Medicare Scam Report: Open Enrollment 2019
Over the first half of 2019, the Federal Trade Commission (FTC) received 1,476,512 reports of fraud, identity theft, and other related crimes.1 Of those, 72,789 reports involved criminals posing as Social Security Administration (SSA) employees and 21,356 were about scammers posing as Medicare and other health officials.2
Because Medicare beneficiaries deal with both the SSA and the Centers for Medicare & Medicaid Services (CMS), there are a lot of opportunities for scam artists to take advantage of enrollees. But don't worry. Here's the skinny on Medicare fraud so you know how to handle them.
While many scammers use similar tactics, scams continuously evolve in response to crackdowns, changing regulations, and new technology. Here are the most popular scams in 2019.
Unnecessary medical braces
2019 saw one of the largest Medicare fraud cases ever investigated by the FBI. In a scheme that lined criminal pockets with $13 million, scammers sold unnecessary durable medical equipment (DME) to Medicare beneficiaries—then billed the government for it.
Medicare card fraud
To help prevent identity theft, Medicare has been sending out new Medicare cards to beneficiaries. These cards will have your new Medicare number that you'll give to providers at the time of service. You won't have to give out your Social Security number anymore.
Unfortunately, scammers have been taking advantage of this change. They've been convincing beneficiaries to pay for a card (it's free) or that they'll send you a plastic card instead of paper (they won't).
The new Medicare card is completely free, and you don't need to do anything to get one. Your card will automatically arrive in the mail if it hasn't already.
“Free” genetic testing
One of the latest frauds takes advantage of genetic testing, which is becoming more and more popular. These scammers will offer you free genetic screening for cancer or other illnesses in exchange for your Medicare information. You may receive a test kit in the mail or be approached by someone offering to conduct a cheek swab test.
Don’t be fooled. Medicare doesn’t market genetic testing. If you fall for this scam, it could eat away at your benefits and prevent Medicare from covering similar tests in the future. And if a doctor doesn't order the test as medically necessary, you could end up footing the bill yourself. Many victims never receive their test results.
How Medicare scams work
According to the FTC, Americans lost $717.3 million to fraud in 2019.3 And the top two kinds of fraud in the nation—imposter scams and identity theft—are also the most common types of Medicare fraud.
Chances are, you or someone you know has received a phone call from someone trying to get your Medicare or Social Security number. But getting your information is just one way scammers can cheat you. Here are the most common goals and tactics for Medicare scams.
Goals of Medicare scammers
Medicare scams come and go as officials crack down on one type of fraud and new technologies or creative criminals discover new ways to scam beneficiaries. While each year sees new scams, most scams have one or more of the following goals.
Steal your money
Imposters who threaten to take away your Medicare benefits typically ask for money to prevent a (false) negative consequence. They’re after your money and may ask you to pay them in untraceable methods such as a wire transfer or gift cards.
Steal your identity
These people may ask you to confirm your Social Security number, birth date, and other uniquely identifying information. These criminals may then use this information to open credit cards in your name or conduct other financially damaging activities.
Steal your benefits
Some scammers ask for your Medicare number so they can get Medicare to pay them for benefits you've never received or didn't need. While this doesn't take money directly out of your pocket, it does cause the government to spend more on your benefits, raising costs for everybody. Plus, if the scammer collects for a service that you end up needing later, you may have to pay out of pocket if Medicare only covers it once.
Medicare scam tactics
To accomplish the above goals, many scammers use the same strategies over and over. That's because these tactics are effective—that is, unless their victims know what to look out for.
Pretending to be trustworthy
Often, criminals try to create an air of trust with their victims right away. In the case of Medicare fraud, they may pose as someone from Social Security or the Medicare program. Other scammers might pose as friends, relatives, law enforcement, or the IRS. Pretending they’re trustworthy helps criminals convince victims to let down their guard.
Most imposters wield telephones as their weapon of choice. Scam artists can trick your caller ID into making it look like they're calling from a legitimate number. This tactic also makes it difficult for law enforcement to track the criminals down.
Scam artists like to use fear as a tool too. The person on the other end of the phone may say you'll lose your benefits unless you give them the information they want. Other criminals say you owe money and will send your case to a collections agency if you don't pay them right now.
Some scammers use hope, instead of fear, against their victims. They’ll promise you free services or medical equipment. Or they may dangle irresistible gifts in front of you—but only if you pay them in advance for shipping costs. But if you open your wallet, you may never receive the promised item.
How to avoid getting scammed
The idea of getting scammed can be scary. But don’t worry. Just as scammers have go-to tactics for tricking their victims, there are tried and true strategies you can use to fight them off.
Understand your benefits
Knowledge truly is power when it comes to Medicare fraud. Knowing that Medicare will never call you and ask for your Medicare number, for example, will alert you to fraud if you do receive a call like this. It’s also important to understand your Medicare benefits and read your statements carefully. Doing so can help you identify when false claims are made in your name.
Do your research
If you think you're being scammed, take a minute to investigate. Google the caller's phone number to see if anyone else has linked it to fraud. If the caller says they're from Medicare or the Social Security Administration, hang up and call the organization's main phone number. Ask the person who answers if the organization is trying to get in contact with you.
What to do if you get scammed
If you do fall victim to a Medicare scam despite your best efforts, you can still help lessen the damage and prevent future incidents. As mentioned above, report the fraud to the FTC. But first, protect yourself.
Secure your information
If you gave out any financial information, such as credit card or bank account numbers, call the financial institution. Have them cancel your cards and accounts and issue new ones. If you gave away any passwords, change those. If you gave out your Social Security number, call the Office of the Inspector General at 1-800-269-0271 to report it. If you gave out your Medicare number, call 1-800-MEDICARE.
If you gave the caller any funds, cancel them through your bank or credit card company if possible. Unfortunately, most scammers try to get victims to pay using untraceable means, like a wire transfer. If you act quickly, you may be able to reverse a wire transfer before it’s accepted, which may be just a few hours or a day later.
Do your part to prevent Medicare fraud
If you're worried about Medicare scams, know that there's a strike force at the US Department of Justice that works to keep you safe. But we can all do our part by staying informed about the schemes and strategies criminals use. We can understand Medicare benefits better, so we can sniff out fraud more quickly. And we can report suspected fraud to prevent others from being targeted.
Medicare scammers take money out of beneficiary pockets and drain federal funding for this vital program. But you're already doing your part to stop them by reading this report. Stay safe and vigilant!
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