Date: November 6, 2007
For more information contact: Mikaela Reck, Public Information Officer, (608) 267-9336 or mikaela.reck@wisconsin.gov

Insurance Commissioner reminds Medicare eligible to be cautious

Madison, WI—The Office of the Commissioner of Insurance (OCI) urges Medicare eligible consumers to be cautious during the upcoming Medicare Advantage and Medicare Part D open enrollment periods. The open enrollment period runs from November 15 through December 31.

"It's important for consumers who are considering either signing up for Medicare or switching to a different plan to consider all the terms and conditions of the contract," said Sean Dilweg, Commissioner of Insurance. "This is especially important since Medicare products can be complicated and confusing."

Medicare is a federal program that provides health insurance for people age 65 or older and some other qualifying people. There are several options for coverage under the Medicare program. Traditional fee-for-service Medicare includes Part A (hospital coverage) and Part B (medical coverage - covers preventative care and outpatient care, such as doctors' office visits). Relatively recent additions to the Medicare program include Medicare Part C (Medicare Advantage - offered by private insurance companies through a contract with Medicare) and Part D (prescription drug coverage - outpatient prescription drug coverage offered by private insurance companies through a contract with Medicare). Part C and Part D are not included under traditional fee-for-service Medicare.

If you are thinking about switching Medicare plans, be sure to check to see if your current provider will be covered under your new plan.

"Consumers need to be careful when signing up for these insurance products," said Sean Dilweg, Commissioner of Insurance. "We are concerned that some beneficiaries might get confused about what they are being sold and are making buying decisions with inaccurate or incomplete information."

OCI has been investigating questionable practices some agents have been using to market Medicare products, especially Medicare Advantage Private Fee-For-Service Plans and Medicare Part D prescription drug plans.

Although Medicare Advantage plans are regulated by the federal government, the Wisconsin Office of the Commissioner of Insurance still regulates insurance agents and their behavior.

"OCI investigates agents who have been engaged in questionable marketing and sales practices," said Dilweg. "It is our job to monitor agent behavior and make sure consumers are well informed and protected from improper agent activities."

Federal and state laws prohibit agents from engaging in the following activities when selling Medicare plans. If you experience any of the following situations during the Medicare open enrollment period, contact OCI.

  • Door-to-door solicitation.
  • Cold calls, if not invited to do so, if the person is on the Wisconsin and/or the National Do Not Call Registry. If this occurs notify the Do Not Call Registry.
  • Offering rebates or other cash payments of any sort as an inducement for enrolling in a Medicare Part D or Medicare Advantage plan.
  • Stating that a person must enroll in a Medicare Part D prescription drug plan in order to not lose coverage under Medicare Parts A and B.
  • Using scare tactics to get enrollments.
  • Destroying existing insurance documents, insurance ID cards or Medicare cards.
  • Misrepresenting the benefits included in the Medicare Part D or Medicare Advantage plan.
  • Refusing to leave a place of residence if requested to do so. If this occurs, call 911 immediately.

"The important thing for people to remember is to never make important decisions in a vacuum," said Dilweg. "Talk with a family member or someone you trust, such as an elderly benefit specialist or an area advocate for seniors, before signing anything."

If you or someone in your family is a Medicare beneficiary and you have questions regarding agent activity or wish to file a complaint involving an agent, contact OCI at 1-800-236-8517. Further information and complaint forms are also available at the OCI Web site: oci.wi.gov.


Created by the Legislature in 1871, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.