Medicare Expert Offers Tips on How To Protect Yourself Against Fraud and Abuse

The cost of prescription drugs, home health care, and other medical expenses are one less thing to worry about thanks to Medicare. However, this doesn’t mean you’re completely in the clear. With millions of people currently enrolled in Medicare plans, it’s common for fraud and abuse of this program to take place. 

Fortunately, Ari Parker, the lead licensed Medicare advisor at Chapter, offers ways to spot and protect yourself against this type of fraud – and ensure that your personal information is safe. 

What is considered Medicare abuse?

Medicare abuse is when people fall victim to schemes offering free medical supplies or claims about refunds in exchange for social security numbers, Medicare numbers, and credit card information. 

The FBI estimates that around $3 billion of losses occur annually from Medicare abuse and other kinds of fraud, as adults 65 and over are typically targeted. “Scammers often prey on the elderly because this demographic has built up savings over years of work experience as well as a credit history, which makes them the ideal target for credit card fraud,” Parker explains to Woman’s World.

He adds that Medicare fraud and abuse can be caused by providers, beneficiaries, and scammers – and generally results in higher costs and taxes for everyone.  

What is the most common type of Medicare abuse?

Parker notes that one of the most common forms of Medicare abuse is scams. This is where scammers act as a Medicare professional to solicit personal or medical information that allows them to steal from older adults. 

Below are three prevalent scams used in Medicare abuse: 

• Scammers target mature adults by offering them “free” medical supplies. For instance, they may offer people durable medical equipment or medical checkups at “no cost to you” and say Medicare will cover it. These thieves will then ask for your Social Security number or Medicare number to verify coverage for their shipping costs. Do not share this or any other personal information with anyone who reaches out with so called “free” offers.
• Scammers call people to tell them they are eligible for a Medicare refund due to a change in their coverage. These callers typically ask for your Medicare number as well as your bank information. Again, do not share this financial information with them.
• Scammers create fake Medicare email addresses that can redirect you to a website that looks identical to the real Medicare.gov page. Never log into any accounts following links in an email, since this could redirect you to a fake page. Instead, always login to your Medicare.gov account directly or your insurance account to update your information and verify your data.

“Most importantly, if you get any calls, emails, or in-person visits that are unsolicited, do not share any personal information,” Parker says. “Instead, call Medicare or a trusted advisor.”

What are other red flags for Medicare fraud?

Some of the red flags for Medicare fraud are listed above, but Parker lists these two additional signs to be aware of:

• If someone calls you claiming to be from the Centers for Medicare & Medicaid Services, take down any information you can without sharing any of your own information on the call. If you or a loved one believe you may be a target of Medicare fraud, call 1-800-MEDICARE (1-800-633-4227) immediately.
• If you or a loved one has Original Medicare, you can also log into Medicare.gov to check any Medicare claims or sign up for “Medicare Summary Notices.” If you see any charges on these notices for services you did not receive, call 1-800-MEDICARE (1-800-633-4227) immediately. 

How is Medicare fraud determined?

Parker acknowledges that it isn’t always easy to determine on your own whether you have been a victim of fraud without contacting Medicare directly. He encourages you to call Medicare if you or a loved one suspect you’ve been targeted. Be sure to have your Medicare number ready, as well as details about the suspicious service or item ready to share with an expert on the call. 

What Medicare plans have the best secure coverages?

With thousands of Medicare plans available throughout the country, finding the right one for you is key. According to Parker, plans should take into account a person’s doctors, specialists, prescription drugs, and financial situations. 

“Many Medicare brokerages may try and steer you into a plan that does not put your best interests first,” he notes. He recommends working with an independent Medicare broker to ensure that you’ll find the best plan for your needs that offers the most comprehensive coverage at the most affordable cost.

Parker concludes that you can always hang up the phone should you receive any calls you believe to be suspicious – and call Medicare directly to ensure you’re speaking with the right person.

Looking for other ways to avoid common scams and fraud? Read our stories on how to avoid lottery scams and ways to spot and report scam text messages.