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Attorney General Jason R. Ravnsborg

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Consumer Alert- Medicare Related Scams Continue to Target South Dakota Seniors

Consumer Alert- Medicare Related Scams Continue to Target South Dakota Seniors

PIERRE, S.D. - South Dakota seniors are being targeted by some individuals that use aggressive marketing tactics to get them to consider changing their Medicare health-care coverage. Medicare beneficiaries across the state have reported feeling pressure to switch to Medicare Advantage Plans even though the coverage they already have may suit them well. Even more alarming are the number of seniors who are reporting that they were switched to a Medicare Advantage Plan without their knowledge. Many of the seniors who were switched without knowing it thought that they were signing up for the stand- alone Medicare Part D plans that cover prescription drugs only. They learn that they have been switched to a Medicare Advantage Plan after they have been hospitalized and Medicare denies payment because they no longer belong to the traditional Medicare Program. Correcting this unauthorized switch can take months and causes many problems with the doctors and hospitals that do the billing.

Medicare Advantage Plans, also know as Medicare Health Plans come in forms such as HMO’s, PPO’s, and Private-Fee-for-Service Plans. Recent Medicare reform laws have allowed beneficiaries a greater number of choices in how they receive their health-care coverage, making this area of healthcare highly competitive.

Seniors must use caution when selecting a plan because not all doctors or hospitals accept all Medicare Advantage Plans. Also, there may be monthly premiums as well as high out of pocket co-pays and deductibles for hospitalizations.

Marketing guidelines established by the Centers for Medicare and Medicaid Services, the federal agency that oversees the Medicare program, prohibit agents from going door-to-door and soliciting. The sales approach many are using is offering a "community information session" on Medicare Advantage. If you attend one of these sessions, be careful not to give out your name or address and NEVER give your Medicare or Social Security number, unless you intend to enroll in a Plan.

If you have been switched to a Medicare Advantage Plan without your knowledge or full understanding please contact the South Dakota Division of Insurance at 1-605-773-3563 or the Consumer Protection Division 1-800-300-1986. For more information on ways to protect yourself or to report possible Medicare fraud, call the South Dakota Senior Medicare Patrol at 1-800-822-8804 (East River) or 1-800-695-8168 (West River).