Medicare Scams

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 WHAT ARE THE SIGNS THAT THIS IS A SCAM?

 You suspect that you have been double-billed, overcharged or charged for a medical service or medication never received.

 An individual or company offers some type of free service, such as a power wheel chair or medical testing, but needs your Medicare number and/or social security number to provide the service.

A salesman comes to your door and tries to sell you a Medicare policy that is accepted by your doctor or hospital.

You receive a phone call asking for personal information, such as social security numbers, bank account information and Medicare numbers. The caller claims he needs this information to mail your Part D rebate check ($250 check for Medicare Part D recipients who enter the doughnut hole).
HOW CAN CONSUMERS PROTECT THEMSELVES?

Don’t be afraid to ask questions of your provider or your health insurance – if you think you’ve been overcharged, you didn’t receive a specific service or medication, or you think the service received was unnecessary, speak up.

The free services in this scam are often a ploy to gain your personal information and Medicare number. Always stay on top of your personal medical records. Review your Medicare Summary Notice and Part D Explanation of Benefits for any mistakes, and keep track of all your medical visits, prescriptions for medications and/or medical services that you receive.

Research the company offering free services through Better Business Bureau (www.cincinnati.bbb.org) or the Ohio Attorney General’s office (www.speakoutohio.gov) to ensure the company is legitimate.

When selling Medicare products, agents legally cannot sell policies door-to-door or falsely inform you that your doctor or hospital accepts their plan.

Medicare Part D rebate checks will be mailed automatically. Those who qualify can expect to receive their checks within 45 days of reaching the doughnut hole. Your check will be mailed to the address Social Security has on file for you. Medicare tracks your drug costs for you. Once you reach the coverage gap, you will receive a check. No one will call you and ask for your personal information in order to send you the check.


HOW TO REPORT IF YOU’VE BEEN A VICTIM

Medicare Fraud Hotline: If you think you’ve been a victim of Medicare Fraud, call 800-447-8477 or TTY 800-377-4950.

Senior Medicare Patrol: Gather all the paperwork and information that proves you are the victim of fraud, and contact your local Senior Medicare Patrol (www.smpresource.org). Your SMP will be able to report the possible fraud or direct you to the appropriate state or law enforcement to report the possible crime.

Better Business Bureau (BBB): You should also submit a complaint to BBB (513-421-3015 or www.cincinnati.bbb.org) to report the problem and to receive assistance with resolving the dispute.

Ohio Department of Insurance Enforcement Hotline: Report agents who use negative sales tactics by calling 800-686-1527.


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For more information on preventing senior scams, visit these Web sites:

Print these worksheets, and protect yourself!: How can I spot Medicare sales fraud?, How can I prevent healthcare fraud?

Ohio Department of Insurance – Elderly Insurance Scams

Ohio Attorney General’s office – Elderly Fraud

Medicare.gov – Medicare Fraud

U.S. Department of Health & Human Services and U.S. Department of Justice – STOP Medicare Fraud