Groups advocating on behalf of older adults and people with disabilities are asking federal agencies for a "full-scale investigation" following what they say are misleading Medicare Advantage advertising practices by UnitedHealthcare.
The Center for Medicare Advocacy, National Health Law Program, Disability Rights Connecticut and National Disability Rights Network wrote CMS and the Federal Trade Commission on Dec. 7 requesting an immediate intervention over UnitedHealthcare's advertising of dual eligible special needs plans in Connecticut, which provide health coverage to individuals eligible for both Medicare and Medicaid.
The ads in question are aimed at dually eligible individuals and advertise extra benefits under a Medicare Advantage plan such as dental or vision. In Connecticut, all individuals with Medicaid or D-SNP coverage are already entitled to unlimited dental services and routine eye examinations. There are no copays or premiums associated with those public benefits.
"Unquestionably, this misleading advertising is intended to induce, and has induced, thousands if not tens of thousands of older adults and disabled low-income individuals we are charged with representing to sign up for UnitedHealthcare's plan, having been led to believe this means they can get extra healthcare benefits," the letter to CMS said. "And, because the advertisement does not mention either the limited network or the restrictive prior authorization rules applicable under UnitedHealthcare's plan compared with traditional Medicare plus Medicaid, these individuals have no idea that they are giving up something valuable."
The groups are seeking fines against UnitedHealth, a ban on any further advertising in Connecticut, and that letters be sent to individuals now enrolled with UnitedHealth to inform them of their coverage options. The letter also called for a national investigation of all D-SNP marketing by Medicare Advantage carriers to see if they are offering extra benefits that may already be covered by the respective state Medicaid program.
"The allegations in this letter are completely baseless," a UnitedHealthcare spokesperson told Becker's. "Our Medicare Advantage marketing efforts are focused on ensuring Medicare-eligible individuals have access to clear, accurate and complete information regarding their Medicare options. Our plan benefits are filed and approved by CMS and our advertising factually describes these benefits and is filed in accordance with CMS marketing guidance."