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Strict Rules For Medicare Advantage Plan Companies

Posted: 4:46 pm MDT October 1, 2008Updated: 7:19 pm MDT October 1, 2008

After a slew of cases of Medicare fraud in El Paso, insurance agents selling Medicare Advantage Plans have a whole new set of strict rules to follow this year.

This Oncology medical center in Central El Paso continues to deal with the ramifications of unscrupulous insurance agents deceiving senior citizens.

"When the patients come in and don't know the insurance they have," said Norma Boeta, a business manager at the Oncology office.

As KFOX reported last year, deceptive insurance agents were selling senior citizens any Medicare Advantage Plan. The problem is the agent only cared about his hefty commission for every enrollment he made and didn't care what would happen to the senior citizen."

"Patients would show up for cancer treatment the Medicare system says you're no longer in original medicare, we don't accept the plan you work with, it delayed treatment for life threatening conditions," said Norma Almanza who works with the Texas Department of Insurance in Austin.

Almanza specializes in Medicare. She's experienced the frustration of a system gone astray because of greedy insurance agents. She's in El Paso to inform the public about new rules set up to protect them.

"Last year we saw that suddenly we had a rash of temporary agent applications. Temp agents don't have the training to sell these products," said Almanza.

One of the first changes made is that insurance companies will no longer hire agents with temporary licenses. Companies have to notifiy the Department of Insurance about every licensed agent it appoints. And companies are required to report any agents that they terminate and the reasons why.

The rules were applied in the hopes to stop the fraud because it keeps affecting thousands of people in El Paso including doctors.

"The doctors are the ones that are constantly losing out. Our office is constantly battling with the insurance," said Boeta.

If you or your family members are getting calls from agents selling a Medicare Advantage Plan, they are in violation and you can report them to the Area Agency on Aging. The number you can call is 1-800-252-9240.

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