Misleading marketing has run rampant in the private program for too long, though new CMS regulations will attempt to offer more protection for enrollees.
Medicare Advantage (MA) can attribute its growth to several factors, but deceptive marketing is undeniably somewhere on that list.
When your consumer base is senior citizens, the ease with which MA and traditional Medicare can be confused isn't a bug, it's a feature. Health plans selling the private program are able to take advantage of beneficiaries' confusion with marketing tactics that prioritize profits over well-being.
Whether it's a celebrity endorsing MA on a TV advertisement or a broker not being completely forthcoming, MA has been ripe with misleading and deceptive practices.
Where exactly is that marketing coming from and what is being done to protect enrollees?
According to a recent report from the Commonwealth Fund, non-government entities—agents, brokers, partners, and health plans—account for one-third of all Medicare-related search records and 87% of all search engine ads.
"Medicare Advantage plans are promoted through direct mailings, telemarketing, and advertising on radio, television, websites, and social media channels," the report stated. "No organization, including the federal government, directly 'markets' traditional Medicare, although commercial insurers sell supplemental Medigap and Part D plans for people in traditional Medicare. Thus, nearly all beneficiaries are subject to some form of marketing effort."
When people aged 65 or older sought help with their plan choice, the analysis found that 31% turned to agents and brokers in MA. As brokers and agents are paid commission by insurers, enrollees can be at risk of manipulation.
The Commonwealth Fund also highlighted that CMS reported more than 41,000 complaints in 2021 about Medicare private plan marketing, which was double the number in 2020 and up from about 6,000 in 2017.
The marketing problem has gotten out of hand, which is why plenty of lawmakers have taken notice and attempted to push CMS to implement necessary regulations.
CMS listened and cracked down on unscrupulous marketing tactics in its MA 2024 final rule. The changes will take effect on September 30, before the open enrollment period when plans will once again attempt to lure beneficiaries through TV ads and other media.
As part of the rule, CMS will:
- Prohibit any ads that do not mention a plan name, use words and imagery that could confuse enrollees, or use Medicare logos in a misleading manner.
- Protect beneficiaries from prevent predatory behavior and strengthen the role of plans in monitoring agent and broker activity.
- Protect enrollees by ensuring they receive accurate information about Medicare coverage and are aware of how to access accurate information from other sources.
"This final rule will strengthen Medicare Advantage and hold health insurance companies to higher standards for America’s seniors and people with disabilities by cracking down on misleading marketing schemes by Medicare Advantage plans, Part D plans and their downstream entities," CMS said in a press release.
Jay Asser is the contributing editor for strategy at HealthLeaders.
Medicare Advantage marketing has been under fire for its dishonest tactics in targeting beneficiaries.
A report by the Commonwealth Fund found that CMS reported more than 41,000 complaints in 2021 about Medicare private plan marketing, which doubled 2020 and dwarfed 2017's figure of 6,000.
CMS made marketing a priority in its Medicare Advantage final rule for 2024, which includes restricting any ads that do not mention a plan name or use confusing imagery.