Keeping the Consumer First: It’s Time to Address Misleading Medicare Advantage Marketing

November 29, 2022

by Michael Bagel

As Medicare Advantage, with its high-quality and affordable offerings, has grown to become the predominant choice of America’s seniors, the amount of unclear and deceptive marketing material – and associated complaints – has risen considerably.

With more than 29 million seniors enrolled in Medicare Advantage and more than 10,000 new seniors aging into Medicare every day, it is no surprise seniors are being inundated with information. Unfortunately, too much of today’s Medicare Advantage marketing from third party-marketing organizations is inappropriate, confusing, misleading or inaccurate, misrepresenting choices in a program that works for America’s seniors.

Third party marketing organizations, agents/brokers and field marketing companies’ trip over themselves to blitz the market and secure their portion of the billions invested in marketing campaigns – and the accompanying commissions – each year. Seniors have the right to select the best health coverage for their individual circumstance without high-pressure sale tactics, inaccurate information or misleading claims.

More than 29 million Americans have chosen Medicare Advantage (MA) — and the program continues to grow at a record place. Learn why MA has become the choice of America’s Seniors.

Learn More

Health plans have a duty to their consumers and taxpayers to be responsible stewards of every dollar spent on premiums. ACHP supports taking steps to ensure unbiased, comprehensive, actionable and transparent information is provided to consumers when selecting their health care coverage. We recently detailed how the Administration can take immediate action to keep consumers first.

The Centers for Medicare & Medicaid Services (CMS) has committed to oversight, detailing in an October 2022 guidance memo that they have conducted “secret shopping” and will initiate enforcement action against third party marketing organizations and agents unduly pressuring consumers. These are critical first steps, but more can be done. CMS should begin by reforming agent and broker administrative compensation through standardizing and limiting override and supplemental commission dollars.

Most consumers stay with their health plan year-after-year, yet marketers, agents and brokers have misaligned financial incentives to get consumers to switch plans. That is wrong. CMS should keep a close eye when seniors are disenrolling and being reenrolled in a different health plan to identify outliers and focus on the agents and brokers with the highest disenrollment activity. CMS must lead this important work in partnership with health plans. Offloading responsibility and increasing the burden on issuers would be ineffective at addressing the root causes of misleading and inappropriate marketing practices.

We know seniors watch television and are influenced by commercials and infomercials. Promises made in these advertisements may be limited to eligible seniors or geography; they may also come with other benefit package implications that are not clear and evident to the senior, or in their best interest. To their credit, CMS has announced that they are monitoring advertisements during the 2022 Medicare annual enrollment period and will be taking further action next year to regulate information used in television marketing. If seniors are to rely upon television advertisements to inform their health plan selections, comprehensive, accurate and direct information must be available.

Seniors deserve the opportunity to be informed consumers, selecting the health coverage best suited to their individual needs. It is time to raise the bar on Medicare Advantage marketing, the choice of America’s seniors.