Story Archives: DA warns residents of scam
|DA warns residents of scam|
Some local Medicare recipients may have recently fallen victim to an insurance scam, according to 5th Judicial District Attorney William R. "Billy" Coenen.
Coenen's office has recently received a number of instances in which insurance agents may have falsified statements and documents to switch senior citizens from the traditional Medicare plan to a replacement coverage.
"My office has recently learned of allegations that agents may have forged victims' names or otherwise misstated the nature of documents the victim was signing," Coenen said. "Based on the agents' representation that they were adding a supplemental prescription drug coverage to their existing Medicare, some victims may have been unknowingly switched completely off Medicare and into what is called a Medicare Advantage plan that essentially replaces the Medicare benefit."
Coenen added that the Medicare Advantage plan is a legitimate replacement policy authorized by law and said many insurance companies market such a plan. The plans do have different co-pay and deductible requirements. The plans may carry monthly premium payments as well.
Coenen suggested that any Medicare recipients who have recently met with insurance agents to discuss prescription drug benefits may want to examine any paperwork associated with the changes to their Medicare plans.
Also, Coenen said Medicare recipients who knowingly made the switch to a Medicare Advantage plan should check with their doctors and other healthcare providers to ensure those providers accept their Medicare Advantage plan.
Seniors who unknowingly made the switch do have an opt-out period under most of the plans, Coenen said.
Coenen said his office will continue to investigate claims of fraud as they come in.
"We've begun an initial look at these allegations," said Coenen. "If it
appears that criminal violations have occurred, we will determine the best
method to address them."
"If warranted, prosecutions will follow," Coenen said.