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Durante el Período de Inscripción Abierta (OEP) de Medicare, que comienza el 15 de octubre y termina el 7 de diciembre, los beneficiarios de Medicare pueden escoger los planes que sean mejores para ellos. Tú puedes obtener ayuda para comparar los planes de Medicare de parte de los Programas Estatales de Asistencia sobre Seguro Médico (SHIPs) que tienen sede en todos los estados y territorios de EE. UU. También es conveniente comprender lo que los vendedores pueden — y no pueden — hacer para estar preparado si un agente o representante de seguros trata de inscribirte en un plan de Medicare que no es el adecuado para ti.

Los planes de Medicare pueden comunicarse con los beneficiarios dentro de ciertos límites. Las personas que ofrecen planes de Medicare:

  • No pueden llamarte si tú no tienes una relación con su compañía.
  • No pueden enviarte un email si tú no has dado tu acuerdo para que se comuniquen contigo por este medio.
  • No pueden ir a tu casa a vender productos de Medicare sin una invitación.
  • No pueden dejar folletos, panfletos colgados en la puerta ni volantes en tu carro ni en tu casa. Sin embargo, los agentes e intermediarios que tengan una cita programada contigo pueden dejar información sobre el plan en tu casa si no te presentas a la cita.

Cuando te reúnes o habas con un agente, ellos:

  • No pueden iniciar una conversación sobre otros productos de seguro, tales como anualidades de seguro de vida, si tu reunión es para hablar sobre la Parte C o la Parte D de Medicare.
  • No pueden establecer sus propios plazos para que te inscribas en un plan. Tienes tiempo para inscribirte hasta el 7 de diciembre y no puedes obtener ningún beneficio adicional por inscribirte antes.
  • No te pueden amenazar con quitarte tus beneficios si no te inscribes en un plan ni pueden ofrecerte regalos si lo haces.
  • No pueden sugerir que Medicare endosa o prefiere el plan que ofrecen.
  • No pueden hablar sobre productos de Medicare que tú no pediste tratar cuando completaste un formulario de alcance de la cita.

Una vez que hayas escogido el plan adecuado para ti, asegúrate de obtener todos los detalles por escrito antes de inscribirte. Tómate tu tiempo para leer toda la información y verificar los detalles. Por ejemplo, comunícate con tus médicos para confirmar que estén en la red del plan.

Si llama un estafador

Los estafadores podrían llamar y hacerse pasar por representantes o agentes de Medicare con la intención de robarte tu número de Medicare. Pueden falsear la identificación de la llamada para hacerse pasar por representantes de Medicare u otra organización que conozcas, así que no confíes en el nombre que aparece en la pantalla de tu teléfono. Si alguien te llama y te pide tu información de Medicare, del Seguro Social, o datos de tu cuenta bancaria o tarjeta de crédito, cuelga el teléfono. Un estafador puede usar tu información personal para presentar reclamaciones falsas, inscribirte en un plan que no aceptaste o incluso para robarte tu identidad. Un empleado de Medicare legítimo siempre tendrá registrado tu número de Medicare.

Para más información sobre fraudes, errores o abusos relacionados con Medicare, visita smpresource.org. Para reportar a un individuo que se está haciendo pasar por un representante de Medicare, llama al 1-800-MEDICARE y visita ReporteFraude.ftc.gov.

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Dejar un comentario es su elección. Para dejar un comentario, tiene que crear un nombre de usuario. De no ser así, no podemos publicar su comentario. La ley Federal Trade Commission Act autoriza la recolección de esta información con el fin de monitorear comentarios al blog. Los comentarios y los nombres de usuarios formaran parte del sistema de la FTC de registros públicos, los nombres de usuarios también formaran parte del sistema de la FTC de registros de usuario de computadora.

Puede que usemos rutinariamente dichos registros cómo se describe en el sistema de avisos publicados. Para más detalles sobre qué hace la FTC con la información personal que recolectamos, por favor lea nuestra política de privacidad.

El propósito de este blog y su sección de comentarios es informar a los lectores acerca de la actividad de la Comisión Federal de Comercio (FTC) y compartir información con los lectores para ayudarlos a evitar, reportar y recuperarse del fraude, las estafas y las malas prácticas comerciales. Valoramos sus opiniones, ideas e inquietudes y alentamos los comentarios. Pero tenga presente que este es un blog que está bajo moderación. Revisamos todos los comentarios antes de publicarlos y no publicaremos comentarios que no cumplan con nuestra política de comentarios. Esperamos que los comentaristas traten a los redactores del blog y entre sí con respeto.

  • No publicaremos comentarios fuera de tema, comentarios idénticos y repetidos, ni ningún comentario que incluya promociones de venta.
  • No publicaremos comentarios que incluyan mensajes vulgares, ataques personales que mencionen nombres, o términos ofensivos dirigidos contra personas o grupos específicos.
  • No publicaremos amenazas, declaraciones difamatorias, ni sugerencias que alienten actividades ilegales.
  • No publicaremos comentarios que incluyan información personal, como números de Seguro Social, números de cuentas, domicilios residenciales y de email. Para presentar un reporte detallado sobre una estafa, visite ReporteFraude.ftc.gov.

No editamos los comentarios para eliminar el contenido objetable, así que asegúrese de que su comentario no contenga ninguno de los contenidos mencionados anteriormente. Los comentarios publicados en este blog pasarán a ser de dominio público. Para proteger su privacidad y la de otras personas, por favor, no incluya información personal. Las opiniones de los comentarios publicados en este blog pertenecen exclusivamente a los individuos que las expresan. No pertenecen a la Comisión Federal de Comercio (FTC) ni representan sus puntos de vista.

Jill from the Hills
November 04, 2020
Thank you for this! I am just now at that age where I am mandated to sign up for Medicare (Part A). I spent several days during my vacation trying to navigate through the mounds of information! I have no idea what happens to those folks who have trouble deciphering and trying to work through this mess called "Medicare." It's ridiculous. At 65, we're supposed to be losing our "edge" - yet it almost takes an insurance salesperson to wade through it all. Also, I have an issue with our "government" provided healthcare making us seek out a for-profit entity (insurance company) in order to plug the holes of Part A and Part B.
FTC Staff
November 04, 2020

En respuesta a por Jill from the Hills

You can choose to purchase a Medigap or supplemental insurance plan, but the government doesn’t require you to buy additional coverage. A supplemental insurance can help cover the remaining 20% of costs after Medicare has paid.

If you would like to explore other Medicare arrangements, like Medicare Advantage plans that cover different services, now is the time during Medicare's Open Enrollment period. Reach out to your local State Health Insurance Assistance Program (SHIP) by visiting their website and setting up a free and unbiased counseling appointment: shiptacenter.org/about-medicare/regional-ship-location

Lena
November 05, 2020

En respuesta a por Jill from the Hills

Thank you so much for this informative information. I have Ben violated, but didn’t realize it until you sent this email. I have received calls, mail, etc, even though I’m on the National Do Not Call, mail, email or text lists. What do we do when there is a violation?
FTC Staff
November 05, 2020

En respuesta a por Lena

Please report unwanted calls and recorded calls (or "robocalls") to the FTC at www.ReportFraud.FTC.gov.

AboutToTurn65
November 04, 2020
I'm going to be 65 in May of next year. I'm not suppose to sign up until next year, right? I think it's February (month1) to end of August (month 7) with May being Month 4. So, it's not until NEXT year that I need to think about Open Enrollment...right? In February, I get to think about initial enrollment. Since I'm still working, I can use my employer-provided health care (the employer said so). Can we get a "What to know if you turn 65 soon..." (PLEASE!) and thank you!
Curious
November 04, 2020
What about the recording phone calls from pharmacy I usually use and the MEDICARE supplement insurance company that I signed up for this year. I reported to FTC one time for the pharmacy's corporate office using recording voice messages and kept calling to me asking for the refill of medication. It's been so annoying, and even after reporting it to FTC, the calls have yet to stop. I feel like I do not want to sign up with them for the next year enrollment.
FTC Staff
November 05, 2020

En respuesta a por Curious

Even when your number is on the Do Not Call registry, a business may leave you a recorded message that's strictly informational. You could call the pharmacy and tell them you don't want to get phone reminders. Some businesses give customers a choice about how they want to be contacted.

Spooky
November 04, 2020
I already have my secondary insurance... have for a year and over this past year and especially now I must get 10 to 20 calls a day trying to sell me insurance plus email and regular mail. This is harassments from all the agencies. I block their numbers so they just use another number to call from. THIS IS HARRASSEMENT!!!
saherring
November 06, 2020

En respuesta a por FTC Staff

It is a waste of time to report these calls. They come from fictitious numbers that fool my caller ID into thinking that the call is from a local number (usually one that has been disconnected). They also give me fake company names. The Public Service Commissioner says there is no way to track them down. Just hang up.
FTC Staff
November 09, 2020

En respuesta a por saherring

Reporting unwanted calls does help the FTC and law enforcement. The FTC analyzes report data and trends to identify illegal callers based on calling patterns.

The FTC takes the phone numbers you report and releases them to the public each business day. This helps phone carriers and others working on call-blocking and call-labelling solutions. Your reports also help law enforcement identify the people behind illegal calls.

Faye
November 05, 2020
This is the best news that I have read since opening enrollment begin. It is like they Medicare are pushing people to enroll in Humana & United Health Care. Thanks for the information. Faye
Sheila Johnson
November 05, 2020
Jill is so right. I help my parents (87 and 84 years of age now) every year with open enrollment and I am so confused. I can only imagine how hard it is for the elderly that have no one to help them. Our government needs to do something to streamline this issue. And yes, it is not a requirement for them to have the supplemental, but the threats they get about not being able to pay for things without it is ridiculous and should be illegal. Nor, should a person be penalized and have to pay more for coverage at a later date if they don't get a supplement when they first start receiving Medicare benefits. That should be ILLEGAL!! Our government has a long way to go regarding health coverage no matter what party wins the election! I hope someone has a plan that is beneficial to all!!
jlalt4403
November 07, 2020

En respuesta a por Sheila Johnson

Good Morning. I turned 67 in September 2020. I started receiving my Social Security when I turned 66 in 2019. However, someone registered me for Medicare Part A, effective September 2018; however, I didn't receive my Medicare card until after I started receiving Social Security in 2019. I didn't want to apply for Medicare Part A&B at this time because I am still working for the State Highway Administration and covered under their Health Insurance Plan. In the meantime, I am receiving dozens of requests to join their insurance plans. What should I do now that I have been pushed into Medicare Part A? Should I stay with my current company health insurance? They are also in the process of open enrollment. I read that I have to apply for Medicare Part B now. Is that correct? Please help!!
Carol
November 06, 2020
Why do plan "Yearly Drug & Premium Cost" amounts change during the enrollment period? And why are they *allowed* to change? Shouldn't they be "locked in" once submitted by the insurance company to the Medicare website? I have been comparing for several weeks and for the SAME PLAN, amounts have changed from week to week within the enrollment period! I have the screenshots to prove it? Why does this happen and why is it allowed?!
Carol
November 06, 2020
How can I resolve a discrepancy between a medication's Tier as reported on the Medicare website and the same medication within the company's formulary? On Medicare.gov, a Plan says a med is a Tier 2 Drug but in their own formulary for the same Plan and the same play year, it shows that it will be a Tier 4 drug. I contacted the Plan, itself, without any satisfaction. Why are the insurance companies allowed to do this - to lure you into selecting by promoting a med as a lower-tiered drug than in their formulary? And once you are in the Plan year, when you purchase the drug, which Tier will "win" when the invoice arrives? Will the member/customer win the dispute with screenshots of the Medicare "advertised" Tier?