Medicare, Seniors

Beware of Medicare enrollment scams

From the Office of the Insurance Commissioner

We are rapidly approaching 2019 open enrollment for Medicare and health insurance for individuals and families. That also means we’re starting to see scammers try to trick consumers into buying illegal products.

An Office of the Insurance Commissioner employee recently received a phone call from an insurance agent who tried to sell her a health insurance policy. The agent—who isn’t licensed in Washington state—told the employee that if she provided the address of a friend or relative from out of state, he would sell her a policy using that address that would be covered under a “national plan.”

Here’s what’s wrong with in this scenario:

  • Consumers can’t buy an ACA-compliant health insurance plan outside of open enrollment unless they qualify for a special enrollment.
  • It’s not legal for agents and brokers to sell consumers a policy using someone else’s address.
  • It’s not legal for agents and brokers to try to circumvent state insurance laws by selling a policy that’s valid in another state.
  • It’s not legal to solicit or sell insurance in Washington state without a license.

The agent is now the subject of a legal investigation.

Remember, the only time most people can switch or buy a new health insurance policy is during open enrollment:

  • Medicare: Oct. 15 – Dec. 7
  • Individual health plans: Nov. 1 – Dec. 15

If someone tries to sell you a health insurance plan outside of those dates, you are probably not getting the coverage you think you are. Here are some red flags to watch for:

  • NEVER give an agent any financial or payment information before you review the policy.
  • If the agent refuses to give you any plan information in writing until you have signed up, “locked in,” “reserved a spot” or provided financial information.
  • The agent may direct you to website to check your provider network. Before you sign the policy, contact your medical providers directly to ask if they accept the plan.

For Medicare-related plans, it’s illegal for agents and brokers to initiate unsolicited door-to-door visits, phone calls, or emails to consumers.

Here’s where you can find more information:

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