Mr. Jones didn’t think he would ever contribute to Medicare fraud. Then, he answered his phone one afternoon and spoke with a nice young woman.
The woman on the phone told him about a program that could save him hundreds of dollars each month on his prescriptions. Of course he was interested. She offered to sign him up over the phone. Mr. Jones provided his Medicare number and bank account information.
After talking with his caregiver, Mr. Jones realized that sharing his information with the caller was a mistake. He reported the fraud to the Medicare fraud hot line. He also contacted his local Senior Medicare Patrol (SMP). The SMP helped him close his account and report the crime to the police and Medicare.
This fictional example may happen in real life more often than you might think. Each year, almost $65 billion is lost to Medicare fraud and abuse1.
Stopping Medicare Fraud
There are many scams that criminals use to take advantage of older adults, and the Medicare system. You should contact Medicare, your health care provider, or caregiver if:
- Someone who says they are from Medicare calls or comes to your home uninvited.
- Any company asks for your Medicare number “for their records.”
- You are offered something free, if you will give them your Medicare information.
You Can Make a Difference!
Reviewing your Medicare Summary Notice (MSN) and Explanation of Benefits may help stop Medicare fraud. You should make sure the charges are correct, and that you received the services or equipment listed. These statements are mailed to your home, and are also online at MyMedicare.gov. If you have trouble, ask someone to help you read your MSN.
Another way you could help stop Medicare fraud is to volunteer for the Senior Medicare Patrol. It is one of many organizations that report Medicare fraud to the government. Their mission is to teach older adults and caregivers how to identify and report health care fraud and abuse. Many SMP volunteers are receiving Medicare benefits, so they know what to look for. SMP volunteers help Medicare beneficiaries and caregivers deal with this problem. They also talk to community groups, promote SMP at events, and answer the SMP help line.
For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
1, 3 Centers for Medicare & Medicaid Services, 2013
2 Senior Medicare Patrol, 2013
Report Medicare fraud: US government website to report Medicare fraud
Medicare.gov: Tips on how to avoid Medicare scams