Protecting Yourself from Medicare Fraud: What Every Senior Should Know

Medicare fraud costs the federal government an estimated $60 billion annually -- and seniors are the primary targets. Protecting yourself requires knowing how fraud works, guarding your Medicare information, and reviewing your Medicare statements carefully.

Since 2018, Medicare has been issuing new Medicare cards with a unique Medicare Beneficiary Identifier (MBI) -- a random alphanumeric number -- replacing the Social Security number-based cards. This change was specifically designed to reduce identity theft.

Protect your Medicare number:

• Never give your Medicare number to anyone who contacts you unsolicited
• Only share it with your doctors, pharmacists, and other healthcare providers you've chosen
• Treat it like your Social Security number or credit card number

Medicare will never call, email, or come to your door to sell you anything or ask for your Medicare number. If someone contacts you claiming to be from Medicare and asks for your number, it's a scam.

Red flags:

• "We're updating Medicare records and need your Medicare number"
• "You've been selected for a free medical device -- just give us your Medicare number"
• "Medicare is sending you a new card and we need to verify your information"

Fraudsters offer "free" medical equipment (back braces, knee braces, CPAP supplies, diabetic supplies) in exchange for your Medicare number. They then bill Medicare for equipment you never received or didn't need.

Rule: Never accept medical equipment from someone who contacts you unsolicited, even if they say it's free.

A growing fraud scheme involves offering "free" genetic tests (cancer screening, pharmacogenomics) at health fairs, senior centers, or by phone. Fraudsters collect your Medicare number and bill Medicare thousands of dollars for tests that may be unnecessary or never performed.

Rule: Genetic testing should be ordered by your own doctor based on your specific medical needs -- not offered unsolicited.

Scammers pose as Medicare Advantage or Part D plan representatives and pressure seniors to switch plans, collecting personal information in the process.

Rule: Never give personal information to someone who contacts you unsolicited about Medicare plans. If you want to compare plans, go to Medicare.gov or call 1-800-MEDICARE.

Some providers bill Medicare for services, tests, or equipment that were never provided. This is one of the most common forms of Medicare fraud.

How to catch it: Review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) every time you receive one. Compare the services listed to what you actually received.

Medicare sends an MSN every 3 months (or you can view it online at Medicare.gov). Review it carefully:

• Is every service listed something you actually received?
• Are the dates of service correct?
• Are the providers listed ones you actually saw?
• Are the amounts billed reasonable?

If something looks wrong, call 1-800-MEDICARE to report it.

1-800-MEDICARE (1-800-633-4227): Report suspected fraud directly to Medicare.

HHS Office of Inspector General: oig.hhs.gov or 1-800-HHS-TIPS

Senior Medicare Patrol (SMP): Florida's SMP program trains volunteers to help seniors detect and report Medicare fraud. Contact your local Area Agency on Aging for SMP resources.

Medicare Fraud Strike Force: For large-scale fraud schemes.

Reports of Medicare fraud are investigated by the HHS Office of Inspector General and the Department of Justice. Whistleblowers who report fraud may be eligible for a portion of recovered funds under the False Claims Act.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.