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VICTIMS OF FRAUD CAN SWITCH BACK

The 2007 enrollment period for picking a Medicare plan ended more than three months ago, but a little-known rule allows people to switch plans all year long if they were victimized by fraud or misrepresentation.

Hundreds of Floridians have complained that insurance agents from health maintenance organizations and other private Medicare plans signed them up without their knowledge or consent. Some people went to luncheons about Part D drug coverage and unwittingly ended up in an HMO. Then their long-standing doctors refused to treat them.

An internal memo circulated this month within the Centers for Medicare and Medicaid Services describes how people can disenroll from an unwanted plan under some circumstances. If you feel you wrongfully ended up in a private plan, call 1-800-Medicare and say you want to qualify for a special enrollment period because you were misled into a plan you didn't want.

A Medicare caseworker will investigate.

Grounds for disenrollment, according to the memo, can include:

- Statements by an agent or company employee that suggest the plan will be accepted by all Medicare providers.

- Statements that imply the plan is a Medicare supplement or Medigap policy.

- Statements that suggest you can switch back to traditional Medicare any time you wish.

While you don't need to prove your case with documents, you will have to convince Medicare that you are not trying to disenroll from a plan just because you don't like it.

Provide as many dates and details as possible, such as the insurance agent's name or names of other company employees you contacted.

Anything in writing will help, such as any of the insurance agent's cards or sales materials, or notes you took from conversations.

You had until March 31 to disenroll from a private plan. If you wrote any letters asking to disenroll and the company did not take you off its client list, provide copies of that as well.

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