Medicare fraud is widespread and is among the long list of health care fraud schemes that cost the government billions of dollars annually. Medicare scammers continue to evolve their methods, making their ploys increasingly more believable.
Recently, a RetireMed client contacted our team after being targeted by a scammer who claimed they were from Medicare and offered the client enhanced health benefits. Thankfully, the client thought something sounded off and didn’t provide the scammer with any personal information, so they didn’t become a victim of the scam. It’s more important now than ever before to be vigilant in protecting yourself against Medicare fraud, so we encourage you to consider our tips below to help you avoid it.
Don’t provide personal information such as your Social Security number, bank account details, or your Medicare Number to anyone except authorized individuals you trust.
Scammers contact their victims in various ways, including text messages, direct mail, email, and fliers. As a general rule, don’t reply to solicitations from companies you’re unfamiliar with or click links in emails that you’re unsure about.
Medicare will never call or show up at your home to verify your information or sell you something except in the limited situations mentioned below. Some scammers who request your information may claim to be “Official Medicare Agents.” Medicare does not employ sales representatives, so any individual claiming they hold this job title is always a scam artist.
Medicare or someone representing Medicare will only call and ask for personal information in these situations:
• A Medicare health or drug plan may call you if you’re already a member of the plan. The agent who helped you enroll in the plan, such as an advisor from RetireMed, can also call you.
• A customer service representative from 1-800-MEDICARE can call you if you’ve called and left a message or a representative said that someone would call you back.
If someone contacts you with a Medicare offer that sounds too good to be true, it probably is. Some scammers may offer free services or equipment, such as genetic testing or durable medical equipment (like walkers or braces) if you provide your Medicare or Social Security information so they can in turn bill Medicare for more expensive services or equipment.
Remember that Medicare will never contact you to request personal information except in the specific instances outlined above.
If you’re on a Medicare Advantage or Medicare prescription drug plan, you will receive an Explanation of Benefits (EOB) statement from your insurance company either monthly or quarterly (depending on the insurance company) after receiving any kind of medical service or purchasing prescription drugs. Your EOB will include an itemized list of claims for that month, stating what the charges were, what the insurance company paid, and what your financial responsibility might be.
If you’re enrolled in a Medicare Supplement plan, Medicare will send you a Medicare Summary Notice (MSN) every three months. This statement is Medicare’s version of an EOB. It provides details about the services and/or supplies billed to Medicare within the previous three-month period. Your insurance company will also send you a separate EOB outlining how it covered your services after Medicare paid its portion of the costs.
Whether you receive an EOB, MSN, or both, your provider will bill you directly for any outstanding costs.
Be sure to review your statements regularly to verify that the dates, locations, and services billed are accurate. Don’t make any payments until you receive a bill from your provider. If you notice any discrepancies, contact RetireMed or your insurance company.
If you have an interaction that you suspect may be attempted Medicare fraud, try to get the individual or organization’s information and contact the Centers for Medicare and Medicaid Services Medicare help line at 800.633.4227 to report the incident.
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