Now is the time of year Jan. 1 through March 31 that many Medicare beneficiaries weigh the options of choosing a different health plan. These health plans are often called Medicare Advantage Plans. The most common type of health plans sold in North Dakota are Private Fee-For-Service Plans
The Centers for Medicare and Medicaid Services (CMS) recently implemented new guidelines to protect Medicare beneficiaries purchasing health plans. CMS released guidelines to help the industry implement new Medicare regulations on Sept. 15, 2008. Here are some examples of protections that keep you safe during this open enrollment period:
--You must receive your Annual Notice of Change (ANOC) from your current plan by Oct. 31 of each year. An ANOC is a description of what changes are going to take place the following year in the plan; including medications and costs for the services covered under your plan. It is always wise to check the formulary, which is the list of prescriptions approved by your plan. This protection is to ensure that you have enough time to make an educated decision about your plan. This will help you determine which plan is best for you as plans change from year to year.
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--At events, companies can offer a gift to potential enrollees if it's of nominal value (around $15). Anyone who attends the event must receive this gift, regardless of whether or not you enroll in the new plan.
--A company cannot call you unless you have requested their services. Oftentimes, you may not even be aware that you have provided permission to have a company contact you. You may have received a mailing offering you cheaper premiums or prescriptions and signed the form and mailed it back. Pay attention to the details before you sign anything!
--If you are no longer a member of the plan, the company may not contact you.
--An agent cannot "cross-sell." This means that when an agent comes to talk to you about a health-related insurance (such as a Medicare Advantage Plan or Medicare Prescription Drug plan), they cannot market a non-health care related product such as an annuity or life insurance.
--You cannot be provided meals at meetings where plan benefits are being discussed or plan materials are being distributed.
The company can provide limited snacks such as vegetable and cheese trays.
There are other new guidelines for companies and agents implemented by CMS. For additional information, visit (www.cms.hhs.gov). If you have a question about a certain practice, if you have witnessed a violation of these marketing guidelines, or if you are not sure if a Medicare Advantage Plan is right for you, please contact the North Dakota Insurance Department at 1-888-575-6611.