Are insurers profiting from your Medicare plan? New Trump DOJ lawsuit targets major insurance players
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If you rely on Medicare Advantage for your health coverage, you’re not alone—millions of older Americans do.
But a new lawsuit is raising serious concerns about whether some plans are being sold with your best interest in mind—or simply to benefit insurance companies and brokers.
The US Department of Justice (DOJ) has filed a sweeping lawsuit against several major insurers and brokers, accusing them of paying and receiving illegal kickbacks in exchange for steering seniors into specific plans.
If true, these actions may have led some people to enroll in plans that weren’t right for them.
Here’s what’s happening, why it matters, and how you can protect yourself.
Filed in Massachusetts federal court, the lawsuit names three of the largest insurance providers—Aetna, Elevance (formerly Anthem), and Humana—as well as brokers eHealth, GoHealth, and SelectQuote.
The DOJ, under the Trump administration, alleges that these companies paid hundreds of millions of dollars in unlawful commissions.
In return, brokers are accused of pushing Medicare Advantage plans based on how much money they’d make—not based on what was best for the person enrolling.
That could mean some seniors were steered into plans that didn’t cover their doctors or medications, came with higher out-of-pocket costs, or left out key benefits.
Medicare Advantage has become incredibly popular, with more than 32 million Americans currently enrolled—over half of all Medicare users.
That number is expected to grow even more in the years ahead.
With so many relying on these plans, how they’re marketed and sold makes a big difference.
If brokers are prioritizing commissions over care, older Americans may be paying more for less.
According to the DOJ:
If proven, these actions could violate the False Claims Act, which allows the government to take legal action against fraud involving federal programs like Medicare.
All of the companies involved have denied the accusations and said they intend to fight the charges in court.
Federal leaders are making their position clear.
Michael Granston, deputy assistant attorney general at the DOJ’s Civil Division, emphasized the agency’s stance, stating, “Health care companies that attempt to profit from kickbacks will be held accountable. We are committed to rooting out illegal practices by Medicare Advantage insurers and insurance brokers that undermine the interests of federal health care programs and the patients they serve.”
Leah Foley, US attorney for Massachusetts, added: “It is concerning, to say the least, that Medicare beneficiaries were allegedly steered towards plans that were not necessarily in their best interest.”
Even though this case is still in progress, it’s a good reminder to stay alert and informed. Here are five steps you can take:
1. Review your plan every year: Don’t let your plan auto-renew without checking the details. Coverage, providers, and costs can change annually.
2. Ask your broker questions: Be direct. Ask if they earn more for selling certain plans, whether they show you all available options, and why they’re recommending a specific plan for you.
3. Use unbiased resources: Visit Medicare.gov or reach out to your State Health Insurance Assistance Program (SHIP) for help or more information.
4. Watch for warning signs: Be cautious if a broker rushes you to sign up, avoids answering questions, or doesn’t show you all your choices.
The Medicare Advantage market is booming, and with that growth comes increased risk for abuse.
This lawsuit is a reminder that not all plans are sold with your needs in mind.
But staying informed, asking the right questions, and reviewing your coverage regularly can help you stay in control of your healthcare choices.
Have you ever felt pressured to choose a Medicare plan? Do you have tips for navigating the system or helping others make smart choices? Share your experiences in the comments. At The GrayVine, we’re here to look out for each other—and that starts with staying informed.
But a new lawsuit is raising serious concerns about whether some plans are being sold with your best interest in mind—or simply to benefit insurance companies and brokers.
The US Department of Justice (DOJ) has filed a sweeping lawsuit against several major insurers and brokers, accusing them of paying and receiving illegal kickbacks in exchange for steering seniors into specific plans.
If true, these actions may have led some people to enroll in plans that weren’t right for them.
Here’s what’s happening, why it matters, and how you can protect yourself.
A new federal lawsuit is raising concerns about how Medicare Advantage plans are being sold—and who truly benefits. Image Source: Unsplash / Tingey Injury Law Firm.
What’s the lawsuit about?
Filed in Massachusetts federal court, the lawsuit names three of the largest insurance providers—Aetna, Elevance (formerly Anthem), and Humana—as well as brokers eHealth, GoHealth, and SelectQuote.
The DOJ, under the Trump administration, alleges that these companies paid hundreds of millions of dollars in unlawful commissions.
In return, brokers are accused of pushing Medicare Advantage plans based on how much money they’d make—not based on what was best for the person enrolling.
That could mean some seniors were steered into plans that didn’t cover their doctors or medications, came with higher out-of-pocket costs, or left out key benefits.
Why does this matter?
Medicare Advantage has become incredibly popular, with more than 32 million Americans currently enrolled—over half of all Medicare users.
That number is expected to grow even more in the years ahead.
With so many relying on these plans, how they’re marketed and sold makes a big difference.
If brokers are prioritizing commissions over care, older Americans may be paying more for less.
Also read: Are you at risk? Representative reveals how UnitedHealthcare might be taking advantage of Medicare
What the lawsuit claims
According to the DOJ:
- Insurance companies paid extra money—so-called kickbacks—to brokers for enrolling people into specific plans.
- Some brokers allegedly refused to offer plans from companies that didn’t pay enough in commissions.
- Brokers are accused of creating sales teams that only promoted the most profitable plans.
- In some cases, people with disabilities or chronic conditions may have been discouraged from enrolling in certain plans because they were seen as less profitable.
If proven, these actions could violate the False Claims Act, which allows the government to take legal action against fraud involving federal programs like Medicare.
Also read: Health insurers’ rates skyrocket for Medicare–what this means for your wallet!
How the companies responded
All of the companies involved have denied the accusations and said they intend to fight the charges in court.
- Humana said: "Humana strongly disagrees with the allegations in the complaint and we look forward to vigorously defending ourselves in the legal proceedings. As always, Humana's highest priority remains ensuring our members are provided with outstanding healthcare coverage and access to care, while also continuing to support healthcare innovation, better health outcomes, and deeper patient engagement."
- Aetna said they are reviewing the complaint but plan to “defend the case vigorously.”
- Elevance stated: "Elevance Health and its affiliated health plans are committed to delivering high-quality healthcare services. We are confident that our health plans have complied with and continue to comply with the Centers for Medicare & Medicaid Services (CMS), marketing and broker compensation regulations, rules and guidelines."
- GoHealth called the lawsuit disappointing and claimed it contains “misrepresentations and inaccuracies.”
Also read: Dr. Oz nominated to lead Medicare—what his vision could mean for you
What federal officials are saying
Federal leaders are making their position clear.
Michael Granston, deputy assistant attorney general at the DOJ’s Civil Division, emphasized the agency’s stance, stating, “Health care companies that attempt to profit from kickbacks will be held accountable. We are committed to rooting out illegal practices by Medicare Advantage insurers and insurance brokers that undermine the interests of federal health care programs and the patients they serve.”
Leah Foley, US attorney for Massachusetts, added: “It is concerning, to say the least, that Medicare beneficiaries were allegedly steered towards plans that were not necessarily in their best interest.”
Leah Foley, US attorney for Massachusetts, expressed concern over allegations that Medicare beneficiaries were steered into plans that weren’t in their best interest. Image Source: YouTube / CBS Boston.
Also read: Update: Find out how a new bill could change Medicare for millions overnight
What you can do to protect yourself
Even though this case is still in progress, it’s a good reminder to stay alert and informed. Here are five steps you can take:
1. Review your plan every year: Don’t let your plan auto-renew without checking the details. Coverage, providers, and costs can change annually.
2. Ask your broker questions: Be direct. Ask if they earn more for selling certain plans, whether they show you all available options, and why they’re recommending a specific plan for you.
3. Use unbiased resources: Visit Medicare.gov or reach out to your State Health Insurance Assistance Program (SHIP) for help or more information.
4. Watch for warning signs: Be cautious if a broker rushes you to sign up, avoids answering questions, or doesn’t show you all your choices.
The Medicare Advantage market is booming, and with that growth comes increased risk for abuse.
This lawsuit is a reminder that not all plans are sold with your needs in mind.
But staying informed, asking the right questions, and reviewing your coverage regularly can help you stay in control of your healthcare choices.
Have you ever felt pressured to choose a Medicare plan? Do you have tips for navigating the system or helping others make smart choices? Share your experiences in the comments. At The GrayVine, we’re here to look out for each other—and that starts with staying informed.
