CMS has guidelines to be followed surrounding the sale of Medicare Plans offered through Private Insurance Companies. Since 2020 it seems no one is watching or overseeing this industry. There used to be “Secret Shoppers” who would pretend they were looking for Medicare Plans simply to ensure the rules & guidelines were being adhered to by Licensed Agents/Brokers.
For example: Advertisements cannot be misleading, they must be in clear legible font, cannot say the word “Free” but rather a $0-copay amongst other rules. Licensed Sales Agents must talk Audibly being mindful of hearing impairments, & other disabilities when conducting meetings, sometimes a sign language interpretor or translator may be required & there are strict rules banning soliciting. Permission to Call is Paramount. Only direct permission from the beneficiary allows them to be called by phone. Agents/Brokers cannot call based on referrals.
Secret Shoppers used to help ensure Compliance–however they dont seem to exist any longer. The TV Advertisements have become highly misleading for example: dangling much needed/wanted benefits infront of Beneficiaries just to get them to call a phone number. Food Allowances or Food Benefits attached to their Health plans & in most cases require they have Medicaid in addition to Medicare- & I’ve seen commercials where they advertise unrealistic $ amounts of OTC/Food Benefits to people who are not even eligible to receive them. Them calling=their plan being changed most times without their permission or knowledge.
And the kicker: Instead of Licensed Insurance Agents qualifying individuals like they used to ‘Call Centers’ & Direct-Mailer’s have allowed unlicensed people to essentially solicit Medicare Plans & has allowed the rules to be prevalently abused… with Call Centers companies are using Unlicensed individuals to “vet” callers, & pass them off to the 'Licensed Broker/Agent’s who will then illegally obtain the client & be rewarded monetarily.
Whereby the employee who answered the phone will earn a small fraction of the money paid to the Broker/Agent who is 1099- who has broken numerous laws surrounding Medicare plan sales. Theyre circumventing the rules/laws & they just keep on doing it, while these Brokers are reaping the benefits with no checks or balances… Call Centers, Misleading Direct Mailer Advertisements, & Skilled Nursing Facilities have all been changing Medicare Beneficiaries Plans for going on several years now without their permission/knowledge. Medicare as well as Insurance Companies have been playing Plausible Deniability by refusing to take wgat seems like any complaints. Compliance departments refuse to investigate written complaints year after year after year. If no one is complaining everything is ok right? Its not, Medicare Beneficiaries who are age 65+ or Disabled are on Medicare & they need us to ensure their plans cannot change due non-compliance, lack of oversight, due to hefty Commission/Residual Incomes they Provide.
Collusion between Contracts is wreaking havoc to those on Medicare leaving members unable to get their Medications, see their Doctors, or even have their surgeries as scheduled. States that were Kept in Constant States of Emergencies by Governor’s in 2020
& beyond kept Election Periods open & available rather than having an Annual Election Period. Example: a Special Election Period- SEP’s allow for changes to be made almost at anytime because of a ‘Special’ circumstance like moving or changing eligibility. When you elect a Plan change, it normally begins on the 1st of the next month & enrolling in a plan in many cases will automatically disenroll you from your current plan. When someone moves someone Fraudulently its causes confusion, chaos, & leads to wasteful spending. It also effects diligient Agents/Brokers who strive to serve their Client’s while maintaining their business. When the plan is changed by someone other than the Agent for the individual, the Agent is removed and no longer paid & in many cases has to return unearned premiums to the insurer sometimes earning them zero$ for massive amounts of work they’ve done. The money gets chargedback to the Agent all because someone else broke the law and changed the person’s coverage. Here no one wins except the non-compliant individual who will be paid so long as that person remains on the new plan. Broker’s can do multiple insurance companies in comparison to Agents so once a client is gained they can pretend to be their savior while continuing to be rewarded for their bad behavior. If the plan doesnt work for them they can just move them to a different company while maintaing them. Bad Brokers seem to just throw at the wall to see what sticks and whats best for the member is out the window. So lets vet those who work for the Marketing & sale of Medicare Plans as well as Medicare itself. We need people to oversee this industry. So far both Medicare, Insurance Companies, have refused to respond to complaints --stating they dont know the rules! Please create some oversight & do better by our elderly & disabled. They need us! They’re dying and suffering due to the “forced innoculations as well”.