Medicare fraud and identity theft costs more than $100 billion a year, according to estimates from the National Health Care Anti-Fraud Association. The sheer size of Medicare and amount of spending—upwards of $901 billion a year for 65 million beneficiaries—make Medicare fraud a lucrative “business” for criminals. And makes seniors (the majority of Medicare’s beneficiaries) prime targets for these criminals looking to make “easy” money.
That’s because with most of these schemes, a criminal can scam you out of your personal, financial, and Medicare information from anywhere in the world using just a computer and/or smartphone. But you don’t have to be an easy target or the next victim. Here are the top Medicare scams you need to know:
1. Medicare Card Replacement Scams
In spring 2018, Medicare began sending then-current beneficiaries updated Medicare cards with new, randomly generated ID numbers meant to better protect against identity theft. All existing Medicare beneficiaries had their new cards by January 2019, with new enrollees receiving these more secure cards starting in 2019. Medicare hasn’t sent out “new” or replacement cards in mass since. This hasn’t stopped criminals from trying to scam Medicare beneficiaries into believing they need a “new” card and convince them to hand over their personal information in order to get it.
The Medicare card scam has a couple of angles, but typically the fraudster will call claiming to be a representative from Medicare, the Social Security Administration, or state insurance office and inquire if you’ve received your new card. As Medicare is not sending out new cards, your answer is probably going to be no, so the fraudster will then claim you need to provide them with your updated information to receive your new card.
Some scammers use the angle of calling to confirm that you have the “new” secure Medicare card, say you need to activate it or haven’t properly registered it, or claim it no longer works or is incorrect. You just have to provide your personal information, and they’ll activate, register, or send a replacement card to you.
It’s all a ruse to get your information for identity theft or to file fraudulent Medicare claims. Hang up before it gets that far!
2. Scams Threatening to Cancel Your Medicare Plan
Similar to saying you need to “confirm” your new Medicare card and/or provide your information to get a replacement card, fraudsters up the ante with this scam—threatening to cancel your Medicare coverage altogether!
Posing as official representatives from Medicare, the Social Security Administration or other government agency, these scammers call using fear tactics, like saying your Medicare coverage is about to be canceled because of missing or incorrect information or because you have outstanding coinsurance and/or premium fees. All you have to do to prevent the cancellation of your Medicare benefits is provide them the requested information—like your Social Security number, Medicare number, or even your credit card number or banking information—to update your account and pay any outstanding bills. It’s all a ruse to steal your identity and possibly drain your bank account.
This scam can also come via mail in official-looking letters supposedly from Medicare, instructing you to call a number to update your account and avoid cancellation. You’ll actually be calling that fake Medicare “representative” or “government agent” and handing them your personal information. Emails with exclamation point-filled subject lines like, “Final Notice! Outstanding Medicare Bill” and “Last Chance to Avoid Medicare Cancellation,” are phishing for the same information. They may come from what appear to be legitimate Medicare email addresses, contain Medicare logos and urgent messaging asking you to update your information. The email will direct you to a website that looks like a legitimate Medicare webpage for you to enter your information, but it’s all run by scammers.
3. Scams Offering Medicare Refunds
Who doesn’t like to hear that they are getting cash back?! Fraudsters use this ploy in Medicare refund scams, in which they contact Medicare beneficiaries to inform them they are owed a refund from Medicare.
The scammer claims to be a representative from Medicare, government agency, or insurance company with the “great news” that you’re owed a refund because of premium overpayment, billing errors or some other reason. To receive your supposed refund, just provide your personal information—Social Security number, Medicare number, bank account number. But there’s no refund coming, and a criminal now has your sensitive information to steal money from your account and your identity.
If you believe you are owed a refund from Medicare, it’s best for you to contact Medicare directly. This way you can verify the legitimacy and amount of any refund.
4. COVID-19 Scams
While much of the anxiety around COVID-19 has dissipated, for older adults COVID remains a health concern. The CDC recommends that those age 65 and older stay up to date on their COVID-19 vaccinations, dosages, and testing due to the “risk of severe disease from COVID-19 in older adults.”
Scammers have exploited seniors’ health concerns by offering fake vaccines and tests, scheduling “free” (and fake) vaccination and/or testing appointments, and ordering legitimate but unnecessary testing kits, leaving Medicare beneficiaries to foot the bills.
This scam can come in the form of phishing emails or texts that appear to be from healthcare organizations, Medicare or other government agencies, offering information on the latest COVID-19 vaccines, luring you to “schedule an appointment” by entering your information in a fake web portal. Scammers may also call, posing as healthcare workers or representatives from health organizations, and offer fake COVID-19 vaccination appointments—all to get your personal, financial, or Medicare information.
Other scams utilize these same methods to sell fake and unauthorized at-home COVID-19 test kits in exchange for your personal or medical information. On the flip side, you can find yourself receiving a legitimate COVID-19 test kit you never ordered. That’s because billing fraudsters are sending COVID-19 home test kits to Medicare beneficiaries and then billing Medicare for reimbursement. Medicare has been “bilked for millions of dollars in these unwanted tests.”
5. Medicare Diabetes Scams
COVID-19 isn’t the only health concern that attracts scammers. Medicare beneficiaries with diabetes are targeted with fraudulent schemes built around the very equipment and treatments they desperately need.
Using email phishing or phone callers pretending to be a Medicare representative, government agent or from a diabetes association, these scammers offer free or discounted diabetes-related medical equipment and supplies, like glucose meters, lancets, test strips, or insulin pumps. All you have to do is confirm or provide your Medicare, financial, and personal information. But your “free” supplies never arrive or are faulty and your personal information has been stolen. If you do actually receive the promised diabetes supplies, Medicare may be billed for the items at inflated prices, creating a nice profit for the criminals.
This billing fraud can show up in other ways—like if you find yourself with an excessive order of test strips, a new glucose meter you didn’t order, or waiting on diabetes supplies you did order that never come. A scammer has submitted false claims to Medicare in your name for diabetes-related supplies that were not ordered, not medically necessary, or never received. The criminals pocket the payments from Medicare and both you and Medicare take the financial loss.
6. Scams Offering Free or Discounted Medical Supplies and Equipment
With the high cost of durable medical equipment (and you responsible for 20% of the Medicare-approved costs), the offer of discounted or even free medical supplies and equipment can be a tempting one. That’s why criminals dangle it as bait.
Scammers call, email, or send mailers advertising discounted or free medical supplies and equipment, such as mobility aids, lift seats, foot orthotics, joint braces, catheters, and even heating pads. They then bill Medicare for these items at inflated prices or for equipment that was never actually provided. Not only are criminals making a profit off of your name, but this is also using up your Medicare benefits and could leave you unable to pay for medical supplies you actually need and ordered.
Plus, you’ve handed over your personal, financial, and Medicare information to a scammer who may not deliver on the “free” supplies or equipment offered, and instead, steals your identity.
7. Genetic Testing Scams
You’ve probably seen commercials for DNA and genetic testing. Scammers are taking advantage of this growing popularity to offer Medicare beneficiaries “free” genetic tests, screenings, and kits with no doctor’s prescription required.
These genetic tests are advertised as being able to screen for cancer, Parkinsons, dementia, and other hereditary diseases. Who wouldn’t want to get a free screening to see if they’re at risk for these scary diseases? But even scarier is handing over your personal and biological information (your DNA) to a scammer.
These scammers target you with phone calls, booths at health fairs, and even going door-to-door offering “free” screenings or cheek swabs for genetic testing. It’s all a ruse to obtain your information for identity theft and/or to file false claims for fraudulent Medicare billing.
To make this scam appear legit, many will schedule you for a “free telemedicine” appointment where a “teledoc” orders the test. You think you’re getting a prescribed genetic test kit from a doctor, when in fact they are part of the criminal scheme. While the test itself may be free, as it was not ordered by a legitimate physician for medically necessary purposes, Medicare may deny the claim by the lab processing the test, leaving you responsible for the entire cost, which could be thousands of dollars.
Genetic tests must be ordered by a physician and deemed medically necessary in order to be covered by Medicare. Any pitch, promise, or advertisement of “free” genetic testing covered by Medicare with no doctor prescription required is a scam!
8. Telemedicine Scams
Telemedicine has exploded in popularity, providing a quick and convenient way to see a medical practitioner, especially for seniors who may have mobility or transportation challenges. And scammers are taking advantage, setting up shop through fake telemedicine websites and even whole companies.
Via phone calls, email phishing, and in-person solicitations at your door or at health and senior fairs, scammers advertise their services to Medicare beneficiaries. They may offer virtual consultations, diagnoses, or treatments covered by Medicare—or so they promise. They then bill Medicare for these unapproved, unnecessary, or non-existent telemedicine “services,” submitting false claims for virtual consultations or medical treatments that were never provided.
With some of these scams, you never even make it to an appointment. Instead, scammers trick you into providing personal, billing, and Medicare information under the guise of setting up a telemedicine appointment that never happens.
Another lure these scams use is offering you discounted medications or prescription drugs without needing a prescription only through their telemedicine service. Most of the time, you receive medications that are either expired, counterfeit, or unsafe, and a criminal has your information for fraudulent billing or identity theft.
9. Scams Pressuring You to Switch Medicare Plans
When you enroll in Medicare, you have a choice between the federally managed Original Medicare (Parts A and B) or a Medicare Advantage Plan (Part C), issued and managed by private insurance companies. Where there’s private companies, there’s profits, and this can lead some to resort to deceptive or aggressive tactics to sell their plans.
While not always an outright scam (there is in fact a Medicare plan being sold to you), some insurance agents or sales representatives for Medicare Advantage plans may misrepresent the benefits, coverage, or costs, leading you to enroll in a plan that does not meet your needs or falls short of what was promised. Some may offer incentives or inducements, such as cash payments or “free” gifts, in exchange for you enrolling in a particular plan. This is illegal and can result in penalties for both you and the plan provider—and licensed insurers and brokers know this.
If you find yourself being pressured by a sales pitch or the plan offered sounds too good to be true, it may be a scam by a fraudulent “insurance agent” angling to get your money and personal information in exchange for a substandard (or possibly fake) Medicare Advantage Plan.
Don’t Fall Victim to Medicare Scams: Wandacare Can Help!
If you’ve received suspicious Medicare communications or think you may be the victim of a Medicare scam, the Wandacare Team is here for you. With over a decade of experience, we are your personal Medicare advisors providing advocacy and assistance, so you can be confident in your Medicare coverage.
