As a Medicare Beneficiary, you have many avenues to turn to when looking for information on Medicare and the various options that come with that. As the opportunities and access to information grows, there will be a growing market of people that will scam and steal information from Medicare Beneficiaries. Unfortunately, it does not seem to be slowing down. At the same time the regulating bodies, mainly CMS, cannot keep up with the number of scams and people out there “selling Medicare” or Medicare related products. This brings up the questions: what is identity theft and what does Medicare fraud look like?
A common way to define identity theft is when an individual or individuals use your personal information without your consent. The information they want is typically private and usually used for financial gain. Some examples of private information include your name, social security number, Medicare number, credit card number, or banking information. With our growing rolodex of passwords for different websites, it is also important to keep those private as well. Only give this personal information out to trusted individuals; don’t give out your information to anyone that contacts you by phone, email, or a person until you do some research into who they are or who they work for.
Concerning your Medicare number, treat it like your social security or bank account number. The only people who will require your Medicare number will be doctors, insurance companies (and their licensed agents or brokers), or trusted people that work with Medicare like your state Medicaid program. The only times Medicare or your Medicare plan agent will call you is if:
- You are already a member that is enrolled in the Medicare supplement, Prescription drug, or Medicare Advantage plan.
- A customer service representative from 1-800-Medicare (1-800-633-4227) can call you if you’ve left a message, or a representative said that someone will call you back. TTY users can call 1-877-486-2048.
- If you filed a report of suspected fraud, you may get a call from someone representing Medicare to follow up on your investigation.
How does Medicare fraud or medical identity theft work? It is the process when someone steals or uses your information to submit false claims to Medicare and other health insurance companies without your consent. An easy way to fight Medicare fraud is when you receive health care services, record the dates on a calendar and keep any receipts or statements they send you. Make sure to check for any errors or mistakes. If you see an error or you get a bill for services you did not receive check your “Medicare Summary Notice (MSN)” if you have original Medicare or any statements if you have a Medicare health plan. If you know the health care provider or supplier, call and ask for an itemized statement, they should give you this within 30 days.
Medicare advantage plans and agents must follow strict rules when marketing their products and collecting your enrollment information. These people can’t ask for credit card or banking information over the phone or via email, unless you are member of that plan. Medicare advantage organizations or people marketing these plans can’t sign you up for these plans unless you called them and asked to sign up, or you’ve given them permission to contact you. Report any agent that: asks for your personal information over the phone or email, called to enroll you in the plan, visits you unexpectedly, or use false information to mislead you.
Most people you meet in the Medicare industry or financial services industry are great people and want to help your health or financial position. However, like any industry, there are people that will take advantage of you if you aren’t careful. Only give out private information to people you fully trust and want to work with.
Here are some important phone numbers to call if you need to report Identity theft or Medicare Fraud:
- The Federal Trade Commissions Identity Theft Hotline: 1-877-438-4338.
- Medicare: 1-800-Medicare (1-800-633-4227) TTY: 1-877-486-2048
- Senior Medicare Patrol Program: 1-877-808-2468
- Medicare Drug Integrity Contractor: 1-877-772-3379