As you get older, the risk that you’ll be a target or victim of health care fraud increases. Scammers take advantage of your trust, your health concerns, and the fact that you’re likely to be covered by Medicare. From fake insurance plans to deceptive billing practices, these schemes can lead to financial loss and even identity theft.
Here’s what you should know to protect yourself.
Common Scams to Look Out For
Unfortunately, fraudsters are always coming up with new, sneakier ways to deceive their victims. So it wouldn’t be possible to list all potential health care scams here. But here are examples of some of the most common ones that might target you today.
Fake health screenings
Phony mobile clinics or health fairs are a common trick to steal your personal information. Scammers may set them up near senior centers or other places where older adults gather. They offer free health checks, like blood pressure, hearing, or vision tests. All they ask for is the information on your Medicare card. Then they bill Medicare for the services and keep the money.
Offers of free health care products or services
Scammers might call, text, email, send information in the mail, or even make an in-person visit to your door to offer you free medical equipment or medical tests. In recent major scams, fraudsters offer older adults free urinary catheters and various orthotic devices, such as knee and backbraces.
The impostor may say the equipment or test is free for people with Medicare. They might also offer to help you fill out the paperwork to get it covered.
Once you agree, they ask for your Medicare card information or even your Social Security number. You might never get the equipment, but the scammer still sends a bill to Medicare for it.
Calls, texts, and emails from Medicare or insurance agents
Scammers often call, text, or email and pretend to be representatives of Medicare or other health insurance companies. They may say your account has a problem they need to fix or that they plan to send you a new Medicare card.
They could also say you owe money for bills you have not paid. No matter what reason they give, their goal stays the same. They want your Medicare card number, Social Security number, or other personal information so they can bill your insurance or steal your identity.
If you push back, the caller might get aggressive or start making threats. They may say they will freeze your assets or take away your benefits if you do not give them your information.
Red Flags of Health Care Fraud
These are just a few of the most common scams. Scammers often use new tricks to con people out of money or personal information, but many of these cons show the same red flags. Watch out for these common ones:
- You receive a bill or an “explanation of benefits” (EOB) for health care services you never received. (You’ll learn more about EOBs in the next section.)
- You receive more than one bill or explanation of benefits for the same service.
- You’re asked for personal information, such as your Social Security number, date of birth, or Medicare card number, over the phone or via text or email to “verify” your health insurance. Medicare will not do this.
- You’re asked to pay a fee for a new Medicare card. Medicare doesn’t charge for cards.
- You’re told your card is expiring. Medicare cards don’t expire.
- You’re offered a discount health plan, but none of your doctors are part of the network.
- You’re offered a discount health or prescription drug plan, but the salesperson doesn’t offer detailed information about it.
- You’re asked for personal information, such as your Social Security number or Medicare ID number, in exchange for a price quote.
- You’re offered help navigating the health insurance marketplace for a fee.
- A caller makes threats or uses other aggressive tactics to push you to pay now, provide personal information immediately, or make some other decision quickly.
How to Protect Yourself or a Loved One
Now that you know that you or an older loved one might be more vulnerable to health care fraud, you can take steps to protect yourself.
Review and keep records, bills, and EOBs
If you receive a medical bill shortly after receiving health care, you may simply pay it without reading it carefully. But it’s important to review and keep any bills or documentation related to your health care that you receive, including EOBs.
An EOB is a document you receive by mail or email shortly after you’ve received health care. It may look like a bill, but it’s clearly marked “This is not a bill.” The EOB documents the health care you received, how much the provider charged, how much your insurer paid, and how much (if anything) you may still owe. If you owe anything, you usually get the bill a few days after the EOB.
Carefully reading bills and EOBs will help you ensure that no one is filing claims for care you didn’t receive.
Don’t give personal info unless you made the call or email
As a rule, don’t share personal details like your Social Security or Medicare number by phone or email unless you made the contact. Medicare will never ask for this unless you call them first.
Confirm the existence of health plans you’re offered
Before enrolling in any new health or prescription drug plan, make sure it’s not too good to be true.
- Ask to see the full list of benefits or the full insurance policy before you decide.
- Check that the plan is real and compare it with others on healthcare.gov or medicare.gov.
- If someone says the plan is connected to a big insurance company, call the company to confirm.
Use an official “navigator” on the Health Insurance Marketplace
The government provides “navigators” or “assisters” to help you navigate the Health Insurance Marketplace for free at healthcare.gov/find-assistance. You can get help exploring Medicare plans through your State Health Insurance Programs (SHIPs) at shiphelp.org.
Educate older loved ones
Talk with older family members about common health care scams, why they are often targeted, and how to protect their personal information. Help them learn the warning signs, like unexpected phone calls asking for Medicare or Social Security numbers, or offers that seem too good to be true.
What to Do If You Suspect Fraud
If you suspect you’ve been a victim of fraud or attempted fraud, report it. You won’t get in trouble for reporting fraud. You’re helping protect others from the same scam.
You can contact:
- The Medicare Fraud Line at 800-MEDICARE or online here.
- The Federal Trade Commission (FTC) at 877-382-4357 or online here.
- Your local police department
Recap
- Older adults are more susceptible to health care fraud than others.
- Beware of free products and services that you weren’t seeking and that require you to provide personal information.
- Never provide personal information via phone or email to someone who contacted you first.
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
National Council on Aging: “The Top 5 Financial Scams Targeting Older Adults.”
Department of Health and Human Services Office of the Inspector General: “Consumer Alert: Urinary Catheters.”
U.S. Department of Justice: “Owner of Telemedicine Companies Charged with $110 Million Medicare Fraud Scheme,” “Owner of Telemedicine Companies Pleads Guilty to Role in $136M Medicare Fraud Conspiracy.”
Georgia Attorney General’s Consumer Protection Division: “Top 10 Scams Targeting Seniors.”
U.S. Senate Special Committee on Aging: “Fighting Fraud: Scams to Watch Out For.”
Federal Trade Commission: “Spot Health Insurance Scams.”
U Health: “Explanation of Benefits.”
