Sick Of Endless, Misleading Medicare Ads? New Rules May Help

Nov 21, 2023 | Medicare, Medicare Advantage, Medicare Supplement

If you watch any amount of television the old-fashioned way—live—it would be hard not to notice the onslaught of Medicare ads. Faded comedy stars and sports heroes flood the airwaves each year between October 15 and December 7, the Medicare Annual Enrollment Period (AEP). During nearly every commercial break, seemingly low-budget, high-pressure ads urge Americans over 65 to check their options and make sure they’re getting all the benefits to which they’re entitled.

With 65 million Americans on Medicare, it’s no wonder that health insurers and brokers are falling all over themselves to reach Medicare beneficiaries. The AEP is the only time many people on Medicare have the option to make coverage changes, such as joining or switching Medicare Advantage (MA) or prescription drug plans or moving between Original Medicare and MA.

Those ads aren’t just annoying; historically, many of them have been misleading, according to an analysis by KFF. That may be changing this year thanks to new Medicare rules.

Inundating, Misleading Ads

KFF analyzed 650,000 airings of Medicare ads that appeared on air between October 1 and December 7, 2022. While the ads promoted all types of Medicare plans, including Part D prescription drug plans and Medigap supplemental plans, MA ads dominated with 85% of all airings.

More than one-quarter (27%) of the MA ads showed images of government-issued Medicare cards or images that closely resembled the official Medicare card. Most (83%) ads sponsored by brokers or other third parties pointed people to call a private Medicare hotline rather than the official Medicare line (800-MEDICARE). More than 50,000 airings used messaging that warned viewers they might be missing out on benefits, suggesting their current coverage could be incomplete.

The vast majority of MA ads (92%) focused on extra benefits, such as dental, vision, hearing, and prescription drug benefits, which most enrollees can get. However, 67% of third-party or broker ads promoted financial benefits such as getting a rebate for Part B premiums known as the “give back” benefit despite just 17% of plans offering such a rebate.

KFF also conducted focus groups to understand how consumers experience the process of choosing a Medicare coverage. The research found that many Medicare beneficiaries were unclear on their Medicare coverage options and the trade-offs between them. Focus group participants noted feeling overrun with often-misleading ads. Despite—or perhaps because of—the abundance of messages, participants reported feeling confused or unclear about the options.

At a September briefing on KFF’s findings, Lindsey Copeland, director of federal policy at the Medicare Rights Center, a national nonprofit organization, said that her organization often receives calls about misleading Medicare marketing. Copeland said that consumers often report feeling unsure who to trust. They may feel pressure to take action based on TV ads or direct mail, even if they are happy with their current coverage. Some report being confused about who is sending them official-looking mail and questioning if offers seem too good to be true are legitimate.

According to Copeland, 20% of calls to the Medicare Rights Center’s helpline about misleading marketing are from people who were enrolled in a plan without their knowledge or consent. Callers report thinking they were talking with Medicare or believing they were providing information to a broker but not consenting to switch plans. They may only realize what has happened weeks later when paperwork arrives, by which time they have little or no recourse. Other callers say they switched willingly but learned their decision was based on inaccurate or incomplete information, and that they failed to understand what they might be giving up.

New Rules To Protect Consumers

New CMS rules may be shifting the nature of Medicare advertising. Advertisers can no longer use the Medicare logo, name, or the official Medicare card in a way that could imply that the ads are coming from the official Medicare program. Broker ads will need to specify which plans they are selling and benefits that aren’t available to everyone must be clearly identified as such.

“We are really trying to reign in misleading marketing practices,” Meena Seshamani, M.D., Ph.D., director of the Center for Medicare, said in an interview.

Seshamani said the agency is instituting what she calls common-sense rules and considering the experience of Medicare beneficiaries who are bombarded by ads and confused about their options, which include Medicare Advantage, Original Medicare, and Medicare prescription drug plans.

“These are all important pieces of the Medicare program; they are all important options for people to have,” she said. “But if they are getting confused and if they’re getting misled, then the program’s not working for them.”

In the KFF briefing, CMS administrator Chiquita Brooks-LaSure said that in response to skyrocketing complaints over the last couple of years, the agency will review all television, radio, and web-based ads in advance to make sure they meet the requirements.

“These protections that we put forward are really spurred in large part by the feedback that we have gotten through partners and from the people we serve,” LaSure said. “What we are focused on is just making sure that people have access to accurate information.

Terri Swanson, president of Medicare for Aetna, a CVS Health company with nearly 11 million Medicare members, is positive on the new rules.

“We want to make sure Medicare beneficiaries are getting the information they need and feel supported in their experience,” Swanson said in an interview. “That’s why Aetna fully supports CMS oversight of marketing practices, and we are committed to partnering with CMS to ensure that beneficiaries receive clear, correct and helpful information about their Medicare plan options.”

Swanson encourages Medicare beneficiaries to take the time to learn about their options and understand what plan is right for them. She recommends starting with a few basic questions, such as does the plan fit your budget? Are your favorite doctors, hospitals, and pharmacies in the plan’s network? And does the plan cover your specific prescriptions?

“As with all things in life, one size does not fit all,” she said. “Your team of doctors and healthcare professionals can also help you understand your health needs, which is important when deciding on a plan.”

According to Seshamani, CMS’ objective is similarly focused on consumers’ needs: “How can we make sure that people are getting the information that they need, so that they can make the best decision for them?”

Author: Deb Gordon I am co-founder and CEO of Umbra Health Advocacy and co-director of the Alliance of Professional Health Advocates. I’m the author of The Health Care Consumer’s Manifesto: How to Get the Most for Your Money, based on research I conducted as a Senior Fellow in the Harvard Kennedy School’s Mossavar-Rahmani Center for Business and Government. For nearly a decade, I served as Chief Marketing Officer for a health plan during Massachusetts health reform and the ACA implementation. I am an Aspen Institute Health Innovators Fellow and an Eisenhower Fellow, for which I traveled to Australia, New Zealand, and Singapore to explore the role of consumers in high-performing health systems. I hold a BA in bioethics from Brown University and an MBA with distinction from Harvard Business School.

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