Senior edition

5 steps for avoiding Medicare scams

National Council on Aging - For The Register-Herald

PREBLE COUNTY — You’re sitting at home one afternoon, three weeks prior to the start of Open Enrollment, when you get a call from a friendly Centers for Medicare and Medicaid Services (CMS) employee. The caller tells you that Medicare is issuing new cards, and that you need to provide your Medicare number in order to receive yours. The catch? The caller doesn’t work for CMS, and he’s actually trying to steal your identity.

Elder abuse in the Digital Age is a serious problem — studies have shown that 2 in 10 older adults have been financially exploited. Read on for five key tips on avoiding common types of Medicare scams.

1. Know the difference between identity theft, Medicare fraud and improper care

Identity theft happens frequently under the guise of Medicare, as in the example above. Someone pretending to work for Medicare may contact you and tell you they need your personal information in order to update your forms, but they’re actually looking for a way to steal your identity—i.e. your savings. A legitimate Medicare employee would never ask for your personal information over phone or email—they already have it on file.

Medicare fraud happens when Medicare is billed for services or supplies you never got. Examples include a healthcare provider billing Medicare for care you didn’t receive, or someone using your Medicare card to acquire medical care for themselves—or bill for fake services and then pocket the money. If you suspect that Medicare is being charged for a service you didn’t ask for (or you don’t recognize the provider on the claim) you can call the federal government’s official Medicare hotline at 1-800-MEDICARE. You can also learn more here.

Improper care does not qualify as Medicare fraud, although it is still something to be monitored and reported. Your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) can help you if you want to file a complaint about the quality of your medical care.

2. Watch out for anyone asking for personal information

The most important rule to remember? Medicare will never call, email, or visit you and ask for your personal information. Examples of personal information include your Medicare number, social security number, bank account number, birthday, and address.

Scam artists may claim that Medicare is issuing new cards or updating forms, or that they need your financial information to process payment on an overdue medical bill. Even if they accurately cite a few numbers from your checks, do not assume the call is legitimate. Medicare already has this information and does not need to collect it from you.

Key takeaway: If anyone trying to “help you” with Medicare asks for your personal or financial information, assume it is a scam. Hang up the phone, delete the email, or close the door immediately.

3. Compare plans with a trustworthy adviser

Medicare is a massive enterprise that affects millions of people—which means countless insurance salespeople pitching policies that they promise will “save you thousands.” While some of the plans they suggest may be plans you recognize—even the ones that your friends and families use—not all policies are right for everyone.

Depending on your employment status or medical situation, you may need different kinds of assistance from other older adults you know. Some salespeople may employ scare tactics or other below-the-board strategies to pitch their plans, such as free lunch seminars or false claims of being affiliated with a government agency. Additionally, some scam artists work on behalf of companies that sell “Medicare drug plans” that have not actually been approved by Medicare.

To avoid these issues, get advice from a resource you can trust. My Medicare Matter’s Medicare Mini-Check, created by the non-profit National Council on Aging, is a free, brief assessment that helps you compare plans online. It can also connect you to free professional advice from licensed Medicare advisors at the Aon Retiree Health Exchange. Aon advisors have passed NCOA’s rigorous consumer protection standards, known as the Standards of Excellence.

Another excellent resource is your local State Health Assistance Insurance Program (SHIP). SHIPs provide free, one-on-one, and unbiased federally funded Medicare counseling. As they are primarily staffed by volunteers, it is wise to contact them early before the start of the busy Open Enrollment season (October 15-December 7). To schedule an appointment with one of their counselors, visit their website here or call their toll-free national number at 1-877-839-2675.

4. Never sign a Medicare form without thorough examination

Some disreputable insurance agents may also try sending out release forms that allow them to make decisions on your behalf. Never sign anything Medicare-related without reading through it first—and get a friend, family member, or lawyer to review it as well.

5. When in doubt, call Medicare

If anything ever seems suspicious or uncomfortable, don’t hesitate to contact Medicare. They are there to help! You can visit or contact them toll-free at 1-800-MEDICARE with any questions or concerns you may have.

5 steps for avoiding Medicare scams

National Council on Aging

For The Register-Herald