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How Can I Identify Medicare Fraud Online?

How Can I Identify Medicare Fraud Online?

Just the Essentials:

  • Medicare fraud happens when individuals knowingly attempt to access Medicare funds that they are not eligible to receive.

  • The internet has made it easier for scammers to pose as legitimate Medicare insurance agencies.

  • There are tell-tale signs that an insurance company isn’t on the level.

  • You can report Medicare fraud by calling 1-800-MEDICARE.

The Progression of Medicare Fraud

As technology progresses, it becomes easier and easier for unsavory agents to scam and defraud innocent people. If you’re a recipient of Medicare benefits, you’re in a demographic that’s most vulnerable to fraudsters. Believe it or not, you’re at your most vulnerable to Medicare fraud when you’re surfing the internet.

“I don’t want anybody doing anything with my information,” you’re likely thinking, “so how can I identify Medicare fraud online?” It’s not always easy, but with some diligence, you can scope it out.

Many of you are familiar with the signs of Medicare fraud committed by healthcare providers. For instance, it can be relatively easy to spot if you were billed for unneeded services or for services that weren’t provided. Trying to identify Medicare fraud online can be a little tougher because scammers have learned how to make their facades a little more convincing than before.

In this article, we’re going to help you learn how to identify Medicare fraud perpetrated by online sources.

A Quick Primer on Medicare Fraud

Medicare fraud is an issue that affects everyone that’s in the system, whether you’ve been a direct victim or not. Fraud has a ripple effect that can cause anything from a rise in health care premiums to an increase in the payroll taxes that workers pay into the Medicare system. It’s important to prevent Medicare fraud and abuse so that the system remains on the level and costs stay low for everyone involved.

Medicare fraud takes many different forms. Some of the most common forms of Medicare fraud include:

  • Fraud committed by providers
  • Fraud committed by beneficiaries
  • Identity theft to obtain benefits

Each form has its own different signs to spot, and they aren’t always easy to see right away. However, if you feel that something isn’t right with your bill, or you feel that you’ve been the victim of a scammer, it’s important to report Medicare fraud right away if you suspect it. You can report Medicare fraud by calling their hotline, 1-800-MEDICARE.

Medicare Fraud Goes Digital

In many aspects, the internet has made life easier for most. You can shop without having to deal with crowds, start conversations with people you haven’t seen in years, or experience adventures that life has to offer from the comfort of your living room. It has also made it easier for fraudsters to take your information and benefits, all with the simple click of a button.

With organized crime rings entering the Medicare fraud fray online, it’s gotten a lot tougher to identify what is legitimate and what isn’t. In other words, the days of identifying a fraudulent company based simply on poorly-written and misspelled social media ads are long gone. The way scammers operate may have changed, but the aim remains the same: to obtain your money and information.

Fortunately, the content launched and created by scammers often contains major giveaways that they are involved in Medicare fraud. Some Medicare fraud examples you often find woven into the content of fraudulent insurance companies include:

  • Insisting that you’ll pay higher premiums for Medicare Part B unless you sign up for a specific plan. Your Part B premium will never increase based on your coverage choices.
  • Insisting that you can switch back to Original Medicare at any time if you are dissatisfied with the plans they offer.
  • Stating that you’ll lose your benefits unless you sign up for certain plans.

It’s important to remember that no legitimate insurance company will ever tell you that you’ll lose benefits unless you sign up for their plan, or that you can enroll in a plan at any time of the year. If you have Original Medicare and you sign up for a Medicare Advantage plan, you still retain your Original Medicare benefits. 

The Falsehood of “Free”

One way providers and companies set about committing Medicare fraud online is by insisting that they provide something for “free” in exchange for your Medicare number. More often than not, these providers and companies fraudulently claim that they offer “free” consultations or services for Medicare patients. All you have to do is give them your Medicare number while you’re signing up. This is a major red flag.

Some examples of these “free” offerings include:

  • Delivery of high-dollar medical supplies
  • Mental health consultations
  • Counseling services
  • Testing and diagnostic services

No healthcare or health insurance provider will ever claim to offer something “free” in exchange for your Medicare information. Seeing medical services or consultations being offered for free as a means of getting your Medicare information is a sure-fire way to identify Medicare fraud.

Be Wary of Providing Your Information to Anyone

It’s one of the most common grifts around: a “Medicare agent” calls you up after dinner and tells you one of three things:

  • Your Medicare card is no longer valid.
  • Your Medicare coverage is about to expire.
  • You have outstanding charges due for medical services rendered.

The aim in every case remains the same – these fraudsters are trying to obtain your personal information so that they may be able to use your benefits.

In the modern age, most fraudsters have smartened up and are realizing that cell phones and Caller I.D. have empowered you to ignore calls from numbers that you do not recognize. As a result, they’ve taken to email, social media, and specialized web pages to make their grift seem more legitimate.

It’s important to remember that all communications from Medicare or from a health insurance company will come via regular mail. They will never email you regarding issues with your account, or to ask about renewing coverage. If you receive an email communication asking you to reveal personal information, such as:

  • Your social security number
  • Your Medicare number
  • Your driver’s license or state I.D. number

It’s safe to say that the source is not legit, and you absolutely should not provide them with personal information. The same goes for “Authorized Sellers” who ask you to provide personal information so that you can apply for any of the following:

  • Medicare Part B plans.
  • Medicare Advantage plans that offer prescription drug coverage.
  • Medicare Advantage plans that claim to offer “specialized benefits” that are actually benefits provided through Original Medicare (Parts A and B). 
  • Medicare Advantage plans that offer Out-Of-Network coverage not typically provided by Advantage plans in your area.

While some legitimate Advantage plans may offer out-of-network coverage, it’s always best to be wary. If you’re unsure about what an Advantage plan is offering, contact the provider and ask questions about what you’re actually getting before you make the decision to apply. You might be saving yourself a lot of time, money, and heartache in the end.

As far as “Authorized Sellers” offering Medicare Part B plans? Those are as illegitimate as it gets. True Medicare Part B is controlled and regulated by the Federal Government and the Federal Government only. No private company is authorized to sell Medicare Part B plans, and if they’re claiming to do so, they should be reported immediately.

Keep Yourself and Others Safe - Report Medicare Fraud

Medicare fraud does a great deal of harm to a lot of people on a daily basis. The only way you can prevent Medicare fraud from affecting you and others is to follow this basic mantra – if you see something, say something. To report Medicare fraud as you see it is to keep your own information safe from compromise and the costs of Medicare and healthcare premiums down.

If you suspect that providers or individuals are committing Medicare fraud, call the Medicare hotline at 1-800-MEDICARE (1-800-633-4227). You have the option to report Medicare fraud anonymously.

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