MA/PDP agents. Are you falsely bestowing a designation upon yourself?

When it comes to MA/PDP insurance, accuracy and honesty in marketing are paramount. The Centers for Medicare & Medicaid Services (CMS) has strict guidelines to protect beneficiaries, particularly seniors, from misleading information. Medicare agents must adhere to these guidelines, avoiding any false statements.

I see many MA/PDP agents marketing themselves as a "Medicare Certified" agent, or "Medicare Specialist". Many agents are unaware that these are misleading and false statements that could get them in trouble with CMS and state insurance departments.

An agent that says they are "Medicare Certified" or a "Medicare Specialist" has bestowed a false designation upon themselves. Medicare does not certify agents, and capitalizing the word "Specialist" infers that Medicare has designated you as a "Medicare Specialist" which of course they have not done.

Using false statements like "Medicare Certified" can create a false sense of security and trust among seniors. Medicare beneficiaries, many of whom are navigating complex healthcare decisions, rely heavily on accurate information, especially from health insurance agents they trust. Misleading statements can lead them to trust an agent who without their misleading self-descriptive statements may not have utilized their services.

From a regulatory standpoint, CMS explicitly prohibits the use of false or misleading statements in the marketing of Medicare plans. According to CMS guidelines, agents must not use language that suggests a special relationship or endorsement by Medicare. Violating these guidelines can result in severe penalties, including fines and the loss of the agent’s license to sell Medicare products. This regulatory framework is in place to ensure that all marketing materials are clear, accurate, and do not deceive beneficiaries.

Furthermore, maintaining ethical standards in marketing practices is essential for the credibility of the insurance industry. Trust is a fundamental component of the relationship between Medicare agents and their clients. When agents use deceptive practices, it not only harms the individual beneficiary but also damages the reputation of the industry as a whole. Ethical behavior ensures long-term trust and loyalty, which are vital for the sustainability of any business.

Our CMIP®, CMIS™, and CMIR™ professional designations have been reviewed and approved by a state insurance department legal counsel as being in compliance with the National Association of Insurance Commissioners Model Regulation 278-1 on the use of senior-specific certifications and professional designations.

The CMIP®  professional designation has been determined by FINRA® to be appropriate for listing on the FINRA®  website database for professional designations. The CMIP® designation is the only Medicare Insurance designation listed on FINRA's website database for professional designations.

Go to: https://www.finra.org/investors/professional-designations/cmip for more information.

For more information go to:https://www.certifiedmedicareinsuranceplanner.org

Kevin Firth, President

Certified Medicare Insurance Planner™, DBA

Unethical Enrollment Practices by Medicare Advantage Agents, Agencies, and TPMOs Put Medicare Beneficiaries at Risk

In the realm of healthcare, trust and integrity are paramount. This is especially true when it comes to programs like Medicare, designed to provide essential medical coverage to millions of vulnerable individuals. However, a troubling trend has emerged within the Medicare Advantage landscape, where some agents, agencies, and especially TPMO call centers and lead generation companies resort to unethical practices to enroll beneficiaries, often leading to detrimental outcomes for unsuspecting individuals.

Medicare Advantage, also known as Medicare Part C, offers an alternative way to receive Medicare benefits through private insurance companies. While these plans can provide additional services beyond original Medicare, such as dental, vision, and prescription drug coverage, the methods employed by some agents, agencies, and TPMOs to enroll beneficiaries have come under scrutiny.

The most concerning tactics are cold-calling beneficiaries or using misleading advertising to get beneficiaries to call. Organizations utilizing these tactics often use persuasive language and misleading information to convince beneficiaries to switch plans, regardless of whether it is truly in their best interest. For instance, I have an agent friend whose daughter, an employee call center agent of a very well-known TPMO agency, known primarily for quoting and selling life insurance plans, has gotten into the Medicare Advantage industry. According to this employee agent, they were instructed to persuade the beneficiary to change plans and if they could not do it in a certain period of time, they passed the beneficiary off to a “Closer” who specializes in getting beneficiaries to change plans! Can you believe that? Using “Closers” to persuade Medicare beneficiaries, elderly in many cases, to change plans whether it is in their best interest or not! Placing Medicare beneficiaries in the wrong plans can be detrimental to their health care and finances.

The issue is compounded by the fact that beneficiaries may not fully understand the complexities of Medicare Advantage plans. The nuances of deductibles, copayments, provider networks, and prescription drug formularies can be overwhelming, especially for elderly adults. This lack of understanding leaves them vulnerable to exploitation by unscrupulous agents seeking to capitalize on their confusion.

Furthermore, these agents often employ high-pressure sales tactics, creating a sense of urgency and fear of missing out on supposed benefits if beneficiaries do not switch plans immediately.

Cold-calling and misleading advertising to Medicare beneficiaries not only violates ethical principles but also goes against the rules set by the Centers for Medicare & Medicaid Services (CMS). According to CMS guidelines, agents are prohibited from initiating contact through unsolicited calls for the purpose of enrolling beneficiaries in Medicare Advantage plans. Such practices not only erode trust in the healthcare system but also put vulnerable individuals at risk of making uninformed decisions about their healthcare coverage.

The consequences of such unethical practices are severe. Beneficiaries may find themselves enrolled in plans that do not cover their specific medical needs or medications, resulting in financial strain and compromised health outcomes. Additionally, frequent plan changes can disrupt continuity of care and jeopardize established patient-provider relationships.

To combat this unethical behavior, stricter enforcement of existing regulations is necessary. CMS must take proactive measures to identify and penalize agents and call centers that engage in cold-calling and misleading tactics. Moreover, increased consumer education and awareness campaigns are essential to empower beneficiaries to make informed decisions about their healthcare coverage.

Insurance companies and Medicare Advantage plans have a responsibility to uphold ethical standards and ensure that agents adhere to all regulations and guidelines. Implementing robust compliance and oversight mechanisms can help prevent the exploitation of beneficiaries for financial gain.

There is a reason that Certified Medicare Insurance Planner™, DBA, will only list an agent in their resident state. We believe that although an ethical agent can sell compliantly long distance over the phone, there are many who do not, and it has created quite an issue with CMS in our industry. Also, there can be nuances and changes in an MA plan, especially in a local MA market, where an agent five states away may not be made aware of until much later. We also want a beneficiary to be able to meet face-to-face with their agent if they want to. There is an accountability factor that is present when an agent knows the Medicare beneficiary knows where they live and work.

In conclusion, the prevalence of cold-calling and unethical enrollment practices in the Medicare Advantage industry is a concerning issue that demands immediate attention. By prioritizing ethical conduct, enforcing regulations, and empowering beneficiaries with knowledge, we can safeguard the integrity of Medicare Advantage and ensure that beneficiaries receive the quality healthcare coverage they deserve.

If you are an experienced and ethical MA/Med Supp/PDP producer who would rather walk away from a sale than make one unethically, we would like you to consider becoming a designation holder with Certified Medicare Insurance Planner™, DBA. We are a community of professionals dedicated to excellence in all that we do.

Our designation holders possess our core “K.E.E.” values of Knowledge, Experience, and Ethics necessary to be at the top of their field.

If this describes you, please go to www.certifiedmedicareinsuranceplanner.org for more information.

Kevin Firth, President

Certified Medicare Insurance Planner™, DBA

Certified Medicare Insurance Planner™, DBA, honors Dr. Martin Luther King, Jr., and his generation's entire civil rights movement.

When thinking about those who have made the ultimate sacrifice for what they believe in. Dr. Martin Luther King, Jr. would be one of those at the top of the list in the past century.

As far as the impact made by their sacrifice... he would be at the very top of that list.

Societal evolution from his service and sacrifice has been enormous. Not that long ago, segregation existed in every part of society. White-only schools, water fountains, public venues, churches, etc., were a normal part of society.

I am 60 years young, and I remember riding the team bus with my dad when I was a boy. He was a high school basketball coach, and I recall how restaurant owners would often turn away the team when they tried to eat a pre or post-game meal because we had black kids on the bus.

I have unique experiences as an adult as well, with racism. My wife of 35 years and I met in college and were married in 1988. My wife is a black and Native American woman. In Oklahoma, you didn't have many interracial marriages back then.

When we first got married, we were looking for a church to attend in the town where we lived. I remember visiting an all-white church, and from the time we sat down in the pew until the service was over, we got glares from the congregation... no welcoming smiles or conversation just glares.

As a matter of fact, when we walked out of the service, the pastor was shaking hands as people left. I reached out to shake his hand, and he pulled his hand back, shaking the hands of the people behind us. The pastor refused to shake my hand!

However, racism isn't exclusive to or committed by only one race. Over the years, I, being a white man, have gotten my share of glares and profane comments from black people and people of various races when seeing me with my black wife. I remember an instance when my wife and I were dating, and my wife (my girlfriend at the time) was competing in the Miss Black Oklahoma Pageant. There was a part of the pageant where the girls would perform a dance routine with their boyfriends. Of course, my wife (girlfriend at the time) asked me to perform with her. The pageant director found out that I was a white man, and she refused to let me perform!

Dr. Martin Luther King Jr. achieved success where others before him had not because he led a peaceful movement based on biblical principles. His movement emphasized that individuals should be judged by the content of their character rather than by the color of their skin. Who in the world could argue with that?

We have come a long way as a society since then. We now have one of the most inclusive societies in the world, i.e., a racist country does not elect someone who is a racial minority as president. Unfortunately, nefarious entities and individuals are trying to take the true message of the civil rights movement and are twisting it to take advantage of it for political and personal gain. This only hurts the cause.

Thank you, Dr. Martin Luther King and those who marched with you, for your sacrifice and for the difference you've made in the world. May we as a society never forget where we've come from and realize that we still have a ways to go. However, let us continue to pursue change with the principles spoken of and demonstrated by those with integrity, like Dr Martin Luther King, Jr. and his generation.

God Bless,

Kevin Firth, President

Certified Medicare Insurance Planner™, DBA