Photo by Andrea Piacquadio via PexelsWe’ve all seen those ads where high-pressure sales tactics are used to encourage older adults to sign up for Medicare Advantage plans, plus the seemingly endless telemarketers and robocalls. If you think these marketing approaches have been getting worse over the past few years, you’re right. 

A new issue brief from The Commonwealth Fund found that nearly all people ages 65 and older have received some plan marketing, with three-quarters seeing one or more television or online ads per day. One in three reported receiving seven or more phone calls per week. And these confusing, high-pressure tactics can mean people are enrolling in plans that don’t meet their health needs. The mixed messages can also affect how people view the Medicare program and the insurers behind private plans, according to Gretchen Jacobson, lead study author and vice president of Medicare at the Commonwealth Fund. 

“We were surprised at the amount of unlawful activities that were occurring, and activities that suggested fraud,” Jacobson said. The number of people who were asked for their personal information before even getting plan details was also much higher than anticipated.

With open enrollment approaching on Oct. 15, journalists can help to set the record straight about what these plans do and don’t cover, associated out-of-pocket costs and the importance of finding the best insurance to meet an individual’s health needs. They can also forewarn the public about the possibility that some of the claims made by ads, slick marketing materials and repetitive phone calls may be too good to be true. 

Diving deeper into deceptive marketing

Deceptive marketing seems to more often target lower-income older adults, according to the report. Aggressive tactics that violate federal rules such as asking for Social Security numbers or Medicare IDs outside the enrollment process or advertising special, time-limited discounts, were highest among low-income older people (those with an annual income was $25,000 or less). And reports of seeing, reading or receiving advertising information that was later found to be untrue were significantly more common among people with lower incomes than those with incomes above $25,000. Approximately 28% of low-income seniors reported misleading advertising compared to 17% overall, according to the Commonwealth Fund report.

The study also found that a larger share of Black adults than white adults reported unsolicited calls in the past 12 months (88% vs. 76%). Journalists should be aware of disparities in marketing certain Medicare Advantage plans to lower-income or minority older adults. Incidence of chronic disease, greater difficulty accessing quality care, and other health disparities are more prevalent among these populations; and being underinsured only adds to these inequities. 

“Lower income people are actually eligible for more plans like dual Medicare/Medicaid or Special Needs Plans,” Jacobson said. So they might be subject to more outreach. It’s also possible that lower-income people are more targeted by marketers; a higher share of lower-income people who received a cold call were more likely to let the marketer complete their pitch. Some policy changes could help address this issue.

Analyzing study results

The results of this aggressive marketing have real-world ramifications, Jacobson said. About one in 10 older adults (11%) said they had enrolled in a plan believing their doctor was covered, only to discover later that there were limitations on seeing that doctor or that the doctor was not in the plan’s network.  

“The bottom line is that it really matters to peoples’ finances and their health that they pick coverage that meets their needs,” Jacobson said. “Coverage choices can really affect health status if it prevents them at all from getting the care they need or they avoid getting care at all due to cost.”

Anyone who did sign up for a plan that turns out to be different from what they were told can change plans without penalty during the special enrollment period.

The Commonwealth Fund report also found:

• More than half of adults ages 65 and older said they weren’t sure how easy or difficult it would be to switch. This suggests beneficiaries may choose their coverage without knowing they may not be able to change it easily if the plan they select doesn’t meet their needs, so they end up sticking with what coverage they already have.   
• The vast majority of adults age 65 and older reported not knowing how to report their concerns. About 1 in 5 said they probably would not be able to figure out how to do so.

“Misinformation about health care coverage, as reported in our survey, can have significant implications for Medicare beneficiaries with complex needs and limited resources,” Jacobson said. Not only can this lead to higher out-of-pocket costs for beneficiaries, but some drugs or procedures may not be covered under certain plans, force people to seek care outside of narrow networks, or be denied needed care because of prior authorization rules. 

Although almost all beneficiaries (96%) said they used an insurance broker to choose their coverage, Jacobson suggested people reach out to an advisor at their State Health Insurance Assistance Programs (SHIP) advisors as a first step. 

“Brokers are often incentivized to market certain plans and may not offer the range of coverage options which actually are best for a person’s needs,” she said. SHIP provides free one-on-one counseling and can help callers navigate the myriad options to find the best solution for their current and anticipated health needs.

The misleading calls and ads got so bad that the Biden administration stepped in earlier this year to rein in Medicare plan marketing practices. The Centers for Medicare and Medicaid Services has posted regulations on the Medicare.gov website highlighting what marketers are and are not allowed to do, including calling people without permission, asking for personal information like credit card or bank account numbers or demanding payment over the phone.

Those actions followed a 2022 Senate Finance Committee inquiry that examined marketing complaints from 14 states and found evidence that beneficiaries were being inundated with aggressive marketing tactics as well as false and misleading information, telemarketing, and robocalls. Some materials are designed to look like official communications from federal agencies, occasionally using the term “Medicare” in their naming and branding, which could lead to the false impression that the company represents the government program. The Committee investigation also found numerous predatory actions, including signing up beneficiaries for plans under false pretenses and changing vulnerable older adults’ health plans without their consent.

Lack of understanding about their coverage options coupled with concern over cost burden make it easier for many older adults to be swayed by misleading advertising and false promises. 

A Sept. 12 Commonwealth Fund data brief examines the financial burden of care that people with Medicare face and how that burden differs for people with traditional Medicare and Medicare Advantage. Key findings show that cost burden is a major concern for those on Medicare, which may lead many to consider Medicare Advantage as an alternative.

Resources

• This 2022 article written by Joe Burns, AHCJ’s Health Beat leader for health reform, details many of the issues that the administration is now trying to address. 
• An excellent story on how older adults fall victim to Medicare Advantage marketing scams written by AHCJ member Cheryl Clark for MedPage Today.
• This New York Times explainer on the differences between Medicare and Medicare Advantage by Paula Span.
• Medicare affordability and financial stress, from The American Society on Aging.
• Advice from the Federal Trade Commission on how consumers can avoid marketing scams during open enrollment.