What is Medicare Fraud?

Medicare Fraud and Abuse: Protect Yourself

Medicare scammers work tirelessly every day to target older Americans, and the fraud they commit is becoming more sophisticated. These criminals cost taxpayers billions of dollars annually and drain resources meant for honest Medicare beneficiaries.

Medicare fraud is more than an inconvenience. It is a serious crime and can impact your health, finances and future care. Unfortunately, there are many types of Medicare fraud.

Scammers always seek new and creative ways to deceive seniors on Medicare. Members of Medicare Advantage plans are targeted, too. Fraudulent activity may include unsolicited calls, texts and emails from imposters posing as Medicare representatives, healthcare providers or medical equipment companies.

How can you avoid Medicare scams?

Your Medicare numbers and personal health information may be as valuable to scammers as your credit card details. When criminals get this crucial information, they can fraudulently bill Medicare for services you did not receive or raise the costs for services you did get.

The good news is that you can take steps to avoid and report Medicare fraud. Here are tips to protect yourself:

Keep your Medicare card close. Safeguard the card and its numbers as you would your Social Security card or credit card, only sharing them with trusted healthcare providers.

Know how Medicare contacts you. Medicare will never call, text or email without your permission. They will never send representatives to your home. If you do receive unsolicited contact, do not engage and call 1-800-MEDICARE immediately. If you have a Medicare Advantage plan, also report Medicare fraud to your plan’s compliance team.

Don’t fall for free gifts. If you receive notice of “complimentary” medical services, read the fine print carefully. Does it sound too good to be true? It is.

Carefully review your plan documents. Original Medicare and Medicare Advantage plans will clearly state how your personal information is used. Become familiar with your plan’s Summary of Benefits to understand what is and is not covered. It’s also important to check your Explanation of Benefits letters to detect inaccurate billing.

Beware of fake Medicare plans. Scammers may contact you to enroll you in a plan that’s not legitimate. While shopping for coverage, you can easily verify any plan using Medicare’s Plan Finder.

How to report Medicare fraud

If you spot anything suspicious, call 1-800-MEDICARE immediately. You can also visit the Medicare website.

Prominence Medicare is also here to help you confront Medicare fraud.

Call the Compliance Team for help at 800-852-3449.