Health care advocates in California say some insurance agents are inappropriately marketing private Medicare fee-for-service plans to some beneficiaries, the San Francisco Chronicle reports. Such plans are similar to traditional Medicare coverage but can include additional benefits such as prescription drug coverage, vision and dental benefits.
Agents' commissions on Medicare fee-for-service plans can be as much as five times higher than commissions for some Medicare drug plans.
Health care advocates who have interviewed consumers said that some insurance agents might have breached Medicare rules by soliciting businesses door-to-door and that some agents are targeting beneficiaries with cognitive challenges or limited English skills.
The Chronicle reports that other agents focused their efforts on low-income beneficiaries who also are eligible for Medi-Cal coverage.
At least two insurers are investigating complaints alleging inappropriate marketing practices by their agents and independent sales representatives.
CMS also is investigating cases that have been reported, and Jeff Flick, regional CMS administrator, said beneficiaries who have been inappropriately enrolled in a plan will be allowed to change their coverage (Colliver, San Francisco Chronicle, 1/26).