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5 Things to Know About New Medicare Security & Privacy Rules and Regulations

By September 25, 2022October 23rd, 2022Enrollment, Medicare
New Security & Privacy Rules and Regulations

There are many news updates this year during annual enrollment among those are security, privacy rules, and regulations. We compiled a list of important updates you should know about.

1. We all renew our Advantage and Part D drug plans every year – make sure that you are involved

All of us at Fortende Health are Seniors and participate in Medicare. And every year, beginning October 1st., we start our own annual review of policies for our clients and ourselves. All Advantage and Part D plans change every year, and all enrollment is annual. Your coverage changes every year, and it is worth taking the time to understand changes to your policies and potential alternatives.

Some of us have supplements which don’t require annual review beyond cost and benefits relative to Advantage participation. For those of us with supplements, we review Part D drug plans that we participate in for cost and coverage. Advantage plan participation is approaching 50% of the total Medicare population, nationwide satisfaction scores were up 3 points (on a 1000-point scale) in 2022, and up 15 points in the last five years (J.D. Power).

It is worth paying attention as costs are changing in 2023 – including some that are decreasing. Last year 69% of Advantage plans had no premium, and average premiums have fallen over the last 5 years to $18 per month. Other important cost changes for 2023 are shown below. If you do not review your plan every year, you will simply be rolled into the next version of the Plan, which may or may not be the best choice for you in your market.

Cost element

2. New Rules are in place for recording all calls

The TV ads featuring former actors and football players are relentless, ubiquitous, and abusive (in my opinion). They are paid for by third-party marketing organizations (TPMO) who sell your contact information to agents and brokers, who then unleash the full power of telemarketing – your response to the advertisement constitutes permission under the existing regulations. Complaints about marketing were up 165% this year, and the government responded with the requirement that all calls must be recorded. This is a pain in the neck (my opinion) but we will comply – in the fond hope that this regulation can reduce the chaos and abuse in the system.

One important point – we at Fortende Health will never sell or divulge anything about our customers to anyone, except to insurers in the process of getting you coverage. We respect your privacy.

3. All calls must begin with a disclaimer

The disclaimer is, “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact or 1-800-MEDICARE to get information on all your options.” I have this disclaimer taped to my computer screen here at work, and I fervently hope that I never forget to start a call with a fellow Senior that does not begin with this kind introduction. This same disclaimer is required in all written communication, so I have attempted to splash it liberally around our website and email signatures. At Fortende, we represent at least a dozen carriers, and will add any carrier that has a policy we feel is the best in the market for our clients. Because of the technical requirements of several carriers, it is not possible to represent every carrier as an independent agent.

4. The rules for Scope of Appointment Forms remain functional

Scope of appointment forms will still be required for any sales presentation for Medicare beneficiaries for Advantage and Part D plans. These forms seem redundant when all calls must be recorded, but if their continued requirement reduces the harassment burden of any Senior, then the juice is probably worth the squeeze.

5. Work with someone you trust

All the rules that are put in place to control sales abuse in Medicare will not stop fraud and abuse. They can limit it, and help to better define it, but they cannot stop it. Medicare sales are reasonably lucrative, and the annual renewal process means that there a 65 million shoppers each year, looking for sales between October 15th and December 7th. This results in an annual feeding frenzy where highly sophisticated sales organizations engage Seniors to sell a necessary product – healthcare coverage. Both your physical and financial health are tied up in this decision – so please take your time and work with someone you trust.

Wes Chapman

Wes Chapman was educated in Mexico and Spain, then had a 20-year career in investment banking in Latin America, finishing with 10 years as region director for Oppenheimer in Latin America. He spent the last 20 years in healthcare, focused on patient-centric, value-based care. He started Fortende to address the unmet needs of Medicare beneficiaries spending time outside the U.S.

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