The Private Medicare Maze

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Last night we told you how a large part of the Medicare program is now privately run by insurance companies — and how confusing and costly that private coverage can be for some senior citizens. Tonight we take a hard look at how far some insurance agents will go to sign up new customers for their private Medicare plans.



T.W. Aldridge lived — and died — in Mississippi, where today there are more insurance complaints about private Medicare plans than Hurricane Katrina, CBS News chief investigative correspondent Armen Keteyian reports.

"I wouldn't be surprised if Dad would still be with us today had he been able to go and felt he could go to the hospital," said T.W.'s son, Mark Aldridge.

The 74-year-old Aldridge fell victim to the kind of scam that has mushroomed since Congress handed over a large part of Medicare to private insurance companies: Sleazy salesmen and con artists signing up seniors for private Medicare Advantage plans without their knowledge — all to collect hundreds of dollars in commission.

For Aldridge it was a forged signature that put him in a plan his doctors and hospital — didn't accept.

"He told the doctor I can't go to the hospital. I don't even have insurance, they got me so fouled up," Aldridge said.

"Brokers, who are often pretty much unregulated in most parts of the country, are going around, working for high commissions," said Bob Hayes of the Medicare Rights Center.

ACBS News investigation has found Medicare Advantage has become a costly disadvantage for tens of thousands of seniors who unknowingly wind up on a private plan they don't want or need...hooked by unscrupulous salesman, leading to complaints in 43 states, including Mississippi.

Leslie Norwalk is the head of Medicare.

Keteyian told her: "We know one man who was dead and he couldn't get out of Medicare Advantage. We got a woman in Kentucky who had to call 9-1-1 to get the salesman out of her house. We have another case where agents are signing up dead people in Georgia. We have another case in Mississippi where 100 people whose IDs were stolen, they turned up on Medicare Advantage. I mean, when you hear things like that,"

"I'm glad that we have such competent law enforcement partners and that we work together with them as soon as we hear of these things," Norwalk said. "One of the things that we've done recently is work with the seven biggest plans. They are no longer marketing."

"Well, here's, here's one that's not in your plan. You want to take a look at that?" Keteyian asked her. "They were crowing about the fact that these other people were out but they're still at $400 commissions per person."

"I think one of the things that we've done for in terms of a commission perspective, if someone is dis-enrolled, we have worked with the plan to ensure that the agent or broker does not get commission," Norwalk said.

Still, at the Medicare Rights Center, complaints pour in about tactics used by some of the 200,000 agents pushing private Medicare plans nationwide.

"The reality is that even if we had, you know, altar boys, [if] we had, you know, saints, going around selling these plans, people would still be confused," Hayes said.

"We're going to drain this swamp," said Sen. Ron Wyden, D-Ore. "This is not an isolated set of instances."

Seniors are so upset CBS News has learned at least 36,000 have pulled out of their private Medicare plans in just the first four months of this year. And nearly 100 private plans have been ordered by Medicare to change the way they do business.

T.W. Aldridge was finally able to get off his plan and back to traditional Medicare. But not until eleven days after he died last August.

"The last thing that he said was 'take care of your mom, make sure you take care of those bills. Don't leave all those on her,'" his son said.

Those are bills that total $40,000; bills that Medicare has yet to lay to rest.
  • Christine Lagorio

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