Medicare is a federal program that provides Medicare Part A Hospital Insurance and Medicare Part B Medical Insurance to individuals who are 65 or older, under 65 with a qualifying disability, and any age with end-stage renal disease or ALS.

Recently, our GIS team has noticed an increase in the number of fraudulent calls we’re receiving related to the Medicare program. To make sure our clients don’t become victims of these scammers, we want to educate you about Medicare fraud and what you can do to protect yourself and your loved ones.

Common Medicare Fraud Scams

The purpose of Medicare fraud is to obtain your personal information like your Medicare ID number, Social Security number, or banking information. These scams take the form of mail scams, door-to-door scams, or fraudulent phone calls.

Mail Scams

In a mail scam, fraudsters send out counterfeit flyers offering discounted prescription drug plans and supplemental Medicare coverage. They may also send you counterfeit billings from an unknown hospital or medical supplier. To avoid being duped, keep track of your medical visits and purchases and compare them with your bill each month. If you have any doubt, contact the listed company’s billing department or your insurance company to verify the charges.

Door-to-Door Scams

Medicare will never visit you at your home. If anyone comes to your door claiming to be a Medicare representative, it is a brazen case of Medicare fraud. We advise you to ask them to leave and report the incident to the police and to Medicare immediately.

Phone Scams

Some phone scams claim that Medicare cards are changing their appearance in some way, such as in their color or material, and that the old card will not be valid if it is not replaced by a certain date.

A valid Medicare card is red, white, and blue with an eleven-digit Medicare ID, which is a combination of letters and numbers. The card is printed on nonlaminated paper. Those who receive Social Security benefits will automatically receive a Medicare card in the mail a minimum of three months before their 65th birthday. Those who do not receive Social Security benefits must apply for their card directly with Social Security or through www.SSA.gov. Medicare will not contact you about this over the phone unless you request a call directly.

Other scams advertise free or low-cost Medicare equipment if you provide them with your Medicare information. The most recent scam promises access to the COVID vaccine if you provide your Medicare number.

As a best practice, it is wise not to provide any personal information over the phone unless you are certain you know who you are talking to and that the information is being collected legitimately.

How to Spot Medicare Fraud

Medicare will never contact you for your personal information unless you’ve given them explicit permission in advance. They will also never call to sell you anything, like equipment or the COVID vaccine.

If you provide a fraudster your Medicare number, you may be fraudulently billed for equipment or other items you think you are purchasing. This uses up your benefits, which means legitimate equipment or other medical items you purchase later may not be covered.

You should review your Medicare Summary Notices each month to locate errors. Compare the dates and services with your calendar to ensure you received each service listed. If you see a charge that you don’t recognize, call the Medicare billing department as soon as possible to report the charge.

Phone scammers often use the premise that your Medicare card is expiring or expired to convince you to provide personal information over the phone. This began when the Centers for Medicare & Medicaid Services (CMS) started issuing new cards in April 2018. You should know that Medicare cards do not expire. Medicare will only contact you over the phone because you have requested a call back or they have sent an official letter in advance to arrange a telephone interview. If you have not received an official letter or requested a call back, then you should assume the call is a scam.

These scams can be tough to spot because the individuals appear to be knowledgeable, empathetic, and trustworthy.

Other times, they are knowledgeable individuals that sound empathetic and trustworthy. In most cases, scammers are able to modify their caller ID to make it appear that their call is coming from Medicare. The best protection is to check the phone number and only answer calls from numbers that you recognize. If you’re not sure if you received a call from Medicare, you can always call them back at their official number to verify.

If you do answer a call and are questioning its validity, you can let the caller know you’d like to call them back and ask for a direct number. Most scammers will become flustered by this request and hang up. A legitimate caller will always respect your privacy and security needs.

How to Report Medicare Fraud

If you suspect Medicare fraud, contact your local authorities and Medicare to report the incident. This helps stop scammers and prevents others from becoming victims of Medicare fraud.

To report fraud to Medicare, you will need to provide your name and Medicare number, your provider’s name and identifying information you have, the service item you’re questioning and when it was supposedly delivered, the amount approved and paid by Medicare, and the date on your Medicare Summary Notice or claim. It is safe to disclose this information when you are calling 1-800-MEDICARE to report a fraud.

GIS is Here to Help!

If you have any questions related to these or other Medicare scams, our team is here to help. Your protection with GIS goes far beyond your insurance policy. Our team cares that you stay safe in all facets of your life, and we’re here to help make that happen. Connect with us to find out what we can do for you.