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Avoid Drug-Plan Scams


By Kelly Greene, Wall Street Journal

October 16, 2005


Government and consumer watchdogs are bracing for the marketing scams likely to spring up alongside the long-awaited Medicare drug benefit.

"We're talking about dozens of companies [offering drug benefits] in every state," says Deane Beebe, spokeswoman for the Medicare Rights Center, a New York advocacy group. "Who knows who's going to pose as a company and prey on seniors?"

Enrollment for the plans starts Nov. 15; coverage begins Jan. 1. Drug-plan marketers are allowed to make calls to describe benefits and offers, and to solicit requests for pre-enrollment information.

Already, the Centers for Medicare and Medicaid Services, the federal agency overseeing the new drug program along with other Medicare benefits, says it has enlisted help from law-enforcement officials to investigate two possible scams in which beneficiaries were asked for bank-card numbers and other personal information.

So, Medicare beneficiaries will have to make sure any marketers they talk to are legitimate.

Stop Them at the Door

It's illegal for marketers of Medicare drug plans to visit your home unless you invite them in advance, or to send you unsolicited emails, Ms. Beebe says. Although marketers can make unsolicited phone calls, they aren't allowed to sign you up during those calls.

Several advocacy groups including the National Consumers League at www.fraud.org/tips/internet/medicare.htm7 are offering tips for protecting yourself from being victimized by a Medicare-related scam, including:

. Check the list of Medicare-approved prescription plans by calling the Centers for Medicare and Medicaid Services at 800-633-4227. If you're contacted by a plan that isn't on the list, it could be a scam.

. No one can enroll in a drug plan before Nov. 15 (though the plans can start advertising this month). If a plan asks for payment before that date, it could be fraudulent.

. Guard personal information, such as Social Security or bank-account numbers. Legitimate plans may ask for a Social Security number -- but not until you actually enroll. And they can't ask for your credit-card or bank data unless you're arranging automatic payments.

Reject Scare Tactics

Enrolling in a drug plan is voluntary. If someone says you must join a plan to avoid losing your other Medicare benefits, you're getting false information. For free, unbiased advice, call your State Health Insurance Program, or SHIP, or your local area agency on aging. For a state-by-state directory of SHIP programs, visit www.medicare.gov/contacts/Static/SHIPs.asp8 or call Medicare's hotline. To find your local aging agency, go to eldercare.gov9 or call 800-677-1116.

See if the plan you're dealing with is licensed. Call your state insurance department; there's a directory of these departments at www.naic.org/state_web_map.htm10.

Even with legitimate plans, advocates for Medicare recipients urge seniors to study and compare several drug plans before choosing. After all, "what incentive does a salesperson have to inform a senior that a competitor's plan might be better for them?" asks Shannon Benton, executive director of the TREA Senior Citizens League, an Alexandria, Va., advocacy group.

The Medicare Rights Center developed a flow chart to help sort through drug-benefit options. To use it, go to medicareinteractive.org/aarp11, then click on the yellow box on the right side of the screen that's labeled, "New! Medicare Drug Coverage Information." That link will connect you to a list of questions and answers. No. 8, for instance -- "Should I enroll in the new Medicare drug benefit?" -- walks you through different scenarios: when your current drug coverage is as good as what Medicare is offering; how you find out; and, if you have no drug coverage, questions to ask while shopping.


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