In an age where scams are running rampant, Medicare beneficiaries – numbering some 6 million – are no exception. Frauds or scammers are trying to steal information or defraud Medicare. Just last year, reports involving identity theft, fraud, or some other scam numbered approximately 2.4 million according to NBC, and Medicare scams accounted for roughly 332,000 of them (these involved Department of Health and Human Services or Medicare imposters).
Annually, about $1 billion hits taxpayers because of these scams. It also opens beneficiaries up to false claims and/or medical identity theft. Because plans with annual caps get maxed out, beneficiaries’ health is endangered. Even retirement age adults living in the safety of a senior living community can be taken in by these scammers.
Let’s look at some types of Medicare scams.
Fraudulent Billing
There are numerous ways that scammers attempt this form of fraud. A fake prescription may be written by a disreputable home healthcare agency, health care provider, unscrupulous clinic, etc. The prescription will order procedures and tests that are unnecessary (and never carried out).
What to do: To ensure you received any services billed, keep a close eye on your Medicare summary notice.
Low-Cost or Free Genetic Testing
Whether it’s at a health fair, on the phone, or through the mail, you may receive an offer for a discounted or free DNA test. They may say that they’re scanning a swab for predispositions for serious illnesses, cancer, etc. They are doing this for fraudulent billing purposes or to get your Medicare information only.
What to do: Random genetic testing is not paid for by Medicare. Return it to the sender if you receive, through the mail, a genetic testing kit. Or just throw it away.
Medical Equipment
People promising to “give” you things may call you requesting your Medicare number. To get your Medicare information, these people are mailing letters, running television ads, calling on the phone, and more offering things like free knee braces, low-cost back braces, etc.
What to do: Do not give your Medicare number to them. Unless your doctor ordered it, never accept delivery of medical equipment. If you didn’t order it, don’t pay for it.
Door-To-Door
It seems that scammers know no bounds these days – they will come right up to your door and knock. They may do the following, claiming to be a representative for Medicare:
- Try to sell you medicine, supplements, or medical equipment
- Try to sell you Medicare coverage for prescription drugs
What to do: Be aware that house calls are not made by Medicare – ever!
Through the mail, the following scams may be received (counterfeit sales materials):
- A bill from a medical supplier
- Bills from the hospital
- Offers for supplemental Medicare coverage
- Offers for discounted plans for prescription drugs
What to do: To make sure charges are valid, contact your insurance provider or the billing department where the received services supposedly took place. Keep track of your quarterly Medicare summary notices, save statements, and compare bills against healthcare services.
Phone Calls
Claiming to represent Medicare, some people operating a scam call beneficiaries on the phone. They claim that unless information is updated, the beneficiaries’ Medicare coverage will be canceled. They may also try to sell you certain products. (Frequently these callers have foreign accents, but not always.) What are these people looking for?
- Banking information
- Your Social Security number
- Your Medicare card number
What to do: Automatically assume it’s a scam if the caller asks for any information. Hang up. Medicare won’t call you unless you initiated the request. Additionally, Medicare will never try to sell you anything.
What You Can Do in General
If you’re concerned about protecting yourself against Medicare fraud and would like more tips or information, you can call 800-633-4227 or visit CMS.gov. You can also contact the Federal Trade Commission if you feel you gave out information you shouldn’t have or if you suspect identity theft.
