Beware of Medicare Scammers this Annual Election Period

By Crystal Manning

Each fall, older adults face a daunting number of choices as they make important financial commitments and medical predictions for the coming year when selecting their Medicare. 

Most Medicare plans change prices, benefits, prescription drug formularies and doctor networks annually. A plan that fits well this year may not next year. Making the wrong choice can cost thousands of dollars in premiums and/or out-of-pocket expense.

Also check for changes in prescription drug coverage. Beginning in 2023, copays for a 30-day supply of any insulin that a Medicare drug plan covers will be capped at $35. Note that Part D plans will have to adhere to the $35 copay limit even if an enrollee has not met their annual deductible. The price could be lower if insulin becomes subject to negotiation with drugmakers.

There are many Medicare Advantage plans, and their availability varies depending on where an enrollee lives. Wading through the onslaught of advertisements and mailers can be overwhelming. However, if you're not shopping your Medicare coverage every fall, you're probably paying too much.

During the Annual Election Period, you can make the following changes to your Medicare coverage:

  • Switch from Original Medicare to a Medicare Advantage Plan

  • Switch from a Medicare Advantage Plan back to the Original Medicare

  • Join a Part D prescription drug plan

  • Drop your Part D prescription drug plan

  • Switch Part D prescription drug plans

  • Join a Medigap policy

  • Drop your Medigap policy

  • Switch Medigap policies

With the Open enrollment season upon us, remember scammers are ready as well, starting with misleading ads on TV. Each year they are after the same thing: Personal data like Medicare numbers and bank account information., however, just like Medicare Advantage benefits change, so do the tactics the fraudsters use.

Scammers thrive on changes They thrive on anything that might confuse the Medicare population and target that. When open enrollment begins, one expects an influx of robocalls, text messages and emails that try to get beneficiaries to reveal their personal information. Mailboxes are flooded with marketing materials, and television commercials are nonstop, although individuals should watch for fraud, also beware of deeds that are lawful but perhaps not in their best interest.

Television advertisements may look official, and they may even appear to prompt viewers to call what appears to be a government agency However, many of the commercials are for lead agencies that try to get viewers to call them first and then pass their information to agents and brokers who are often in other states.

Keep material like Social Security numbers, credit card numbers and banking information private. Beneficiaries also received a personal 11-digit Medicare number within the last few years that should stay private. Scammers may even identify themselves as representatives of Medicare or Social Security. But unless a beneficiary has already initiated a claim, they shouldn't be calling. The minute you hear that, you shouldn't even enter a conversation. Just don't talk to them!

This Annual Election Period, decide which Medicare Plan is best for you

Look for changes in monthly premiums, added value benefits, such as a gym membership, dental, vision, and hearing coverage, and many over the counter benefits. Also check out of pocket maximums, Medicare Advantage Out of Pocket Maximums Medicare is allowing Medicare Advantage insurance companies to place MOOPs at a maximum of $8,300, an increase of 10.3% over last year’s max of $7,550. 

Medicare Advantage plans are based on a provider network, which is generally limited to a certain region or state. However, no matter where you are in the United States, all Medicare Advantage plans provide coverage for emergency and urgent care, as well as a hospital stay if you need to be hospitalized. When it comes to other services, going to an in-network provider will usually save you money, though many plans also provide out-of-network or out-of-state coverage alternatives. Also, investigate in Medigap options. These plans allow the ease of going to any Medicare-accepting provider in the United States.

A person can make changes to their Medicare plan for many reasons, such as saving money, expanding coverage, or due to changing circumstances. Understanding the enrollment windows can help people avoid penalties and keep the cost of their plans low.

Contact licensed Medicare Advisor Crystal Manning at 412-716-4942 or crystalmanning33@gmail.com for any questions or advice.