aired more than 643,000 times in 2022. The organization said more than 85 percent of the commercial airings — about 9,500 ads per day — were for MA plans.
“Ads rarely mentioned traditional Medicare, or potential limitations with plan coverage, such as provider networks or prior authorization requirements, leaving beneficiaries with an incomplete view of their coverage options and the tradeoffs among them,” KFF said of the study results.
KFF President CEO Drew Altman added, “We heard directly from seniors in focus groups that the ads were often perceived as misleading and left them feeling overwhelmed. This isn’t a good basis on which to make a choice that will affect your health and pocketbook.”
The MA Name Itself Is Misleading
I shared my observations (and KFF’s remarks) with Dan Fedor, Director, Reimbursement and Education, U.S. Rehab/VGM & Associates.
“Yes, these advertisements are very misleading — I’d use the word deceptive — and that is intentional by design,” he said. And Dan pointed out that the misinformation campaign starts immediately.
“Just look at the word they use and lobbied for to name themselves: Advantage,” he said. “Most hear that word and think, ‘If I don’t get one of these plans, I’m missing out.’”
One of Dan’s suggestions is to require MAs to be much more transparent. “First, let’s rebrand them to what they are, and let’s move away from that misleading word. They are private, for-profit insurance companies and should be named Medicare Part C Replacement plans, because in reality, most of these plans put the Medicare beneficiary at a dis-Advantage when they require medical equipment and supplies.
“And while more beneficiaries are being lured into selecting one of these plans, it is eroding the original government-run Medicare program, which was established to protect the elderly from insurance companies acting in their own interests.”
CMS Addresses MA Recruitment Techniques
In April, the Centers for Medicare & Medicaid Services (CMS) released a U.S. Department of Health & Human Services (HHS) final rule that, among other things, addresses “misleading marketing schemes by Medicare Advantage plans, Part D plans, and their downstream entities.”
The announcement said, “The final rule includes changes to protect people exploring Medicare Advantage and Part D coverage from confusing and potentially misleading marketing practices. Ads will be prohibited if they do not mention a specific plan name, or if they use the Medicare name, CMS logo, and products or information issued by the federal government, including the Medicare card, in a misleading way. Further, the final rule strengthens accountability for plans to monitor agent and broker activity.”
The April 5 bulletin added, “The final rule includes changes to protect people exploring Medicare Advantage and Part D coverage from confusing and potentially misleading marketing practices. Ads will be prohibited if they do not mention a specific plan name, or if they use the Medicare name, CMS logo, and products or information issued by the federal government, including the Medicare card, in a misleading way.”
As for my personal battle against hard-sell MA tactics: I bought my parents a little bin from IKEA, and they now put all their Medicare and MA mail into it. I review the mail in the bin when I visit on weekends, and I’ve instructed them not to call those toll-free MA numbers or talk with anyone from an MA plan who cold-calls them.
But what about seniors who don’t have someone to screen their mail and MA phone calls? What happens to them and their healthcare coverage?
Since Dan Fedor has spent so much time dealing with MA plans, I’ll give him the last word on this.
“As an industry,” he said, “this should be a top priority, as more beneficiaries are being lured into one of these plans — sometimes unknowingly — thus impacting HME suppliers’ ability to provide medically necessary equipment and supplies.”