In 2017, Medicare spending was over $700 billion. Experts note that for every dollar spent on Medicare, 10 cents is lost to fraud or improper payment. While a lot of Medicare fraud happens during the open enrollment period, fraud still happens all the time. Here’s what you need to know about common Medicare scams.
Some Locations are Worse than Others
Shimon Richmond, former FBI Special Agent in Charge for the Miami office says locations with large populations of Medicare recipients — like Florida — see higher rates of fraud.
Because there’s so much money involved with Medicare, scammers view the program as a source of “easy money,” Richmond says, and he notes that their creativity knows no bounds when it comes to the scams they create.
Common Medicare Scams
Medicare scammers make their money by obtaining your personal information and using that to file false claims. Scammers typically employ the following tactics:
Phone calls: If you receive a phone call from someone claiming to be from Medicare and they ask for your Social Security number, bank account number, or Medicare number, hang up. The Federal Trade Commission (FTC) notes these scammers usually claim to be from Medicare and ask to verify your information. They may also claim there’s a fee for your new card or that your card was compromised and you need to move money into a safer account. The FTC also notes that phone calls claiming to be from Medicare offering important updates to the program are scams.
Free equipment: You may get a phone call or be invited to a health fair where someone claims you’re eligible to receive free medical equipment. These scammers usually claim you qualify for a knee brace or back brace and it’s completely covered by Medicare. In other situations, you may say no, but find a box of equipment has been shipped to you anyway. If you receive a call like this, immediately hang up.
Billing fraud: These are procedures, equipment, or prescriptions that appear on your Medicare statements that you did not receive.
How to Protect Yourself Against Medicare Fraud
If you receive a phone call from someone claiming to be from Medicare and if they ask for your Medicare information or financial information, hang up. Medicare will only call you if you are already a member of a Medicare or drug plan or if you called 1-800-MEDICARE and asked a customer service representative to call you back. The Medicare agent who helped you join a plan can also call you.
Only give your personal information — like your Medicare number — to doctors or insurers acting on your behalf.
When you receive healthcare services, record the date and services on a calendar and compare the statements you receive to what you recorded. If you are billed for services you did not receive or receive a suspicious phone call from someone claiming to be from Medicare, hang up and call 1-800-MEDICARE to report them.