SIKESTON -- Area residents who have both Medicare and Medicaid are being talked into paying for insurance which increases their out-of-pocket expenses.
Brenda Knat, office manager for a Sikeston physician's office, said for some people, such as those on Medicare who don't have a lot of health problems and don't seek a lot of services, Medicare Advantage Plans can save them a little bit of money.
Knat said reputable Medicare Advantage Plan providers "tell them up front that if you have Medicaid, you don't need their product."
At least two companies, however, are now soliciting patients by phone and sending agents door-to-door to sell their product to people who will receive no benefit from the product and who will only end up paying more and getting less.
"They are soliciting heavily the poor, uneducated communities. They're saying nothing changes but a lot changes," Knat said. "They're telling their patients it works the same as Medicare but it doesn't. We've had several patients that have been taken advantage of. They are being sold something that is being represented as something that it's not and they don't find out until they have a large bill or are denied service."
Low income elderly who have both Medicare and Medicaid will actually begin to have to pay for services out of their own pocket, Knat said.
"They don't realize they are relinquishing their Medicare. They're being confused," Knat said. "Most of our patients discover they no longer have Medicare when the bills start showing up. People are showing up at our offices thinking they have Medicare and being stuck with large bills."
Another person who works in billing at a local medical facility who spoke on the condition of anonymity said it is her understanding that Medicare Advantage Plan providers aren't supposed to be calling Medicare patients to solicit them in the first place. "And it's getting worse," she said.
Knat said those who do sign up for a Medicare Advantage Plan can get back on Medicaid but will often find there is a penalty period during which time they will be completely without coverage.
Even if there is not a sit-out period, "once they change back that doesn't make these bills go away," Knat said. "They're obligated to pay them."
In addition to increasing out-of-pocket expenses, a lot of primary care physicians, specialists and and other medical providers won't accept these Medicare Advantage Plans.
Knat said the Missouri Division of Aging and Family Services are both beginning to get a large number of complaints.
"So many complaints that the area Division of Aging is telling us to call the attorney general," she said.