Do Medicare private plans have to follow any rules when they market their products?
Section X.l. Medicare Fraud and Abuse
Question 5 of 7 (use "Last" or "Next" buttons to see more)
Last Update: October 28, 2008
Yes. Companies that sell Medicare private health and drug plans must follow certain rules when promoting their products. The guidelines are meant to prevent plans from deceiving you—through marketing materials or through someone representing the plan—about what the plan offers and how much it costs. That is called marketing fraud.
Companies can market their plan through direct mail and radio, television and print advertisements. Agents can even visit your home under certain circumstances, but only if you have invited them. However, agents for Medicare private plans must follow certain rules.Plans cannot:
- Call you if you did not ask them to do so. "Cold calling" is no longer allowed;
- Send you unsolicited e-mails. You must have specifically requested information in order for a plan to e-mail you;
- Visit you in your home or nursing home without an invitation. You can ask the plan to send someone to your house, but they cannot just knock on your door uninvited;
- Ask for your financial or personal information if they call you. Beware if you are asked for your Social Security or Medicare number or your bank information;
- Provide gifts or prizes worth more than $15 to encourage you to enroll. Gifts or prizes that are worth more than $15 must be made available to the general public, not just to people with Medicare;
- Disregard the National Do-Not-Call Registry and “do not call again” requests. Plans must comply with federal and state consumer protection laws for telemarketing. You can register online for the National Do-Not-Call Registry or by calling from the number you wish to register;
To register for the Do-Not-Call Registry, either call 888-382-1222 (TTY call 866-290-4236) or click on the link in the LINKS box.
- Market their plans at educational events, in health care settings or at locations and events where free meals are provided;
- Sell you life insurance or other non-health related products at the same appointment. This is called "cross selling" and it is prohibited unless you request the non-health related product information;
- Compare their plan to another plan by name in advertising materials;
- Include the term “Medicare Endorsed” or suggest that it is a preferred Medicare drug plan. Plans can use “Medicare” in their names as long as it follows the plan name (for example, the Acme Medicare Plan) and the usage does not suggest Medicare endorses that particular plan above any other Medicare plan;
- Imply that they are calling on behalf of Medicare. Plans are not allowed to give you the impression that Medicare asked them to call you.
For more information on how to avoid being illegally overcharged on Medicare bills, click on "What is Medicare fraud?" in the GO TO box.To find out when you can change your Medicare health and drug coverage, click on the links in the GO TO box.To learn more about how to pick Medicare health and drug plans, click on the links in the GO TO box.For tips on how to make sure the doctor provides the best possible care, click on the link in the GO TO box.