5 Tips to Avoid Medicare Scams and Fraud

Never give your Medicare ID number to someone you don’t know or trust. If that’s all you take away from this article, it should be enough to prevent you from falling prey to the common Medicare scams and frauds going on in the country. Today, we’re going to review five tips to help you avoid Medicare scams and prevent other people from using your Medicare ID number to commit fraud.

Why Is This Important?

Think of your Medicare ID number as being just as important as your Social Security number. You wouldn’t give that away to just anyone, would you? The same should be true of your Medicare ID. But why is this an important topic to address?

Essentially, there are two reasons this is important. The first is that Medicare fraud can lead to huge financial burdens - on you, the insurance companies, and the federal Medicare program.

People who steal Medicare IDs to commit fraud will send false claims and bill Medicare for supplies or services that were never rendered. They pocket those reimbursements, leaving Medicare with less in the trust fund and likely a bill for you. The results of Medicare fraud include higher premiums and even more strict rules about how services are provided. 

The second reason this is important is because you don’t want to be enrolled in a plan you never agreed to. Yes, there are rules in place that should prevent this from happening, but those don’t always do the trick. Countless Medicare beneficiaries have been unknowingly enrolled in a plan that isn’t right for them or one they don’t remember discussing. This can have a huge impact on your healthcare coverage, so it’s crucial to avoid.

Tips to Avoid Medicare Scams

Let’s talk about a few practices you can put in place to keep this from happening to you or someone you love.

Guard Your Medicare ID

We mentioned this one in the introduction, and it’s still the most important tip we have for you today. Yes, you will have to give your Medicare ID to someone in order to get enrolled in supplemental coverage like a Medigap plan, a Medicare Advantage plan, or a Medicare Part D plan. But make sure you know and trust that person before doing so. If someone calls you and wants your Medicare ID to find out what you’re eligible for, that should be a red flag for you.

This can be especially tricky. Sadly, there are people out there who will call you pretending to work for Medicare or for an insurance company. If someone from your current insurance carrier calls you, you should hang up and call them back using a phone number from the back of your ID card or their website. The same is true for text messages, too.

Do Your Research

If you are presented with a plan option, you might want to consider doing your own research to verify it is a real plan. You can do so by checking with the plan provider or looking online at Medicare.gov. If you can’t find it, it likely isn’t a real plan, and someone is just fishing for your Medicare ID number.

Beware the Word “Free”

It’s true; there are some “free” things you can get if you’re enrolled in Medicare. But if someone is only presenting “free” services and items, you should probably question why they need your Medicare ID in the first place. If it’s free, why would they need your personal information?

Be Careful with Door-to-Door Salespeople

Do not accept anything from a door-to-door salesperson. Neither Medicare nor Medicaid will ever send someone directly to your house. In addition, insurance agents are not allowed to come to your home unless you’ve given them permission to do so.

Review Your Medicare Statements

You will receive an Explanation of Benefits (EOB) for any medical services you receive. While this may not sound like a very interesting task, you should look over these statements to ensure you did receive the services lists. If an EOB comes in for a day you had no appointments scheduled, you need to report the error.

How to Report Medicare Fraud

We all make mistakes. Hopefully, if you spot something wrong, it’s something that can be easily explained. For example, if you see a suspicious EOB, consult your doctor’s office or Medicare plan provider first. 

If it still can’t be explained, you’ll need to report the problem to Medicare. This includes receiving phone calls or messages from someone you think could be trying to scam you or commit insurance fraud.

To report a problem, you can call the Medicare helpline at 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). You can also call the Senior Medicare Patrol office in your state. Workers and volunteers there can help you determine if what you have is a scam or fraud and can forward your complaint to the right government investigators.

If you're ready to enroll in Medicare, you can trust the agents at Local Medicare Solutions. We have local insurance agents that understand the plans in your area and are happy to help you enroll or review your current coverage.