Christine Seivers of medicalbillingandcoding.org sent me the following list of common Medicare scams. I have edited and shortened her copy to fit my blog.
1. The Poser Scam
One common way to scam Medicare is to pose as a Medicare employee, a practitioner, or insurance representative. These fraudsters call, email, or send letters asking for personal information that includes bank, Social Security, and Medicare numbers.
2. The Healthcare Reform Scam
Healthcare reform is on the lips of everyone these days, and scammers are using it to cash in. Many adults don’t know what the new health care legislation actually entails. 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.
3. The Free Lunch Scam
There is no such thing as a free lunch. Scammers in low income areas are taking advantage of the neediest Medicare recipients by drawing them in to fake health care clinics with promises of free food or gifts. Once they have the victim where they want them, they get Medicare numbers through coercion and then use them to commit Medicare fraud.
4. The Kickback Scam
Scammers might offer you a cut of the take in exchange for your Medicare number, but they won’t put it like that. 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 call seniors and tell them that they need to confirm Medicare numbers to send out the checks. 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. Some 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. Never trust someone who calls or visits you out of the blue looking for information of this kind.
7. The Free Medical Supplies Scam
Exchanging medical supplies, which are usually of very low value, for Medicare numbers is not a bargain, it’s a scam. 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.
8. 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.
9. 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.
10. 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.
11. The Medical Decisions Scam
Some unscrupulous insurance agents have been taking advantage of Medicare policy holders. Some are sending out release forms that allow agents to make decisions on their behalf. 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.
12. The Fancy Tests Scam
Some doctors and nurses are at the center of Medicare frauds. They make their money from scamming Medicare by scaring or coercing patients into getting unnecessary and 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.
Richard L. Reece is a retired pathologist and the author of The Health Reform Maze: A Blueprint for Physician Practices. He blogs about health reform, medical innovation, and physician practices at medinnovationblog.