How to protect yourself from Medicare scams—and what to do if you become a victim

William of England
By William of England 9 Min Read

“Open Enrollment is prime time for Medicare beneficiaries to be targeted,” says Tatiana Fassieux, a Medicare schooling and coaching specialist with the California Health Advocates and Senior Medicare Patrol watchdog teams.

Open Enrollment season is open season for fraud

“Now is the time where Medicare beneficiaries have to be very, very careful regarding who they’re divulging their information to and to investigate exactly what a particular Medicare plan is offering,” she provides.

Notes Kathy Stokes, director of fraud prevention packages at AARP: “During Medicare Open Enrollment season, we’re hearing about Medicare on the news, it’s all around us. And criminals know when something is all around us, they can take advantage of it.”

Many of the scams are variations on id fraud, designed to steal your Medicare quantity or important monetary data, typically by way of texts, “phishing” emails, social media and on-line platforms.

Some insidiously goal folks with restricted English proficiency, maybe by way of probability conferences by recruiters in mall parking tons says Fassieux.

No one is aware of the precise dimension of Medicare fraud, however the National Health Care Anti-Fraud Association estimates Medicare and Medicaid fraud mixed complete greater than $100 billion a yr. One motive it appears to be rising: extra potential victims. Today, 18% of the U.S. inhabitants is on Medicare; in 1990, it was 13%.

The Medicare Fraud Strike Force, a partnership between the U.S. Department of Health and Human Services’ Office of Inspector General and the Justice Department, works to quash the schemes.

Here are the most recent Medicare scams you (or your family members) want to be careful for and steps to take after getting victimized:

The Medicare imposter rip-off

This is when you get a name or textual content from somebody claiming to be from the Medicare “enrollment center” or a Medicare “advisor.” The impersonator would possibly say they’re conducting a survey, need to assist you get the perfect Medicare protection or will ship you a new Medicare card. (Lately, I’ve been getting persistent cellphone calls with the cryptic ID: Health Care; I don’t reply.)

The name might even appear like it’s coming from Medicare’s toll-free quantity, 1-800-MEDICARE. Fact is, Medicare won’t ever name you, until you left a message with the company and requested to be phoned again.

If you get a name, don’t reply it. But do block the caller. Just perceive that after blocking the quantity, you should hear from the scammer.

“What they do is change the profile of that telephone number” so you proceed getting rip-off calls, simply from completely different cellphone numbers, says Fassieux.

If you get a textual content from somebody claiming to be with Medicare, delete it, says Miranda Bennett, Assistant Inspector General for Investigations on the U.S. Department of Health and Human Services.

Incidentally, if you want a substitute Medicare card, name Medicare (800-633-4227) or obtain and print one from your on-line Medicare account at Medicare.gov.

The Medicare flex card rip-off

Some Medicare Advantage plans (personal insurers’ alternate options to Traditional Medicare) supply members Flex playing cards—pay as you go debit playing cards to pay for out-of-pocket bills Medicare covers. But fraudsters have turned flex playing cards into a rip-off.

The con artists are operating adverts claiming that folks on Traditional Medicare can get flex playing cards with tons of of {dollars} on them to be used for making purchases. In actuality, there aren’t any flex playing cards for Traditional Medicare.

The free medical tools rip-off

Here, a fraudster calls or texts, knocks in your door, reveals up at long-term care facility or runs adverts saying they will get Medicare to give you a free again brace, wheelchair, glucose monitor or different piece of sturdy medical tools.

Often, the tools by no means arrives. If it does, odds are the merchandise is low-quality and the return handle is cryptic, says Fassieux.

Sometimes the con artist works with a physician to pull off this scheme. A Virginia physician not too long ago pled responsible to fraudulently invoice Medicare for over $4 million in reimbursements for again and knee braces, in addition to different medical tools.

Other instances, it’s truly a doctor committing the fraud. In October, a Louisiana anesthesiologist pled responsible to defrauding Medicare out of about $5.6 million for ordering medically pointless knee braces and different gadgets for folks he by no means noticed, spoke to or handled.

While you received’t be on the hook to pay for this tools, the rip-off might forestall you from getting Medicare to cowl a related merchandise when you want it. That’s as a result of Medicare will suppose you already ordered one, says Bennett.

The free lab take a look at rip-off

In this fraud, the criminal reveals up at a well being truthful or a senior heart or calls saying they will organize for you to get a free lab take a look at to assess your well being and that Medicare will cowl it.

“Sometimes, they’re even telling the enrollee that his or her doctor has already authorized it,” says. Bennett.

Then, the con artist payments Medicare on behalf of the “lab” to gather.

The Medicare Advantage gross sales name rip-off

Medicare Advantage corporations and brokers or brokers who promote their plans aren’t allowed to cold-call folks.

So, if you get phoned by somebody you don’t know saying they need to assist you discover the perfect Medicare Advantage plan, it’s unlawful.

How to forestall being scammed

To decrease the possibilities you’ll become a Medicare fraud victim:

Read the Centers for Medicare & Medicaid Services’ Protecting Yourself & Medicare from Fraud free on-line booklet.

Contact your native Senior Medicare Patrol workplace (877-808-2468 is the nationwide quantity) or State Health Insurance Assistance Program (typically referred to as SHIP). “Senior Medical Patrol is a group of trained volunteers that help people understand what Medicare fraud looks like and how to avoid it,” says Stokes. SHIP advisors can alert you about Medicare scams in your state.

Check out the AARP Fraud Watch Network site. Its fraud fighters have ideas and instruments to keep protected. You may join AARP’s bi-weekly watchdog alerts.

Treat your Medicare card like a bank card. That’s the recommendation from Senior Medicare Patrol, since Medicare numbers might be extraordinarily priceless to thieves.

How to know if you’ve been scammed

The greatest manner to discover out if you’ve been a Medicare rip-off victim is to verify your Medicare statements for companies or gadgets you didn’t order or obtain.

If you’re on Original Medicare, these are referred to as Medicare Summary Notices and arrive by mail each three months for Medicare Part A and B lined companies.

If you have Medicare Advantage or a Medicare Part D prescription drug plan, the statements are your Explanation of Benefits and present up after you get medical companies or gadgets.

“Look at those scrupulously,” says Stokes. “It really pays to keep a close eye on those.”

What to do if you suppose you’ve been scammed

If you suppose you might have been defrauded or see that Medicare has been bilked by a criminal utilizing your identify or I.D.:

Call Medicare at 1-800-MEDICARE or the U.S. Health and Human Service’s fraud hotline (800-447-8477).

Report id theft to the Federal Trade Commission at identitytheft.gov.

File a grievance on-line with the U.S. Department of Health and Human Services Office of Inspector General: tips.oig.hhs.gov.

Call AARP’s toll-free fraud hotline: 877-908-3360.

Share This Article
Leave a comment