Medicare scams entail you revealing your personal information through the phone, a website, or even through your email. With your information, this could lead to false Medicare claims from the scammer to receive money or to steal your identity. Read more about common scams you may have to look out for.
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Common Medicare Scam Tactics and What You Should Do
Common Medicare scams may consist of billing fraud and call fraud.
Billing Fraud
Billing fraud is when you’re billed for services or procedures that you have not received or were not provided to you. This could result from someone using your identity and Medicare information.
Warning signs to look out for billing fraud are:
- If someone submits multiple claims on the same service.
- Appointments you’ve been billed for that you never booked yourself.
- Receiving a bill for a health benefit plan that you never signed up for.
How to Protect Yourself
- Save your medical receipts: Use your medical receipts for any errors made on your new bill. If you consistently go to the doctor for treatment or a check-up, the bill should stay consistent. If it does not, you may have your medical receipts as evidence.
- Keep track of your appointment dates, times, and services performed: Knowing when your appointments were and how long each appointment was may protect you from getting billed outside of those appointments.
- Keep track of your credit card and billing activity: If there are unknown transactions from your credit card, you may choose to dispute them.
Call Fraud
Call fraud applies to those who ask for your personal information, such as your Medicare number or Social Security number. These callers may pretend to be a part of the Social Security Administration, your healthcare provider, or your insurer.
Warning signs to look out for during a phone call are:
- A phone number you’re unfamiliar with
- Request that you confirm your personal information
- The caller threatens that you’ll be arrested if you don’t comply with what they say
How to Protect Yourself
- Call the organization the caller is from: If you’re unsure about the caller, you may call the organization that they claim to be from. If the caller provides you with a number to call, do not call that number without first confirming it is the correct number for the organization. Do your own research to find the organization’s publicly available number, then reach out to them to confirm.
- Hang up: If you feel threatened by a caller, immediately hang up and block their number.
Healthcare Provider Fraud
Healthcare provider fraud is when a healthcare provider bills for a medical procedure in exchange for higher reimbursement. This could cause you to pay more money than the actual amount that you should be billed for.
Warning signs to look out for on your medical bill are:
- Having multiple bills for the same service.
- Made up procedures that never occurred.
- Incorrect types of equipment stated on the bill.
- Exaggerated how long the procedure took.
How to Protect Yourself
- Look out for any suspicious behavior: Suspicious behavior from your healthcare provider may consist of referring patients to other providers in exchange for cash or gifts.
- A healthcare provider offering “free” services: Oftentimes, healthcare providers may offer “free” services but may still bill you for the service that was performed.
- Keep track of what kind of appointments you have: Healthcare providers may purposefully bill you for something more serious in exchange for a higher reimbursement. In order to prevent this, keep track of why you went to the healthcare facility and what you were there for.
General Practices to Keep You Safe
To keep yourself safe from scams, you should:
- Do not disclose your Medicare number or Social Security Number to anyone you are not expecting to hear from: Only give your information to someone you are expecting to hear from, such as an insurance broker, agent, or company you’ve contacted. You may receive legitimate calls or emails from companies if you have called or emailed them first, filled out a form for more information, or requested more information online. However, if you did not do any of those things and someone calls you without your permission, do not give them your sensitive information.
- Only purchase Medicare plans from an established broker, company, or Medicare.gov: Be wary of those who contact you without your permission to sell you a new Medicare plan. Instead, only consider purchasing plans from brokers, agents, and companies that you have reached out to on your own. Do research on the seller to ensure they are licensed and reputable.
- Do not accept health services you do not need: You may get billed for services that you do not need, in which case it could lead to a higher medical bill.
What To Do If You Suspect Fraud
If you suspect that fraud is either taking place or that you’ve been a victim of Medicare fraud, you may report it to tips.oig.hhs.gov. You may also call the Medicare fraud hotline at 1-800-MEDICARE (1-800-633-4227). You may also directly call the Office of Inspector General at 1-800-447-8477