By Kay Kaylor
PREVIEW Columnist
I advocate for residents in extended care and assisted living residences as the regional long-term care ombudsman. I also am a Senior Medicare Patrol (SMP) and State Health Insurance Assistance Program counselor, all as an employee of San Juan Basin Area Agency on Aging (SJBAAA). The many aging and care concerns will be addressed here.
This Medicare Open Enrollment period for Part D and Medicare Advantage plans through Dec. 7 is also a prime time for scammers to catch people off guard.
For example, an Oklahoma woman did not hang up after a suspicious caller called a second time and told her she was not selling anything. The caller asked the woman to verify her name, address and Medicare card number and then asked for more personal medical information. The person said Medicare was issuing 2021 cards and replacing paper with plastic. Red flag: Medicare and other government agencies do not call people unexpectedly and ask for information or money, nor does Medicare issue cards in this manner.
The scammer takes such information to steal people’s identity or place false charges on your Medicare insurance. Trusting people easily might become victims of this type of fraud and others covered in earlier articles. Check your quarterly Medicare statements, and notify Medicare immediately if you see false charges or accidentally gave away personal information over the phone or in other ways.
Other enrollment scams to obtain information include offering to send a new health plan card for money, calls about refunds from paid premiums, fake discount cards for buying medicine, calls offering large discounts for a health insurance plan, or selling plans you do not need or that do not exist.
Insurance agents and brokers are prohibited from specific actions by law. The agent must get your permission to meet in person and cannot come to your home without an appointment or approach you in a parking lot, nor can they send texts or leave phone messages without documented permission. Agents cannot use the word “Medicare” in a misleading manner, such as stating they are from Medicare. They must not sell products not related to health care or discuss options you did not agree to discuss.
Agents cannot ask for credit card or banking information or offer gifts worth more than $15. Nor can they ask for referrals to contact others or pressure you with a threat of losing health coverage. Agents also cannot ask you to sign a form before you are ready. During a meeting, they can give you plan materials, leave a business card and collect a completed enrollment form.
As an SMP counselor, I can advise you on scams and ways to report them.
SJBAAA offers resources for people age 60 and older or on Medicare. For further information, please call or text 403-2165 or send an email to leadombudsman@sjbaaa.org.
