Protecting Yourself From Medicare Fraud

Protecting Yourself From Medicare Fraud

Medicare gives you coverage in times of illness or injury. But are you safe from scammers and identity thieves? Learn how you can protect yourself.

Over the past few years, Medicare has undergone a great deal of change. For a many recipients, its new programs have opened the door to greater choice and flexibility. Regrettably, though, another door has been opened too. This is a back door through which scammers and financial predators target aging retirees.

Most of the scams involve some form of deception. For instance, someone claiming to be an insurance rep may sell you a supplemental policy that turns out to be false. Everything looks in order, but it isn’t. By the time you realize it, the agent is long gone.

For those who get taken in, the problems are many. Not only are their bank accounts plundered, but they often end up without medical coverage too. Correcting the situation can take months of letters and phone calls, and sometimes lawyers have to be called in.

To make matters worse, the varieties of fraud seem to be limitless. As soon as one method is uncovered, another pops up. Some recent examples include:

  • Selling bogus Part D prescription cards
  • Selling overpriced policies to people with Alzheimer’s or other forms of dementia
  • Selling policies with low introductory rates that balloon overnight
  • Switching patients’ policies without their knowledge or approval
  • Posing as a Medicare agent to trick patients into buying expensive plans
  • Selling fake long-term care policies
  • Stealing mail to collect personal information
  • Bank account and credit card theft and other forms of identity theft

Medicare is a federal program, which means state governments can’t really regulate it. They can go after individual predators, and they do so all the time. But they can’t really control the overall problem.

This is where an ounce of caution can come in handy. If you or a loved one are enrolled in Medicare, you need to keep your guard up. You could be approached at any time.

But that doesn’t mean you have to be taken in. Your best defense is to be proactive. Decide what kind of coverage you need and then find a licensed agent to work with. Also:

  • Never give anyone your credit card or bank account numbers.
  • Never give out personal information, such as Social Security or Medicare card numbers.
  • Never buy a policy from a telemarketer or a door-to-door salesperson.
  • Never buy coverage outside the open enrollment period.
  • Never purchase a plan without knowing the terms.
  • Never sign anything you don’t completely understand.

Following these guidelines can certainly help protect you. But there are no guarantees. At the end of the day, something still might go wrong. If it does, you’ll need to know how to handle it. The first step is to call your state Health Insurance Assistance Program (HIAP). Your HIAP office can walk you through the paperwork and help you re-establish your insurance.

But there are a few other phone calls you need to make too.

  • Report the incident to your state insurance department.
  • File a complaint with the local Better Business Bureau.
  • Call the state attorney general to report the crime.
  • Inform the Centers for Medicare and Medicaid Services.
  • Call your regular insurance agent for additional help or advice.

With any luck, you’ll never have to go through all that. But if you do, it will be easier if you’ve kept a file of important documents. If someone has changed your insurance, having a copy of your policy will help you get it back. Make sure to keep copies of checks and receipts, just in case you have to prove your payments were current. In short, always be prepared. That way you can act quickly to get back to what matters most: enjoying your retirement.

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