An Adventurous Day in the Life of a Medicare Agent

One of our high-producing Medicare agents called me today (9/16/2015). We had had an appointment that he had missed earlier, and when I had called him to find out if he still planned on coming, he sounded hesitant and even a little evasive. I did not press him; I have forgotten appointments too and have not wanted to admit it to the people whom I had forgotten.

He called me a couple of hours later and said, “sorry for missing the appointment, but when you called, I was surrounded by the police.” He was experiencing one of those moments that we are all led to anticipate as we do our Medicare-Advantage certifications. Here is how his adventure unfolded.

This agent does direct mailing to gather leads. He then has someone else call and set appointments for him, someone who is carefully instructed to not say the wrong things, like “he works for Medicare.” During the call, the appointment setter positions the agent as a Medicare specialist who can explain how the Medicare health plans work. (You know where this is going, don’t you? See, your doing those annual certifications is doing you some good!). The appointment setter called and set an appointment with a woman turning 65 for a few days later. Well, some time before the appointment, the beneficiary called the Medicare telephone number to converse with an operator, although I am not certain of her motivation. During the conversation, the beneficiary mentioned that she was glad that a Medicare agent was stopping by her place in a couple of days. The Medicare operator immediately responded with, “oh, mam, we do not send out Medicare agents. You need to be careful.” The medicare beneficiary immediately leaped to the conclusion that she was being scammed. She called the police and let them know that someone was pretending to represent Medicare, that she was scared, and that she needed their help.

Listening to the agent tell his story, I wondered about the thoughts and feelings of the Medicare beneficiary. At what point did her misunderstanding occur? During the call with the appointment setter, did she leap to the conclusion that a beneficent government was sending out an official representative to help her manage her retirement benefits in the best way for her, only to have her misguided hopes set right by the Medicare operator? Or did a Medicare operator instill in her a fear about scammers pretending to represent Medicare?

The agent showed up at the scheduled time on her doorstep and knocked. No one answered, although he could tell that someone was home from the commotion behind the door. He knocked again; still no answer. He then called and left a voice message. Realizing that there was little else that he could do, he got in his car and started to drive away. Immediately, red lights started flashing in his rear-view mirror. As he was pulling over, a second squad car, also with flashing lights, pulled in front of his car, blocking any potential escape route. The agent thought to himself, “I wonder what is happening.” He was also curious about where the cars had come from, since he had seen no police cars as he walked away from the house.

Three cops took up positions around his car. The agent rolled down his window and asked if he could help them. One of the officers explained that he was suspected of representing himself as an official from Medicare. The agent said that he was doing no such thing, that he is a certified representative of health-insurance companies that offer Medicare insurance. Seeing that the officers were standing in the rain, he offered to sit in one of their cars to get the incident sorted out. Believing that his kindness might be a ruse to lead them to be lenient, the officers did not accept his offer, even stating that this agent was not taking the situation seriously enough. The agent pulled out his insurance license and showed them. If memory serves, he may even have had his carrier certificates with him and showed them too. At a certain point, the officers seem to have believed that he was an insurance agent and not a scammer, so they started telling him the best way to carry on business to prevent such events from happening in the future. The agent responded that he did the things they suggested as a matter of routine and suggested that people often hear what they want to hear. This comment led the officers to say again that he was not taking the incident seriously enough. After being detained for about 30 minutes, the agent was freed.

Nancy and I, both in the Stone Hill office, wondered: should the agent go back to the beneficiary, hoping that she feels silly for the mess and is more willing to listen or should he just let sleeping dogs lie? What would you do? (Speaking with the agent about a week after the adventure, he decided not to go back. I think that I would have made the same decision.)—Doug Draper