6 Medicare Scams To Watch Out For

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Medicare’s 60 million beneficiaries are a huge target for fraudsters who are looking to defraud Medicare or steal personal information. According to NBC, of the 2.4 million reports involving fraud, identity theft, and other scams sent to the Federal Trade Commission this year, 332,000 of those incidents cite government imposters from Medicare or the Department of Health and Human Services.

Not only do these scams cost taxpayers over a billion dollars annually, but it can also hurt beneficiaries by opening them up to medical identity theft and/or false claims, and can put their health in danger by maxing out their plans that have annual caps on reimbursements for treatments or prescriptions. 

Medical identity theft is when someone steals or uses your personal information (like your name, Social Security Number, or Medicare Number) to submit fraudulent claims to Medicare and other health insurers without your permission

This isn’t like the bank or your credit card where identity theft is usually covered. If Medicare suspects malicious activity with an account, the person with coverage could be held accountable and wind up spending thousands in legal fees to resolve the issue. Protect yourself and your loved ones from these Medicare scams.

Phone Calls

Scam operators (many with foreign accents) call beneficiaries claiming to represent Medicare. They may say that new Medicare benefits cards are being issued and threaten to cancel Medicare coverage unless the beneficiary’s information is updated; claim they can improve benefits; “verify” your new Medicare card number to make sure you received your card; tell you to send in your old one, or claim they are selling Medicare policies. The caller might even ask for your information to send you a gift card. Sometimes, they’re selling phony products such as supplemental or prescription drug Medicare plans. 

The whole purpose of all of these calls is to obtain your personal information, whether that is your Medicare card number, your Social Security number, or banking information. Some of these scammers even have the technological ability to make the call appear on caller ID as if it is coming from an official place. And they can sound legit. Some will say anything to try to gain a person’s trust. In some cases, the criminals have done their homework and can use things that are true to add credibility to their story and get you to respond

The fraudster can become aggressive, calling over and over at all times of the day. If a caller asks for any personal information, experts say to assume it’s a scam. Hang up. Unless you initiated the request, Medicare will NEVER call you. Medicare will never call you to sell you anything and they can’t enroll you over the phone unless you called first. Never give your Medicare or other personal information over the phone to anyone who calls asking for it

Mail Scams

You may receive counterfeit sales materials, offers for discounted prescription drug plans, or supplemental Medicare coverage, or bills from an unknown hospital, doctor, or medical supplier through the mail. The scammers know that many people will just pay the bills. 

To avoid this scam, keep records of dates when you receive health care services to compare against bills, save receipts or statements, and keep track of quarterly Medicare Summary Notices to make sure you actually got what Medicare paid for. When in doubt, contact the billing department where the services were received or your insurance provider to make sure the charges are valid. 

Door-to-Door Scam

Brazen scam artists will walk right up and knock on your door, claiming to be a Medicare representative, trying to sell you a Medicare prescription drug coverage, medical equipment, supplements, or medicine. Take heed: Medicare doesn’t make house calls

Medical Equipment

You may get calls from people promising you things if you give them a Medicare Number. Don’t do it. The Federal Trade Commission warns, “Scammers have been targeting Medicare recipients with a scheme to get “free or low-cost” back and knee braces. They’re calling, running television ads, and mailing letters to get people to give their Medicare information. But if you give them your information, they’ll use it to fraudulently bill Medicare for braces or other medical equipment. This uses up your medical benefits, which means you might not be able to get the right brace later, if your doctor prescribes one.”

According to AARP, “Telemarketers call beneficiaries with offers of free state-of-the-art braces to relieve joint pain. Instead, consumers receive a package of the ordinary ankle or knee wraps (or nothing at all), but Medicare gets a bill for thousands of dollars.” If someone calls and says they’re from Medicare and offers you a “free” or “low cost” brace, hang up. No one from Medicare will call you with such an offer. It’s a scam. The FTC advises refusing medical equipment that is mailed to you unless your doctor ordered it. Don’t pay for anything you didn’t order.

Free or Low-Cost Genetic Testing

The US Department of Health and Human Services Office of Inspector General warns of this genetic testing fraud scheme. If anyone offers you a “free” or discounted DNA test, whether it be through the mail, on the phone, or even at a health fair, be wary. The scammers offer cheek swabs to scan for cancer or predispositions for other serious illnesses, and claim that Medicare will cover the costs, but in reality, they’re after your Medicare information for identity theft or fraudulent billing purposes.

Medicare does not pay for random genetic testing. If you randomly receive a genetic testing kit in the mail, simply return to the sender. 

Fraudulent Billing

This scam can take many forms. Basically, an unscrupulous clinic, health care provider, or disreputable home health care agency could write a fake script, order unnecessary tests or procedures, provide treatment that Medicare doesn’t cover then bill it as something that is covered or sign beneficiaries up for services that would be covered by Medicare but are never performed. Avoid this scam by reviewing your Medicare Summary Notice to ensure all services billed were indeed received. 

For more tips on how to protect yourself from Medicare fraud, visit CMS.gov or call 1-800-MEDICARE (800-633-4227).  If you suspect identity theft or feel like you gave your personal information to someone you shouldn’t have, contact the Federal Trade Commission.