Watch Out for Medicare Scams

Once they have your personal information, they may use it for ID theft or to steal money from your bank account or make fake charges in your name. Or they may sell your personal information to other fraudsters.

They submit false claims. “They may use a person’s ID to contact a doctor’s office and request an order for medical equipment or tests, then submit claims without the beneficiary even knowing,” McKenna says. Scammers then get reimbursed by Medicare for the fake services.

In one of the most egregious scams, criminals enroll Medicare beneficiaries in hospice without their knowledge – even though they are not terminally ill – and collect payment from Medicare for hospice services that were never delivered. Meanwhile, the beneficiary has legitimate claims denied because Medicare won’t pay to cure your illness after you are enrolled in hospice.

They order equipment on your behalf. They may also send unwanted and not medically ordered medical supplies to beneficiaries, “then charging both Medicare and sometimes the beneficiary for the supplies,” says McKenna.

How to recognize a Medicare scam

Unexpected calls from Medicare. You receive an unexpected call from someone claiming to work for Medicare. “The only time someone would receive a call from Medicare is if the beneficiary called Medicare first and scheduled a phone appointment with a representative,” McKenna says.

Offers of a new Medicare card. “No one would receive a new Medicare card unless they personally requested one from Medicare, like in a case where their ID has been compromised,” McKenna says.

Fees for new or upgraded cards. Medicare cards are paper; there are no plastic Medicare cards or cards with chips. You can print a new Medicare card at any time from your online Medicare account.

Requests for personal information. “Medicare will not call beneficiaries to ask for personal information or to update your information or give you a new Medicare card number,” Morales says.

Callers don’t clearly identify themselves but they claim to be calling from your health care provider. “Most scammers use generic phrases like ‘I’m calling from your health care provider’ or ‘I’m calling from Medicare Services,’ ” Morales says.

Threats of coverage cancellation. The caller says they’ll cancel your Medicare coverage unless you provide personal information over the phone. Medicare will never call you about canceling your coverage, and you will receive several bills and a delinquency notice in the mail before Medicare cancels your coverage for not paying Part B premiums.

Strange bills or charges. You get a bill from a hospital or medical provider for care you didn’t receive, or you see a suspicious charge on your Medicare summary notice, which is your quarterly explanation of benefits from Medicare.

How to protect yourself

Hang up immediately. If you receive a call claiming to be from your doctor’s office, pharmacy or Medicare office asking for your Medicare card number, hang up and call back on the number you know to be associated with them, says McKenna. Don’t use a number they give you.

Keep your Medicare card at home. Only carry your Medicare card if you need it for a medical appointment. If you’re worried about what happens if you’re in an accident, you can keep a copy of the card in your wallet with the number crossed out. If you’re in an accident, you’ll only need to show you have Medicare and your coverage start date and can provide the number later.

Read your Medicare claims notices. “Review your Medicare summary notice and explanation of benefits as you would with your own credit card statement,” Morales says. Look for claims for services you didn’t receive or for duplicate claims. You can check your claims record by going over the notice you receive in the mail every three months, or you can sign up to receive monthly electronic statements. To see current claims, go to your online Medicare account.  

Investigate odd charges. If you find suspicious charges on your Medicare summary notice, first contact your doctor’s office to make sure it isn’t just an error, and then contact Medicare or your local SMP to report the activity.

What to do if you’ve been targeted

Report the call to Medicare at 800-633-4227 and your state’s Senior Medicare Patrol at 877-808-2468. SMP volunteers can answer questions about suspicious charges and potential scams and help you report the fraud to Medicare and the U.S. Department of Health and Human Services’ Office of Inspector General, which investigates Medicare fraud.

They can also help you find out whether you need to get a new number from Medicare if yours has been compromised.

Report scams to the FBI’s Internet Crime Complaint Center (IC3).

For support and guidance, the trained fraud specialists at the free AARP Fraud Watch Network Helpline, 877-908-3360, can share information on what to do next and how to avoid future scams. The AARP Fraud Watch Network also offers online group support sessions.