Official: Few issues with Advantage in Maine

Maine is not among the 39 states investigating their Medicare Advantage programs, according to Deputy Superintendent of Insurance Judith Shaw. About 4,850 Mainers are enrolled in Medicare Advantage plans.

While there have been “a couple of issues” here associated with Medicare Advantage – including one case in 2006 that resulted in a court-ordered settlement – Maine seniors enjoy a number of protections against unscrupulous insurance vendors, she said.

Most problems that have come up have been inadvertent, Shaw said.

“Part of the problem is that all Medicare products are very complex and can be confusing to [sales agents] as well as to consumers,” she said. For example, improper enrollment in one type of plan can inadvertently lead to a consumer being dropped from other coverage, she said.

“To the extent that we’ve had problems in Maine, the insurance companies have been willing to sit down and work it out,” Shaw said.

Two pieces of state legislation enacted during the current session increase protections for vulnerable seniors, Shaw noted. One regulates the conditions under which insurance agents can market their products, including banning door-to-door sales. The other new law requires agents to clearly identify themselves as sellers of insurance products, as opposed to calling themselves “senior specialists” or other misleading titles.

Shaw said Maine regulators pay close attention to investigations in other states.

Seniors everywhere are vulnerable to unethical sales techniques, she noted. “Sometimes they just want someone to talk to,” she said.