ADVANTRA FREEDOM, Medicare Scam Nightmare

Me and my parents ^ | May 16, 2007 | yosemitest

[Yosemitest]

WHAT A NIGHTMARE!!! Imagine you drive your mother to the doctror's office to have her sugar diabetes checked and the clerk at the check-in desk tells her that her Medicare Part A and Part B no longer covers her. She had been disenrolled in Medicare. She cancelled her appointment and went straight to the Social Security Office, only to find out that it would probably take about a year to undo what had been done by Advantra Freedom.

The Mississippi Commissioner of Insurance's Letter describes it best. Here's an excerpt:

"1). The agent will actually claim to be from Medicare. In many instances, the agent will presednt a red, white, and blue card that looks like a Medicare recipient's card.

2). The agent will have the Medicare recipient fill out a "request for more information," form, when in fact the "request" form is actually an enrollment form for whatever Part C or D plan the agent is selling.

3). The agent will ask the Medicare recipient to sign a form "just to show [my] boss" the agent contacted the recipient.

4). The agent assures the Medicare recipient that enrollment will not affect his/her Medicare coverage. While this may be true of some portion of Medicare plans, MID (Mississippi Insurance Department) is finding that the recipient has been completely disenrolled from the Medicare Part A and B. Often the recipient discovers this fact when a health care provider informs tham that Medicare has declined to pay a charge.

5). The agent tells the Medicare rtecipient that enrollment in the plan he or she is selling will not cost anything. Nothing is free. The agent receives a commission from the sale and premiums will be coledted from policy holders.

6). In a particularly serious case, MID found that several recipients had no knowledge of being enrolled in a Medicare Part C plan, and had never had any contgact at all with the agent responsible for enrolling them. It is believed that the recipient's personal information was obtained fraudulently, and was used on the plan enrollment forms."

Missippi's Social Security Office was a big help and got us started. After consulting Advantra Freedom's web site and following the instruction in question number 11, we were able to fax in the Disenrollment Request before the deadline of Apr 30, 07.

But later, we got the 'royal run-around' in a letter sayin they needed more "proof that member has original Medicare only or original Medicare and a stand alone Part D plan." So we went back to the Socal Security Office, and they tried to help. But that office couldn't disenroll her from Advantra Freedom (should be called slavery and not freedom). They called the main Social Security office and that office told us to file an appeal, which we are now doing. But they said that it would probably not take effect until the next open period of time to disenroll from Advantra. That office gave us a printout showing that my mother and father were still paying for Medicare Part A and B.

Anyway, my main point is that Advantra Freedom should be avoided at all cost, and make sure your parents don't get confused or taken by these crooks.

[Yosemitest]

Avoid these liars. We're considering litagation against Advantra Freedom for misrepresenting what they were doing, but I don't know if we can.

I hope Advantra Freedom is fined out of business, and they have to spend time in jail.

[RSmithOpt]

Many, many others are engaged in sucking up Medicare dollars in front businesses that claim to take care of all the paperwork for the recipients. Some are legit and provide a needed service, however, most, are not. I wish some could read the legislation that allowed the sleazy companies to even start such a business.

All them little last minute add-in items too that somehow get approved by the politicos.

The ones I like are like AFLAC where you pay in so much a year and if you don't use it, they keep it, plus the interest....and there's a minimum monthly amount to be paid based upon the number covered in the family. Also, AFLAC will only pay so much per year/ per situation.

[Yosemitest]

Thanks. I like the AFLAC commercials.

I'm just worried that we can't sue Advantra Freedom because of protection from lawsuits due to government regulation.

[sneakers]

I don’t know if this is the same thing, but last week, after getting my moms meds refilled under her state employee plan (Medco) for the last eight years, she was all of a sudden rejected and I was told she would have to go through her “primary provider”. I told the pharmacist that she had only one provider - Medco. Upon calling Medco, I found out that she had been flipped over to Medicare, Part D without her, or my consent! Medco said the change was on Medicare’s part, not theirs, and that they were no longer listed as the primary provder. We are in the process of trying to get the entire thing straightened out. What a mess. I wonder if the Part D is through Advantra. I’m calling Medicare!

[RicocheT]

The scams on Medicare continue. Grandma’s “free” electric scooter or Gramp’s “free” by mail diabetes test kit actually cost all of us, via taxes to fund Medicare, a heck of a lot more than if the item was purchased locally via your doctor’s prescription than via a TV ad or telephone solicitation.

[Yosemitest]

I wish you luck. I'm writing my Senator and Congressman as well as my State Insurance Commissioner. You should do the same. This site might help.

[RSmithOpt]

Government regulation is the key point. The government protects the crooks for a while so politicians and department heads can skim a few bucks too (kickbacks or political donations) as has been my experience here with the local politics.

BTW, I love that duck too. However, AFLAC is a money making business and a smoke and mirror pacifier to the general public.

[Yosemitest]

The scams continue. Use mygovernmentguide.com

[sneakers]

Thanks, Yosemitest. I’m sending notes expressing my displeasure with this government intrusion.

This is war!!

My mom’s state coverage is excellent. My in-laws have had nothing but trouble and expense under Med., part D.

[M. Dodge Thomas]

I know I'm really, really in the minority here.

But I don't care what free-market theory says, as someone who has been deeply involved in the care of elderly parents and in-laws it's clear to me that in the real world attempts to involve private providers in heath care for the elderly have been a political boondoggle, mostly adding lots of administrative expense that provides little if any additional value, and often ruthlessly exploiting elderly citizens to are in no position to be sophisticated consumers of byzantine medical insurance plans.

[Wiseghy]

Medicare sales are federally regulated, as well as state. Those who solicit usually have to complete special classes and buy E&O. I pity any inexperienced person who gets into this market and gets hooked up with a company like this.

Beware any company that recruits agents who are inexperienced, pushes sales over total compliance and ethics and spends all their time talking about how rich you’re going to be, instead of how much work it is to solicit people in the market place and be honest.

Those in charge in these operations belong in the deepest dungeons of the deepest prisons. They victimize everyone, especially the 99.999% of honest insurance agents who trade on trust and credibility.

[Yosemitest]

Thanks.

[Wiseghy]

I knew a truly dishonest insurance agent only once in 21 years.

I told my various companies that I would never work with him, even though we was regarded a “very successful” and had a great PR profile with the business press, etc.

He is now on parole from two state prison terms for fraud.

Any business person and regulators should recognize that, eventually, these things catch up with people. All it took for this guy was his pushing it too far just once, and a smart DA who could see the behavior and moved to stop it.

[vharlow]

My husband has been in this business since 1966....you don't know how right you are! We have known any number of absolutely shyster agents. Had to go set up our own office and work independently in order to get away from the greed mindset.

Yet, most reputable agents with more than 3 years in the business, and membership in professional associations can do a great deal of good and be very helpful. AHIA is an organization with professionals who have had years in the industry. You can always find a reputable agent by checking their website.

[Yosemitest]

Only one truly dishonest in 21 years? How about the other dishonest agents?

After 24 years of moving around with the USAF and 5 years of moving around with the FAA, I've seen more than one. I know that they aren't all dishonest, but I'd like to get justice from this situation, and I hope everyone e-mails this article to anyone they know that might be considering Medicare Part D.

After typing all day and sending more faxes than I care to count, not to mention the lost money in gas, as well as time... I hope Advantra Freedom gets sued by every customer they have!!!

[sneakers]

bttt

[Yosemitest]

2nd ur btt

[Briansurance]

First, let me say that I am very sorry for your experience. It’s a shame that there is so much confusion about these programs, because they really do help a lot of folks in need save a lot of money.
I am a very small government person, along the lines of Ron Paul or The Constituition Party. And as much as I hate this system we’ve created of socialized medicine for seniors, and as doomed as I know it inevitably is, my reasoning is that for right now, since millions of seniors have paid into this system for all of their working lives, and they could have done much better for themselves by taking that 15% of their income and investing it elsewhere, whatever value of that I can get back for them at this point is not even close to what they deserve, so I do the best I can for them from that perspective.
I am life and health insurance licensed and I do a lot of Medicare Part C (Medicare Advantage) enrollments, including several Advantra Freedom products. Advantra Freedom is a decent product, and the company is totally legit, but like most companies, there is more bureaucracy than there should be, and Coventry Health (the company that issues Advantra Freedom products) has it’s share of inefficiencies that need improvement. But that’s the case with lots of companies these days, whether they sell computers or mortgage loans.
That’s why no matter what Part C Medicare product my client enrolls in, if they have a problem, question, or concern, I always tell them to call me, not the company, because I can often bypass the phone menus and misdirected call transfers and get the answer quicker than they can by calling my Agent Help Line, and usually with less hassle. Even if it’s a pain for me, and I have to do it through customer service, even when the call must be with the client and the company on the phone, I act as their advocate to get the answer they need as painlessly for them as possible. I know how to run around the run around. That’s my commitment to the client.
I note from the original post that the entire problem would have been nonexistent if you and your relative hadn’t been given misinformation by the clerk at the doctor’s office. It’s clear that she didn’t know what she was talking about, and if you’ll take a look at pages 33-35 of the “Medicare & You 2007” book, this year’s issue of the official government handbook for Medicare that is sent to every Medicare recipient each year, you’ll see exactly what I’m talking about. ENROLLMENT IN MEDICARE ADVANTAGE PROGRAMS DOES NOT DISENROLL A MEDICARE RECIPIENT FROM PART A OR PART B OF MEDICARE. THIS IS PLAINLY STATED AT THE TOP OF PAGE 35.
Unfortunately, there is an astounding amount of ignorance in doctor’s offices about what Medicare Advantage is, even in their billing and insurance departments, and that’s where your misunderstanding arose. Had you not heard that incorrect information, your relative might be enjoying the real benefits of that program now, which are substantial to the recipient in most cases.
Based on your reaction, I question whether the enrolling agent had done his/her job at the beginning, as I do by showing my prospects the Medicare book right off the bat. If they had, you would not have been thrown into a frenzy by an ignorant clerk, and if you had concerns, you would have brought the question back to the agent, who would have given you the clear answer, pointing you back again to the horse’s mouth, the Medicare book.
Trust me, this business is highly regulated, and even without any formal complaints being made, an agent who has an abnormally high ratio of clients disenrolled to clients enrolled within a short period of time will not be allowed to continue very long with that company, because the company will have their contract with Medicare rescinded if they have too many complaints or cancelled enrollments, indicating poor training or screening of agents.
Feeding these problems is also the fear of change. The addition of Part C & D were the biggest changes in the senior healthcare infrastructure since the inception of Medicare in 1960’s, and I imagine 40 years ago there was a lot of fear and resistance amongst both recipients and health care providers when Medicare started as well. And a lot of missteps and inefficient delivery of benefits in the beginning by the new government infrastructure. But today, of course, most of us are more comfortable with it and take the system for granted, because the largest kinks have been worked out in day to day operations, we’re used to the remaining inefficiencies, and by the time we become recipients, we’re intractably in the system, like it or not. We all here understand and agree on why that’s not necessarily good in the long run, but that’s water under the bridge at this point.
Again I’m sorry for your difficulty. Don’t let that turn you off completely from the concept of Part C, which when done well is a godsend for seniors as a whole. All companies and all plans are not the same, so shop around. Part C and D are the future of Medicare, by necessity, if it is to have one. The domination of supplements is waning because they are quicky becoming too expsensive for most clients. That’s why C exists.
As a last note, I see that the bulletin you cited from your state says nothing about any particular Part C program, and you don’t say that the enrolling agent in your relative’s case claimed to be from Medicare, which as the bulletin says, would have been unethical, even though they may have been representing a Part C plan that was subsidized with your relative’s Part B premium and taxpayer money, the administration of which was contracted out by the federal government to a private health care company, because the private company is able to provide substantially more benefits to the Medicare recipient for the same money, than can the government. More benefits, lower consumer costs. Isn’t that what we’re all supposedly after?
Again, for clarification on what Medicare Part C really is and what is really does, please see pages 33-35 of the Medicare and You 2007 book.
May God bless you and your family, and give you peace!

[Yosemitest]

First, let me say that I am very sorry for your experience. It’s a shame that there is so much confusion about these programs, because they really do help a lot of folks in need save a lot of money.

Okay ...you're sorry. NOW tell me another lie. Let's address the money "saved" issue.

First, there's the gas cost issue of, not one but four thirty-mile one-way trips to the doctor's office and social security office.
Second there's the cost of faxing letters of complaint to every government official that I could think of to help my parents correct the intentional errors the Advantra Freedom agents(may they rot in hell) made. This expense actually paid off.
Third, there's the health cost of damage done to my mother's body while waiting(about 60 days) to see the doctor who knew here case.

I am a very small government person, ....my reasoning is that for right now, since millions of seniors have paid into this system for all of their working lives, and they could have done much better for themselves by taking that 15% of their income and investing it elsewhere, whatever value of that I can get back for them at this point is not even close to what they deserve, so I do the best I can for them from that perspective.

Like they had a choice of declining Social Security taxes all of their lives...

Listen! This is a rip off, made to enrich shysters. I'm retired military and was promised free medical and dental care for life. But thanks to William Jefferson Blythe Clinton and the democrats, that promise was broken in 1993, as well as increasing taxes on Social Security, and taxing the dead postmortem.

I am life and health insurance licensed and I do a lot of Medicare Part C (Medicare Advantage) enrollments, including several Advantra Freedom products. Advantra Freedom is a decent product, and the company is totally legit, but like most companies, there is more bureaucracy than there should be, and Coventry Health (the company that issues Advantra Freedom products) has it’s share of inefficiencies that need improvement. But that’s the case with lots of companies these days, whether they sell computers or mortgage loans. That’s why no matter what Part C Medicare product my client enrolls in, if they have a problem, question, or concern, I always tell them to call me, not the company, because I can often bypass the phone menus and misdirected call transfers and get the answer quicker than they can by calling my Agent Help Line, and usually with less hassle. Even if it’s a pain for me, and I have to do it through customer service, even when the call must be with the client and the company on the phone, I act as their advocate to get the answer they need as painlessly for them as possible. I know how to run around the run around. That’s my commitment to the client.

I appreciate you helping your clients. But that didn't help my parents, and I'm not sure you're telling the truth. For all I know, you're just doing damage control for Advantra Freedom (May God reward them according to their works). But for me and my parents, we'll drink a toast to their demise, and will tell everyone just how rotten they were.

I note from the original post that the entire problem would have been nonexistent if you and your relative hadn’t been given misinformation by the clerk at the doctor’s office. It’s clear that she didn’t know what she was talking about, and if you’ll take a look at pages 33-35 of the “Medicare & You 2007” book, this year’s issue of the official government handbook for Medicare that is sent to every Medicare recipient each year, you’ll see exactly what I’m talking about. ENROLLMENT IN MEDICARE ADVANTAGE PROGRAMS DOES NOT DISENROLL A MEDICARE RECIPIENT FROM PART A OR PART B OF MEDICARE. THIS IS PLAINLY STATED AT THE TOP OF PAGE 35. Unfortunately, there is an astounding amount of ignorance in doctor’s offices about what Medicare Advantage is, even in their billing and insurance departments, and that’s where your misunderstanding arose. Had you not heard that incorrect information, your relative might be enjoying the real benefits of that program now, which are substantial to the recipient in most cases.

I'm sure the doctor's office knew what they were doing. I'm also sure that we will NEVER--- EVER--- talk to a Medicare Part C or Part D agent again!!!! The Advantra Freedom agents said they were with Medicare and would not take away my parents Medicare Part A or their Part B coverage. But the first thing they done was to cancel my parents Medicare Part A and B coverage with the hospital, doctor's office and drug store. The agent told all three to file those cost to Advantra Freedom, according to what the drug store pharmacist, the hospital insurance claims agent, and the doctor's secretary said.
I still think you're just doing damage control for Advantra Freedom.

Based on your reaction, I question whether the enrolling agent had done his/her job at the beginning, as I do by showing my prospects the Medicare book right off the bat. If they had, you would not have been thrown into a frenzy by an ignorant clerk, and if you had concerns, you would have brought the question back to the agent, who would have given you the clear answer, pointing you back again to the horse’s mouth, the Medicare book.

It wasn't just the Hospital and Doctors clerk, but the Social Security Agent that told us what to do. When we finally got rid of that crooked company Advantra Freedom, and got verification that we re back to the normal Medicare, the doctor and the hospital's insurance agent told us that thousands of people had been lied to by Advantra Freedom, and several people had suffered severe health issues because of the delay caused by having to change doctors, and by the delay of verifying coverage for a certain procedure.

Trust me, this business is highly regulated, and even without any formal complaints being made, an agent who has an abnormally high ratio of clients disenrolled to clients enrolled within a short period of time will not be allowed to continue very long with that company, because the company will have their contract with Medicare rescinded if they have too many complaints or cancelled enrollments, indicating poor training or screening of agents. Feeding these problems is also the fear of change. The addition of Part C & D were the biggest changes in the senior healthcare infrastructure since the inception of Medicare in 1960’s, and I imagine 40 years ago there was a lot of fear and resistance amongst both recipients and health care providers when Medicare started as well. And a lot of missteps and inefficient delivery of benefits in the beginning by the new government infrastructure. But today, of course, most of us are more comfortable with it and take the system for granted, because the largest kinks have been worked out in day to day operations, we’re used to the remaining inefficiencies, and by the time we become recipients, we’re intractably in the system, like it or not. We all here understand and agree on why that’s not necessarily good in the long run, but that’s water under the bridge at this point.

I'm not buying it and I'll cheer the day that the government revokes Advantra Freedom's license to operate. When we asked the customer service agent at the hospital what to do, she said, "I can't advise you what to do". But with her hand, she took the Advantra Freedom Card and held it over the trash can, while with the other hand, she gave the Medicare and Medicare Supplement Cards back to my mother. I thank God for her help and for the Social Security office's help.

Again I’m sorry for your difficulty. Don’t let that turn you off completely from the concept of Part C, which when done well is a godsend for seniors as a whole. All companies and all plans are not the same, so shop around. Part C and D are the future of Medicare, by necessity, if it is to have one. The domination of supplements is waning because they are quickly becoming too expensive for most clients. That’s why C exists. As a last note, I see that the bulletin you cited from your state says nothing about any particular Part C program, and you don’t say that the enrolling agent in your relative’s case claimed to be from Medicare, which as the bulletin says, would have been unethical, even though they may have been representing a Part C plan that was subsidized with your relative’s Part B premium and taxpayer money, the administration of which was contracted out by the federal government to a private health care company, because the private company is able to provide substantially more benefits to the Medicare recipient for the same money, than can the government. More benefits, lower consumer costs. Isn’t that what we’re all supposedly after?

Yes, we're all for lower cost. But this is another democratic boondoggle bigger that the Congressional Post Office Stamp and Rubber Check scandal. By the time the errors are corrected, the scammed money will be long gone, like Global-Crossings and World Comm.

Again, for clarification on what Medicare Part C really is and what is really does, please see pages 33-35 of the Medicare and You 2007 book.

I'll look for it, but it's really doesn't matter if your parents doctor won't accept the insurance. That's where the bullshit walks.

[Yosemitest]

Upon second reading...

"That’s why no matter what Part C Medicare product my client enrolls in, if they have a problem, question, or concern, I always tell them to call me, not the company, because I can often bypass the phone menus and misdirected call transfers and get the answer quicker than they can by calling my Agent Help Line, and usually with less hassle. Even if it’s a pain for me, and I have to do it through customer service, even when the call must be with the client and the company on the phone, I act as their advocate to get the answer they need as painlessly for them as possible. I know how to run around the run around. That’s my commitment to the client."

From this statement alone, it's plane for anyone to see that Advantra Freedom doesn't want to serve their clients. They want to delay, deny, and confuse their customers with the phone menus and misdirected call transfers and ... hassle. ...the run around.

Again ... may the Lord reward Advantra Freedom... according to their works.