Because of the world that we live in, there are always people that are looking to take advantage of others, and Medicare is no different. Each year, the Medicare program loses billions of dollars to false and fraudulent claims. Unfortunately, because of this, health care costs are increased for individuals, businesses, health care providers, and the government. Recently these Medicare scams have become the focus of several government agencies as they try and catch the criminals. These billions of dollars every year are putting a strain on Medicare, which eventually trickles down to the enrollees. As a Medicare enrollee, you shouldn’t have to worry about any of your information being stolen or becoming a victim of a scam. There are several ways that you can spot a scam before you fall under the trap.
While those who participate in Medicare fraud can oftentimes go undetected, there are ways that you can spot various types of illegal activity. By knowing what to look for, you can potentially save yourself, and the Medicare program overall, a great deal of both money and time.
Identity Theft and Medicare
One of the biggest types of Medicare fraud comes in the form of identity theft. This occurs when another individual uses your personal information without your consent in order to commit fraud or other crimes. Your personal information can include your name, your Social Security number, your Medicare ID number, and/or your credit or debit card numbers.
Identity theft can take on a variety of different forms. Just some examples include obtaining medical services or equipment under your name – including having major surgeries, establishing accounts in your name, and even making large purchases.
In many cases, an individual may not find out that his or her identity has been stolen until they have reviewed their credit report or a billing statement has come in and they notice charges that they did not make. In other instances, the individual may still not realize it until they are contacted by a debt collector.
With this in mind, it is important to regularly check your credit report in order to spot any potential activity that does not belong to you. Doing so at least one time per year is recommended. Likewise, reading over your Medicare Summary Notice in detail as soon as you receive it is always a good idea in terms of spotting any potential Medicare fraud having to do with your personal Medicare ID number.
If you become the victim of identify theft, luckily there are several things that you can do to reverse the damages, but sadly, it’s going to take a lot of time and can be a long process. It’s vital that you never give out any of your personal information to anyone, unless you know them personally, and even then you should be extremely careful.
Spotting Other Types of Medicare Scams and Fraud
Medicare scams are not limited only to computer “hackers” and identity thieves, but can also include a wide array of others, including doctors, health care providers, and equipment suppliers too. With that in mind, it is important to be aware of anyone who does any of the following:
- Requests your Medicare ID number either in return for free medical services or equipment, or for their “record keeping” purposes
- Tells you that various medical tests will be less expensive if you get more of them (as in obtaining a “quantity discount”)
- Promotes free consultations to those who have Medicare
- Contacts you saying that they are with Medicare or the federal government
- Uses the telephone or comes directly to your door trying to sell you something that is Medicare-related
- Uses scare tactics or high pressure sales methods to try and sell you expensive medical tests or services
- Bills Medicare for services or equipment that you did not receive
- Offers non-medical services or transportation as being Medicare-approved
- Bills Medicare for services when you do not meet certain Medicare qualifications
These are only a few of the various scams that are used in the health care field. As a good rule of thumb, if anything sounds or feels suspicious, it’s probably a scam. Most times, it can be difficult to discern if any of these fraudulent acts are legitimate and honest. If you have any suspicion that you’ve been scammed, or are currently being scammed by a physician, health care provider, or some other third-party you should report it to your Medicare office immediately.
If you have a doctor or someone call you over the phone looking for Medicare or personal information, you should ask for a name and number and tell them you will call them back as soon as possible. After hanging up, you can call your Medicare office and ask them about the interaction and they can give you professional advice on how to proceed from there. It’s always better to be extra cautious than having to go through the frustration and pain of being scammed.
One common scam that we see is Medicare enrollees receiving calls saying they need to get a new Medicare card because their current one is no longer effective or for some other reason, and in order to verify the cardholder, you need to give them your current Medicare and personal information. While these calls can seem legitimate and authentic, no Medicare official will ever ask for your information over the phone. If you receive one of these calls, or possibly a letter, report it to a local official.
If you have any questions about Medicare scams and ways that you can protect yourself from becoming one of the millions of victims, please feel free to contact us at any time. Our agents would be happy to answer any of your questions and ensure that you’re as protected as possible.