Skip to main content

Are you or a loved one nearing Medicare age? A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that original Medicare doesn’t cover. This includes copayments, coinsurance and deductibles. Some Medigap policies also offer coverage for services that original Medicare doesn’t cover. While the process can be overwhelming, it is important to be aware of these 10 red flags by knowing what to watch for.

10 Illegal Medigap Practices

1.  Pressuring you into buying a gap policy, lying or misleading you to switch from one company or policy to another.

2.  Selling you a second Medigap policy when they know that you already have one, unless you tell the insurance company in writing that you plan to cancel your existing policy.

3.  Selling you a Medigap policy although they know you have Medicaid (except in certain situations).

4.  Selling you a Medigap policy if they know you’re in a Medicare Advantage Plan, unless your coverage under the Medicare Advantage Plan will end before the effective date of the gap policy.

5.  Claiming that a gap policy is part of the Medicare program or any other federal program. It is private health insurance.

6.  Claiming that a Medicare Advantage Plan is a Medigap policy.

7.  Selling a Medigap policy that can’t legally be sold in your state. Check with your State Insurance Department to make sure that the policy you’re interested in is available in your state.

8.  Misusing the names, letters or symbols of the U.S.Department of Health & Human Services (HHS), Social SecurityCenters for Medicare & Medicaid Services (CMS) or any of their various programs like Medicare.

9.  Claiming to be a Medicare representative if they work for a Medigap insurance company.

10.  Selling you a Medicare Advantage Plan when you say you want to stay in original Medicare and buy a gap policy. A Medicare Advantage Plan isn’t the same as original Medicare. Enroll in a Medicare Advantage Plan, will dis-enroll you from original Medicare and will not be able to use a gap policy.*

For more information, please contact our Medicare certified agents with any questions you may have. Just call us at 724-929-2300. We would be happy to assist you.