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About Medicare Advantage Plans 

Medicare Advantage Plans Are Often Useless

Judy Gray, Outreach Coordinator for The Department of Insurance, SHIIP Division

(Article was written by Judy Gray when she was with the NCDOI)

Some health insurance agents are misleading seniors into buying Medicare Advantage plans that are not accepted by many doctors and hospitals, insurance officials warned.

Aggressive agents are giving bad financial advice to many Medicare beneficiaries, according to Judy Gray, outreach coordinator for the Seniors’ Health Insurance Information Program (SHIIP). Gray’s in-laws were among recent victims.

Tom and Carolyn Gray of Hurdle Mills, near Roxboro, signed up for a Medicare Advantage plan in mid-January, only days after Tom Gray had been diagnosed with advanced pancreatic cancer, Judy Gray said. They said an agent promised that their Medicare coverage would not change, but that they would get additional benefits for free.

Tom Gray died about a week after he and his wife signed the papers. But before that, they had called their daughter-in-law, who realized they had enrolled in a plan their doctor didn’t accept. She contacted the company and canceled the plan. “Even when I talked with the agent, he was very argumentative,” Judy Gray said. “He said, ‘They can go anywhere they want to,’ And I said, “No sir, they cannot.’

There are numerous doctors and hospitals that will not touch these plans,” she said.

Medicare Advantage is a variation on traditional Medicare coverage that allows private companies to cover doctor, hospital and often prescription drug bills. 

How To Protect Yourself

Insurance agents cannot come to your home without permission. If they call you to schedule an appointment, make sure you get the agent’s name, the company name, and a phone number. Call back to verify the person is who he says he is. If you have any doubts, the Seniors’ Health Insurance Information Program can tell you if that person is a licensed agent. Do not be pressured into making quick decisions. SHIIP counselors are trained to help with health insurance questions. They can be reached at 1-855-408-1212.

 

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