Medicare Fraud Prevention Week: Avoiding Health Care Scams

Senior couple in the kitchen with calculator and paperwork, looking worried about bills.The week of June 5 marks Medicare Fraud Prevention Week. Seniors and their caregivers should be aware of the risks that Medicare scams pose and how to avoid falling victim to this type of fraud.

Each year, Medicare loses tens of billions of dollars to abuse and errors. Identity thieves, scammers, and deceitful health care providers often target older adults who receive Medicare.

Safeguard Yourself From Medicare Scams

To start, you can lower your risk of falling for a scam in the first place by keeping the following points in mind:

  • Avoid sharing your Medicare number over the phone.
  • Keep your Medicare card on your person only when necessary. Otherwise, leave it at home. (Think of it like a Social Security card or credit card and protect it in the same way.)
  • Keep in mind that Medicare representatives will never come to your residence uninvited. They also will not call you out of the blue to verify your information. Phone calls with Medicare personnel will never involve offering you free or low-cost equipment, such as a back or knee brace.
  • Hold onto your receipts and bills from past medical appointments so that you can compare them to your Medicare statements.
  • Always look through your Medicare Summary Notices when you receive them. Keep an eye out for any errors or discrepancies regarding services, tests, or medical supplies that you did not receive, or that you were charged for more than once. You can call your health care provider and ask them to explain a charge and, if necessary, you have the right to dispute charges that are wrong.

Why Do I Need to Report Medicare Fraud?

Medicare abuse is far from being victimless. Reporting fraud to the proper authorities is crucial to help stop it.

If someone steals your Medicare card or number, you could receive bills for health services you did not receive or become a victim of identity theft.

A health care provider who may be fraudulently charging you for services can spell trouble for more than your wallet. A dishonest provider could misdiagnose you. They could subject you to treatments or services you do not need or that could potentially negatively impact your health.

Sometimes, billing errors are made by accident, but if you find that your provider makes these types of mistakes frequently, it may signal a potential case of fraud.

Ultimately, fraud that goes unchecked can lead to higher Medicare costs for you as the consumer.

What to Do If You Suspect Medicare Abuse

A number of options are available for reporting incidents that you suspect may constitute Medicare fraud:

  • Call the Office of Inspector General hotline at 1-800-HHS-TIPS or file your complaint online.
  • Call 1-800-MEDICARE to report suspected abuse by a Medicare provider. (The Centers for Medicare & Medicaid Services also offers a free online resource, Protecting Yourself and Medicare From Fraud.)
  • In addition, each state (and the District of Columbia) has a dedicated Senior Medicare Patrol, or SMP. This service can monitor your Medicare account for fraud.

Experienced elder care attorneys also can help protect you from abuse. Experts in this area of law will have an understanding of state-specific laws affecting seniors. You also can seek out their assistance with other legal issues, including seeking long-term care or Medicaid services. Find an elder law attorney near you for further guidance on the legal documents and strategies that make the most sense for you.