Insurance companies selling Medicare Medicare is the federal government health insurance program that provides health care coverage if you are 65 or older, are under 65 and receive Social Security Disability Insurance (SSDI) for 24 months, begin receiving SSDI due to ALS/Lou Gehrig’s Disease, or have End-Stage Renal Disease (ESRD) no matter your age. You can receive health coverage directly through the federal government (see Original Medicare) or through a private company (see Medicare Advantage). private plans must follow certain rules when promoting their products. These rules are meant to prevent plans from presenting misleading information about a plan’s costs or benefits, also known as marketing violations Marketing violations occur when Medicare private plans deceive you—through marketing materials or a person presenting misleading information—about what the plan offers and how much it costs. See also: Medicare Fraud. .
Medicare private plans are allowed to conduct certain activities. For instance, companies can market their plan through direct mail, radio, television, and print advertisements. Agents can also visit your home if you invite them for a marketing appointment. However, insurance agents cannot:
- Call you if you did not give them permission to do so
- Visit you in your home, nursing home A nursing home, also called a long-term care facility, is a residential facility for people with chronic illness or disability. Nursing home services include room and board, nursing care, personal care, and therapy services. A skilled nursing facility (SNF) is a nursing home that provides skilled care, but not all nursing homes are SNFs. Medicare does not cover the cost of nursing homes that are not SNFs. , or other place of residence without your invitation
- 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 federal and state consumer protection laws for telemarketing, the National Do-Not-Call Registry, or do-not-call-again requests (you can register online for the National Do-Not-Call Registry or by calling from the number you wish to register)
- Market their plans at educational events or in health care settings (except in common areas)
- Sell you life insurance or other non-health products at the same appointment (known as cross-selling), unless you request information about such products
- Use the term “Medicare-endorsed” or suggest that their plan is a preferred Medicare 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 that Medicare endorses that particular plan above other Medicare plans
- Imply that they are calling on behalf of Medicare