12 Common Medicare Scams to Look Out For

Medicare is often very quick to dole out payments for medical bills, a boon to those who really need support for their medical care, but also an open invitation for the less than honest to take advantage of a system that often doesn’t spend too much time investigating claims up front. While Medicare is cracking down on thieves with a new multi-million dollar program, there are still plenty of unscrupulous people out there working over those who depend on Medicare for their health care needs and making millions of dollars a year in the process.

Whether you or someone you care about is a recipient of Medicare, it’s essential to watch out for scammers in order to protect your benefits. Here, we’ve listed some common scams that criminals use to try to get their hands on your Medicare number and the potential goldmine of benefits it can mean for them. Remember, never give out your information to anyone other than your healthcare provider, no one else should ever ask for it!

1. The Poser Scam

   One of the more common ways criminals scam those with Medicare is by posing as Medicare employees, health care practitioners, or insurance representatives, something many may not be expecting. These fraudsters call, email, or send a letter asking for personal information that usually includes bank, Social Security, and Medicare numbers. While the interactions may seem legitimate, it’s important to remember that federal employees, working for Medicare or otherwise, will never phone or email you to get bank or Medicare information. Why would they need to? Neither will your insurance provider or doctor. If you encounter any of these mailings or calls, hang up, ignore, and report them.

2. The Healthcare Reform Scam

   Healthcare reform is on the lips of just about everyone these days, and scammers are using it to cash in. Many adults don’t know what the new healthcare legislation actually entrails, and that’s just the way criminals want it. It makes many Americans easy targets for scams, like those that claim to sell "healthcare reform insurance" that purportedly protects seniors from any losses to their Medicare or any fines they make incur from not meeting guidelines. The thing is, healthcare reform insurance doesn’t exist. Identity thieves and scammers will try to get Medicare numbers, SS numbers, and even bank account info for these policies, but don’t bite. You’ll be throwing money away and getting yourself in a whole heap of trouble with your identity.

3. The Free Lunch Scam

   Everyone loves free stuff, right? Well in this case, there truly is no such thing as a free lunch. Scammers in low income areas are taking advantage of some of the neediest Medicare recipients by drawing them in to fake health care clinics with the promise of free food or gifts. Once they have the victim right where they want them, they try to get Medicare numbers through coercion and then use them to commit Medicare fraud. No legitimate clinic or government program will ever exchange gifts for using their services, so no matter how great it looks on paper, it’s probably bogus.

4. The Kickback Scam

   While you’d think that you’d be able to smell this scam from a mile away, some fraudsters can be pretty darn tricky. They might offer you a cut of the take in exchange for your Medicare number, but they won’t put it like that. Criminals might veil it under a prize, reward, or other guise to mask the fact that they’re doing something that is very clearly illegal. If anyone ever promises you any gift or monetary rewards for your Medicare number, decline their offer immediately. You’ll be drawn into the scam, and could face criminal charges for your role.

5. The Refund Ripoff Scam

   As part of the Affordable Care Act, many senior Medicare recipients may be eligible to receive a refund from the government of $250 to help cover their prescription drug costs. Criminals have pounced on these checks as an opportunity to make some extra cash and scam some Medicare numbers at the same time. Many have called seniors and told them that they need to confirm Medicare numbers in order to send out the checks. The scams are varied and quite nefarious in that they prey on those that need the benefits of Medicare the most. Keep in mind that Medicare numbers are like credit card numbers: they should never be given out to strangers over the phone.

6. The Imposter Employee Scam

   Anyone can claim to work for the government, and many who fall victim to fraudsters may not even have thought to ask for identification (though that could easily be faked as well). The reality is that many criminals looking to scam those on Medicare will call or even come to the home of recipients asking for personal information like Medicare numbers and bank accounts. Medicare will not send people out to collect this information, nor do they cooperate with private insurers to collect this information. Never trust someone who calls or visits you out of the blue looking for information of this kind.

1. The Free Medical Supplies Scam

   Freebies are one way that scammers lure in a lot of victims, and when those freebies are of the medical variety it gives them legitimacy that many other gifts don’t have. Exchanging medical supplies, which are usually of very low value, for Medicare numbers is not a bargain, it’s a scam. Criminals know that many seniors depend on medical supplies to keep them feeling good, and use that desire for backup or extra supplies, free of charge, to get personal and private information out of those who wouldn’t normally be swayed by such scams. If someone tells you that an item is free but they just need your Medicare number for their records, you’re better off buying the items on your own.

2. The Not Usually Covered Scam

   If something isn’t covered by Medicare, it isn’t covered. Period. If your provider or someone you don’t know tells you that an item isn’t covered but they know how to bill it so you won’t have to pay, that might sound great. But it’s also fraud and can get you, and that provider, in a lot of trouble. Additionally, be equally wary of those who charge co-pays for services that should be covered by Medicare — they’re pocketing that cash and billing Medicare to boot. When it comes to Medicare at your clinic, hospital, or doctor’s office, there should be no funny business. If you suspect there is, report the provider and find yourself a new one.

3. The Extra Equipment Scam

   Those with diabetes, arthritis, and sleep problems are frequent victims of this scam. Salespeople will go to homes of those they know suffer from these conditions and try to get them to buy extra equipment, often things that they really don’t need. It sounds great because these extra items can be billed to Medicare and you won’t have to pay a thing. Of course, once you hand over your Medicare numbers, scammers simply use it to rack up loads of bogus charges and if you ever see the equipment they promised it’ll likely end up collecting dust.

4. The New Card Scam

   Another way scammers are taking advantage of new health care regulations is by telling seniors that in order to keep receiving benefits or get their refund checks they’ll need to get a new Medicare card. This simply isn’t true, and if it were, they certainly wouldn’t need your Medicare number to do it — they already have it on file.

5. The Medical Decisions Scam

   Some enterprising and highly unscrupulous insurance agents have been taking advantage of Medicare policy holders in a couple of different ways. Some are sending out release forms that allow agents to make decisions on their behalf. This can cause serious legal and financial issues, so never, ever sign anything without reading through it first and making sure you understand it. If it’s confusing, get a friend, family member, or lawyer to look over it before signing.

6. The Fancy Tests Scam

   Sadly, many doctors and nurses out there are the ones at the center of large Medicare frauds. One of the ways they often make their money from scamming Medicare is by scaring or coercing patients into getting unnecessary and often very expensive tests. Your medical provider should never use pressure or scare tactics to get you to consent to any medical decision, it’s just unethical. If you feel this is going on, get a second opinion.

Taken From Medical Billing and Coding