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

“Open enrollment is the perfect time to target Medicare beneficiaries,” says Tatiana Fassieux, a Medicare education and training specialist with watchdog groups California Health Advocates and Senior Medicare Patrol.

Open enrollment season is open season for fraud

“Now is the time when Medicare beneficiaries need to be very, very careful about who they disclose their information to and investigate exactly what a particular Medicare plan offers,” she adds.

Kathy Stokes, director of fraud prevention programs at AARP, notes, “During Medicare open enrollment season, we hear about Medicare on the news, it’s all around us. And criminals know that when there is something around us, they can take advantage of it. »

Most of these scams are variations of identity theft, designed to steal your Medicare number or vital financial information, often through text messages, “phishing” emails, social media and online platforms.

Some insidiously target people with limited English proficiency, perhaps through chance encounters with recruiters in shopping center parking lots, Fassieux says.

No one knows the exact scale of Medicare fraud, but the National Health Care Anti-Fraud Association estimates that Medicare and Medicaid fraud totals more than $100 billion annually. One of the reasons why this phenomenon seems to be increasing is the increase in the number of potential victims. Today, 18% of the American population benefits from Medicare; in 1990 it was 13%.

THE Strike force against health insurance frauda partnership between the Office of Inspector General of the U.S. Department of Health and Human Services and the Department of Justice, is working to undo these schemes.

Here are the latest Medicare scams you (or your loved ones) should watch out for and what steps to take after falling victim:

The Medicare Imposter Scam

That’s when you receive a call or text message from someone claiming to be from the Medicare “enrollment center” or a Medicare “advisor.” The impersonator may say they are conducting an investigation, want to help you get the best Medicare coverage, or will send you a new Medicare card. (Lately I’ve been receiving persistent phone calls with the cryptic identifier: Healthcare; I’m not answering.)

The call may even appear to come from Medicare’s toll-free number, 1-800-MEDICARE. The fact is, Medicare will never call you unless you leave a message with the agency and request a call back.

If you receive a call, do not answer it. But TO DO block the caller. Just understand that after blocking the number, you can still hear from the scammer.

“What they do is change the profile of that phone number,” so you continue to receive scam calls, just from different phone numbers, Fassieux says.

If you receive a text message from someone claiming to be from Medicare, delete it, says Miranda Bennett, deputy inspector general for investigations at the U.S. Department of Health and Human Services.

By the way, if you need a replacement Medicare card, call Medicare (800-633-4227) or download and print one from your Medicare account online at Medicare.gov.

The Medicare Flex Card Scam

A few Health Insurance Advantage plans (private insurer alternatives to traditional health insurance) offer members Flexible cards— prepaid debit cards to pay for out-of-pocket expenses covered by Medicare. But fraudsters have turned flex cards into a scam.

Scammers are running ads claiming that people with traditional health insurance can get flex cards with hundreds of dollars to use for purchases. In reality, there are no flex cards for traditional health insurance.

The free medical equipment scam

Here, a scammer calls or texts you, knocks on your door, shows up at a long-term care facility, or posts ads saying they can get Medicare to provide you with a free back brace, wheelchair, glucometer or other durable medical equipment.

Often the material never arrives. If so, there’s a good chance the item is of poor quality and the return address is cryptic, Fassieux says.

Sometimes the scammer works with a doctor to carry out this scheme. A Virginia doctor recently pleaded guilty to fraudulently billing Medicare for more than $4 million in reimbursements for back braces and knee braces, as well as other medical equipment.

Other times, it’s actually a doctor committing the fraud. In October, a Louisiana anesthesiologist pleaded guilty to defrauding Medicare of approximately $5.6 million for ordering medically unnecessary knee pads and other items for people he had never seen, spoken to or neat.

Although you don’t have to pay for this equipment, the scam could prevent you from asking Medicare to cover a similar item when you need it. That’s because Medicare will think you’ve already ordered one, Bennett says.

The Free Lab Test Scam

In this scam, the scammer shows up at a health fair or senior center or calls saying they can arrange a free lab test to evaluate your health and that Medicare will cover it.

“Sometimes they even tell the registrant that their doctor has already cleared it,” he explains. Bennett.

Then the scammer bills Medicare on behalf of the “lab” to collect.

The Medicare Advantage Sales Call Scam

Medicare Advantage companies and the agents or brokers who sell their plans are not allowed to cold call people.

So, if someone you don’t know calls you and says they want to help you find the best Medicare Advantage plan, that’s illegal.

How to avoid being scammed

To reduce your chances of becoming a victim of Medicare fraud:

• Contact your local Senior Medicare Patrol desk (877-808-2468 is the national number) or State Health Insurance Assistance Program (often known as SHIP). “Senior Medical Patrol is a group of trained volunteers who help people understand what Medicare fraud looks like and how to avoid it,” says Stokes. SHIP Advisors can alert you to Medicare scams in your state.
• Check AARP Fraud Monitoring Network Site. Its fraud fighters have tips and tools to stay safe. You can also sign up for AARP’s bi-weekly monitoring alerts.
• Treat your Medicare card like a credit card. This is the advice of Senior Medicare Patrol, since Medicare numbers can be extremely valuable to thieves.

How to know if you’ve been scammed

The best way to know if you have been the victim of a Medicare scam is to check your Medicare statements for services or items you did not order or receive.

If you have Original Medicare, these are called Medicare Summary Notices and arrive in the mail every three months for Medicare. Part A And B covered services.

If you have Medicare Advantage or a Medicare Part D Prescription Drug Planstatements are your explanation of benefits and appear after you receive medical services or items.

“Look at them carefully,” said Stokes. “It’s definitely worth keeping a close eye on these.”

What to do if you think you’ve been scammed

If you think you have been a victim of fraud or see that Medicare has been defrauded by a scammer using your name or ID:

• Call Medicare at 1-800-MEDICARE or the U.S. Health and Human Service fraud hotline (800-447-8477).
• Report identity theft to the Federal Trade Commission at identity theft.gov.
• File a complaint online with the Office of Inspector General of the U.S. Department of Health and Human Services: tips.oig.hhs.gov.
• Call AARP’s toll-free fraud hotline: 877-908-3360.