Medicare fraud is on the rise, and although many may feel resistant to the risk of scams, senior citizens lose about $37 billion each year to medicare fraud, and a significant part of that comes from healthcare scams.
There are, luckily, ways to keep yourself safe in Medicare fraud cases. Seniors and caregivers need to be mindful of possible warning signs, vigilant in prevention, and aware of what to do in the case of healthcare fraud.
If found, there are many signs of Medicare fraud you should be suspicious of. In general, scammers may call or use robocalls directly to engage with those they plan to mislead. In return for your Medicare card number, phone scams sometimes include a promise of free medical treatment, appointments, or supplies. They may even call and pretend to work for Medicare and threaten that if your information is not given, you may lose your Medicare coverage. Without contacting them first, Medicare workers can never call you and you can never give your Medicare number to someone who calls unsolicited over the internet.
Your Medicare Summary Notices (MSNs) can display other warning signs. MSNs are Medicare statements that document recent claims made by providers of healthcare. It is most likely a case of Medicare fraud if you ever get an MSN or bill from a hospital or medical provider for treatment that you did not get. Fraud can also come in the form of being paid for services that you are told you can get but never do. Second, by calling the plan provider and demanding an answer, rule out errors.
In the form of unplanned genetic testing between seniors, fabricated-charge fraud has recently occurred. Medicare policyholders will supply their data to undergo what is known as "genetic testing" or "DNA testing." These tests are meant to reveal whether patients have a genetic disposition to certain diseases, however, despite the provider filing a claim using the Medicare records, results are often never provided. While the Medicare recipient generally pays nothing, their personal data is compromised.
The first step in mitigation is to keep the warning signs in mind and confirm all suspect calls and offers. This is particularly relevant during annual enrollment periods (AEPs), a prime time for scammers to try to scam older consumers into providing unnecessary information about enrollment and buying insufficient policies. You can also ensure that your Medicare number and card are only shared with healthcare providers and insurance brokers you trust.
Another preventive step that you may take is to write down the dates of all your appointments related to healthcare. This will mean that you can detect easily if a demand is made for a service that you have not received.
Always destroy any old Medicare cards that you have, paying particular attention to removing your social security number from the wallet. One other way to avoid Medicare scams, and perhaps the most effective way, is to remain informed. Know your rights when it comes to Medicare, keep up to date with what a provider can and should not charge Medicare, and be able to ask questions if an unexpected interaction happens. Always be mindful of the prescription you can receive at the pharmacy.
Anyone may become the victim of fraud, so the security of your personal details is very important. If you find yourself in the middle of what you think could be a Medicare fraud, immediately call 1-800-MEDICARE.
You will need the following to report fraud: the name of the provider, the service item you are investigating, the date the service or item was given or delivered, the Medicare-approved payment amount, the date on your MSN, your name(s), and Medicare number, the reason you think Medicare should not have paid, and any other details you have showing why Medicare should not have paid for a service or item.
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