It is the annual fall season of Medicare sales pitches and we have seen a rise in Celebrity Medicare Sales pitches.  We are happy to see CMS creating tighter rules around the sales pitches and confusion.

We have seen seniors fall victim to different Medicare fraud schemes such as the “Ice Cream Social.”

While popular with seniors, Medicare Advantage has been the target of multiple government investigations, Department of Justice and whistleblower lawsuits and Medicare audits. One 2020 report estimated improper payments to the plans topped $16 billion the previous year.

To Dos Today

Some basics to go over with a senior in your life.

  • Take a second to read up on Medicare fraud and what it is
  • Please let a senior in your life know that they should be extra careful right now because it is fraud season for seniors.
  • Advertisement Caution – be careful to change your insurance plan based upon an ad. New or additional benefits on tv or in the mail might not be available to you where you live.
  • Writing – get all the details in writing before signing up.
  • Confusion – if you do not understand it, do not sign up, get help from someone.
  • Make sure the plan is right for you – before signing up, contact your doctors to verify they are in that plan’s network. Find out if you your prescription drugs are covered.
  • Don’t be pressured or persuaded – If an insurance agent tries to scare you into thinking you must switch plans right away so your Medicare rates do not increase.
  • No such thing as a free lunch – If an insurance agent says it is free to enroll in a Medicare program. Question that.  Premiums are associated with all Medicare products and some products may offer $0 premium, but be sure to verify monthly costs for the coverage.
  • Medigap – You cannot have a Medigap plan (supplemental plan) and a Medicare Advantage plan, at the same time no matter what anyone says.
  • It is okay to have been a victim, you could talk about it and inform someone. 

There are resources to help cut out some of the confusion. For example, here are two states:


“If you are confused about your options or want to find out more about health plans, we highly recommend working with a licensed, local agent, or someone you know and trust to carefully evaluate plan options. Licensed agents can also be found at our website”

Read more: As Medicare enrollment season approaches, beware scammers targeting elderly people

North Carolina

“Medicare plans and prices change, Commissioner Causey said. “It is important for Medicare beneficiaries to take advantage of the Open Enrollment Period by contacting local Seniors’ Health Insurance Information Program (SHIIP) counselors to save money, improve your coverage or both.”

SHIIP is a division of the North Carolina Department of Insurance and offers free, unbiased information about Medicare, Medicare prescription drug coverage, Medicare Advantage, long-term care insurance and other health insurance issues. In addition to helping Medicare beneficiaries compare and enroll in plans during the Open Enrollment Period, SHIIP counselors can help people find out if they are eligible for Medicare cost savings programs.

Read more: Insurance Commissioner Causey reminds Medicare beneficiaries to compare plans

By: Jeanmarie Loria