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How to protect yourself against common Medicare scams

It’s that time of year again when the nation’s 54 million Medicare beneficiaries have the opportunity to switch Medicare Advantage and Part D prescription drug plans during Medicare’s annual open enrollment period.

In addition to the challenge of sifting through the dizzying array of plan options, experts say Medicare open enrollment is also the prime time for Medicare scams.

“Right now…everyone is being inundated with TV commercials, brochures and other official-looking documents in the mail about all the Medicare Advantage plans. It’s so confusing and in an environment like that, fraud is rampant.” says Micki Nozaki of the California Medicare Senior Patrol, which is part of a national network of outreach and education programs working to prevent and report health care fraud.

There are some quick tips when it comes to protecting yourself against scams, experts say.

The first thing is to protect your Medicare number, which in most cases is your Social Security number, the same way you would protect your bank and credit card information. Do not give it to anyone you are not sure is part of your health care team.

“That Medicare number is precious and should not be given out under any circumstances,” says Ronald Bolding, president of Inter Valley Health Plan, which sells Medicare Advantage plans.

Second, keep in mind that Medicare will never call or email you with product offers.

“The moment you receive a call or email requesting your [Medicare] number from someone claiming to be from Medicare, it’s a automated scam,” says James Quiggle, director of communications for the nonprofit Coalition Against Insurance Fraud. That should be an immediate hangup call. the phone, he said he says.

Also, if an insurance agent calls or visits your home to sell or endorse any Medicare product, they are acting illegally. “If someone knocks on your door and you haven’t scheduled an appointment or been invited, that’s abuse,” says Bolding.

1. Changing plans is mandatory. According to Nozaki, a common scam is insurance agents telling you that open enrollment isn’t just an opportunity to switch your Medicare Advantage and Part D prescription drug plans, it’s an obligation, and if you don’t does, you could lose your current plan. coverage.

While experts say shopping around for your options each year is the best way to make sure you’re still covered by the best plan for you, you have the right to keep your current policy and not make any changes if that’s your preference.

“Never believe someone who tells you that you have to change your Medicare Advantage or Part D prescription drug plan,” says Nozaki.

Once you give them your Medicare number, nefarious insurance agents sign you up for a plan that doesn’t fit your needs.

“[Scam victims] they find out later that they can’t see their doctor or get their medications,” Nozaki says. “Or worse, the agent gets their information and signs them up for a plan without them knowing.”

2. Medicare is changing cards. Quiggle says to be on the lookout for anyone who tells you Medicare cards are changing and to get your new card you just need to update your information.

The common line, he says, is to tell him that “you just need to update [your] file with your credit card information and Social Security information so that Medicare can issue [you] a new card.

Is a gotcha. Again, Medicare will never call or show up at your door or ask for personal information via email.

3. For you, a special price. High-pressure launches for Medicare insurance policies that come with especially low costs are common during open enrollment.

Here’s how it happens: Insurance agents tell seniors that, for a limited time, they can sign up for an early bird discount, which equates to a much lower monthly premium for a particular health plan. “Most of the time it’s BS,” says Nozaki.

To shop for or join legitimate Medicare Advantage or Part D prescription drug plans, check out the Medicare Plan Finder at or call 800-MEDICARE, or 800-633-4227.

4. Health fair scams. Health fairs or other events that take place during Medicare open enrollment can be full of opportunities for fraud.

A common tactic by malicious vendors is to take a table at a health fair and advertise a giveaway, such as nutritional supplements. To enter a drawing for a free prize, you’ll be asked to register by giving your name and Medicare number, and come back in a moment to see if you’ve won.

“If you’re going to a senior fair, there’s no reason you should give your Medicare number to a vendor for a free prize,” says Nozaki.

5. Telephone organizations. Finally, experts say to be alert for any calls from people claiming to be from your doctor’s office or from state or local health agencies who are often given a fake, official-sounding name.

Sometimes thieves will gain illegal access to your medical information from your doctor’s office and call with enough details about your personal situation to lure you into sharing more personal details that can lead to fraud.

“They drop information like a fortune teller,” says Elizabeth T. Gutierrez, who helps seniors who have been victims of Medicare fraud with Family Care Specialist Medical Group.

“They throw out keywords and they know the chances are pretty good that an older person is diabetic or overweight…and then they say, ‘I’m not sure your doctor is taking care of you,'” she says.

That’s when they try to convince you to give up your Medicare number so they can switch you to a plan that your doctors participate in.

“What happens is that brokers are hungry” for money, says Gutiérrez.


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