Medicare Fraud Protection: How to Spot Scams and Protect Your Benefits

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The Medicare Annual Enrollment Period or AEP begins October 15th and ends December 7th.  During this time, not only do Medicare beneficiaries receive a lot of information, both solicited and unsolicited, about their plan options for the upcoming year, but they are subject to potential scams from unscrupulous organizations who look to take advantage of people’s confusion.

Here are some tips to help individuals recognize and prevent Medicare fraud:

Review Your Medicare Summary Notices (MSNs):  Medicare sends out MSNs every three months, summarizing the services and equipment billed to Medicare on your behalf. Review these statements carefully for any unfamiliar charges or services. If you spot anything suspicious, contact Medicare immediately.

Protect Your Medicare Number: Treat your Medicare number like a credit card number. Don’t share it unless you trust the person or organization requesting it. Be especially cautious of anyone who contacts you by phone or email requesting your Medicare number.

Be Skeptical of Unsolicited Offers:  Be cautious of unsolicited calls, emails, or mailings that promise free medical supplies, services, or equipment. Legitimate healthcare providers typically don’t contact patients without prior consent.

Verify Providers:  Ensure that doctors, hospitals, and other healthcare providers are legitimate and accept Medicare. You can use the “Physician Compare” tool on the Medicare website to verify your healthcare provider’s credentials.

Watch for Overbilling:  Be on the lookout for bills that show duplicate charges or services you didn’t receive. Medicare fraud often involves billing for services that weren’t provided or unnecessary tests or treatments.

Check for Errors:  Review your Explanation of Benefits (EOB) statements from your Medicare Advantage plan or Part D prescription drug plan. Ensure that the services and medications listed are accurate.

Understand Medicare’s Coverage: Familiarize yourself with what Medicare does and doesn’t cover. This knowledge can help you identify suspicious claims. If a service or product seems too good to be true, it may be a scam.

Guard Personal Information:  Be cautious about sharing personal information, such as your Social Security number or bank account information, over the phone or online. Scammers may use this information to commit Medicare fraud.

Use Reputable Pharmacies:  Only use pharmacies that you trust and that accept Medicare. Avoid online pharmacies that promise significant discounts on medications without a prescription.

Educate Yourself:  Stay informed about the latest Medicare scams and fraud schemes. Medicare periodically issues alerts about new scams. You can sign up to receive fraud alerts through the Medicare website.

Remember, it’s always better to be cautious and question any suspicious activity than to fall victim to Medicare fraud. By staying informed and vigilant, you can protect yourself and help prevent fraud in the Medicare system.

If you have a question about something you have received either by mail, email or telephone, or if you have any other questions about Medicare, or if you just need help enrolling, please connect with one of our Member Agents.  There are never any fees for their educational or enrollment services!

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