Fraud Prevention
Understanding Medicare Fraud
Medicare fraud can have significant financial and health care implications. It involves the misuse of Medicare numbers and other personal information to bill Medicare for services or supplies that were never provided. This can lead to higher premiums and stricter eligibility rules for legitimate health care needs. It is crucial to treat your Medicare card and number with the same care as you would a credit card or Social Security number.
Protecting Your Medicare Number and Card
To prevent Medicare fraud, it is essential to keep your Medicare card and number secure. Never leave your Medicare card out in the open, and only give your Medicare number to authorized health care providers or agents. Be cautious when others ask for your Medicare number, especially over the phone or in exchange for free services or products. Legitimate insurance agents or company representatives will need your Medicare number if you are signing up for a Medicare supplement insurance plan, a Medicare Advantage plan, or a Medicare prescription drug plan, but they should never ask for it over the phone without your prior consent.
Identifying Bogus Medicare Plans and Services
Scammers often try to entice individuals with phony Medicare plans, products, benefits, and services. Always verify any plan or service directly with the plan provider or use the Plan Finder at Medicare.gov. If the plan is not listed, it may not be legitimate. Be wary of “free” health care services or products that require your Medicare information, as these are often scams to obtain your Medicare number.
Avoiding Deceptive Sales Practices
Door-to-door salespeople may offer medical supplies or information, but neither Medicare nor Medicaid sends representatives to people’s homes to sell products or services. Insurance agents may visit your home only if you have requested them to do so. Always be skeptical of unsolicited offers, especially those that seem too good to be true or involve services that do not sound medically necessary, such as mud treatments or dance classes.
Reviewing Your Medicare Statements
Regularly review your Medicare claims summary statements to ensure accuracy. These statements detail the health care services, supplies, or equipment you have received. Compare this information with your own records to verify that you received all the services and products listed. Report any discrepancies or suspicious charges to your Medicare plan provider or the Medicare helpline (1-800-MEDICARE).
Reporting Medicare Fraud
If you suspect Medicare fraud, start by checking with your Medicare plan provider to see if it is a simple mistake or misunderstanding. If you still believe fraud has occurred, report it to the Medicare helpline or contact the Senior Medicare Patrol (SMP) office in your state. SMP workers and volunteers can help determine if you have been a victim of fraud and will forward your complaint to government investigators.