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March 08, 2008

How to Spot a Health Insurance Scam

The law offers Medicare beneficiaries a bewildering array of new health-insurance options. They can now choose from dozens of Part D prescription-drug plans to supplement Medicare, or they can opt out of traditional Medicare and enroll in a Medicare Advantage plan to get both medical and drug coverage from a private insurer.

All of the new choices have resulted in "an immense amount of confusion," says Micah Roderick, of the Illinois attorney general's office. They've also led to an epidemic of fraudulent sales practices, ranging from sales abuses to criminal activity:

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To reap big commissions, some insurance agents sell seniors Medicare Advantage plans without explaining the limitations, and even sign people up without their knowledge.

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Posing as Medicare representatives, unscrupulous agents use Part D to get a foot in the door -- or even into a whole senior high-rise building. Then they tout a slew of high-priced insurance policies, including annuities, life insurance, gap coverage for Medicare Advantage and other products that people may not need.

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Once they have personal information about their victims, some of these renegade agents steal their identities.

In other cases, regulators have uncovered fraud rings selling fake drug-discount cards and bogus coverage for home health care. It's a huge racket, says Paul Greenwood, head of the elder-abuse prosecution unit for the San Diego district attorney's office. "These crooks realize there's money to be taken from elderly victims looking for a way to save on health-care costs."

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Posted by healthinsurance at March 8, 2008 08:11 PM

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