How to Guard Against Medicare Fraud During the Annual Enrollment Period

Medicare’s Annual Enrollment Period (AEP) is Oct. 15-Dec. 7. Unfortunately, Medicare fraud increases during this time of the year, with scammers using a variety of methods to unlawfully gain access to Medicare beneficiaries’ information and finances. Throughout the fall, it’s especially important to be vigilant in protecting yourself from Medicare fraud. Below are some of the top things you can do to avoid Medicare scams this AEP. 

Guard your personal information. 

It’s important to always prioritize the protection of sensitive information. You should be cautious when sharing details like your Social Security number, bank account information, and Medicare ID number. Only share this information with authorized individuals you know and trust.

Medicare or an individual representing Medicare will only call to request 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 if a representative said that someone would call you back.
• If you reported suspected fraud, you might receive a call from an individual representing Medicare to follow up on the investigation.

A good rule of thumb is to always think twice and ask questions when you’re asked to provide any sensitive information to an individual or organization.

Be careful when it comes to advertising.

Medicare advertising during AEP can be overwhelming and sometimes confusing. From infomercials to internet ads, it seems that everyone has a take on which plan is best for your needs and how you might be missing out.

Don’t believe everything you see and hear. Although they may appear “official” and polished, some advertisements, such as TV commercials about new Medicare plans, are misleading and purposely confusing. In certain cases, plans featured in these advertisements don’t tell the whole story about the coverage, or the specific plan may not be offered in your county. Companies that employ these marketing tactics are simply trying to get you to enroll in a plan, regardless of whether the plan is a good fit for you or if you even need the coverage.

The Centers for Medicare and Medicaid Services have begun to apply more strict guidelines to Medicare advertisements to ensure consumers understand the policy being marketed and only enroll in a plan they need, but it’s important to remain informed and vigilant. 

If you have any questions about something you saw, or you’re interested in plan benefits referenced in an advertisement, we recommend calling our team. We can walk you through what’s available to you and how it may compare to your current Medicare coverage. 

Watch out for unexpected calls and visits.

Medicare scammers are increasingly convincing when it comes to direct contact attempts, such as phone calls or in-person visits. Keep in mind that these individuals may have already gained access to some information about you, which makes them even more believable.

Here are a few tips from the Federal Trade Commission for recognizing and avoiding Medicare phone scams:

• Don’t trust the name displayed on your phone. Scammers can fake a caller ID.
• Hang up if anyone calls and asks for your Medicare, Social Security, bank, or credit card information. Legitimate Medicare employees have your information on file.
• Don’t be pressured or rushed into making a health coverage decision.
• Ignore threats to take away your health plan benefits. If you qualify, your benefits can’t be withheld for declining to enroll in a plan.
• Don’t talk to anyone who suggests their plan is preferred by Medicare. Medicare doesn’t endorse a specific plan.

Regarding in-person visits, remember that reputable health insurance agents, including those from RetireMed, will never show up at your door without getting permission from you ahead of time. Any “insurance agent” who shows up unannounced should be avoided, as they are not following the marketing guidelines set forth by the Centers for Medicare and Medicaid Services. 

Report Medicare fraud.

If you come across suspected Medicare fraud, it's important to report it through one of these channels: 

• Call the Centers for Medicare and Medicaid Services: 800.633.4227
• Call the fraud hotline of the Department of Health and Human Services Office of the Inspector General: 800.447.8477
• Visit tips.oig.hhs.gov to file a complaint
• If you’re enrolled in a Medicare Advantage or Medicare drug plan, you can also call the Investigations Medicare Drug Integrity Contractor: 877.772.3379

When you contact one of these entities, be sure to provide as many details as possible about the situation. Doing your part to report suspected Medicare fraud can help others avoid future scams. 

We’re here for you!

By understanding how to avoid Medicare fraud during AEP, you can protect yourself, your finances, and your information. If you have questions, call us at 877.222.1942 or schedule a call, and we’d be happy to help. 

More information on Medicare fraud can be found in this publication from the Centers for Medicare and Medicaid Services.