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Stop Senior Scams: Help stop Medicare fraud

Alicia Colombo

By Jeremy Rodriguez

Medicare helps adults age 65-plus and younger adults living with disabilities pay for life-saving medications and other treatments. (Click Here>> for more information about Medicare.) However, some scammers try to take advantage of consumers by committing Medicare fraud. According to the Centers for Medicare & Medicaid Services’ (CMS) booklet “Medicare Fraud & Abuse: Prevent, Detect, Report,” Medicare fraud includes submitting false claims to obtain federal health care payments, knowingly ordering unnecessary medical equipment and billing Medicare for appointments you did not attend. These scams can result in medical identity theft and unexpected exhaustion of your insurance coverage limits.

This year’s edition of the official U.S. government’s Medicare handbook, titled “Medicare & You,” offers several tips to help you avoid Medicare fraud. The best way to protect yourself is to keep your information safe. You should only give personal information, including your Medicare and Social Security numbers, to your doctors and other health care providers; health insurance company representatives; and other trusted personnel, such as counselors with the State Health Insurance Assistance Program.

It is important to know that Medicare representatives will only call beneficiaries in limited situations. For example, someone who is enrolled in Medicare may receive a call from the person who helped them join. Additionally, if the participant left a message or reported fraud at 1-800-MEDICARE, a representative from Medicare will likely call back to follow up.

Another way to prevent fraud is to review the Medicare Summary Notices to confirm that the correct services were billed to Medicare. People with original Medicare can also create a secure online account for free at to view claims, which are usually available online within 24 hours of processing. You can also contact the health care provider or supplier directly to request an itemized statement, which you should receive within 30 days.

Lastly, upon suspecting Medicare fraud, older adults should call 1-800-MEDICARE to report it. recommends having the following information ready when you call: your Medicare number, the name and other identifying information of the provider, the item(s) or service(s) in question, the amount(s) that Medicare approved and paid, and the date (from the Medicare Summary Notice or the provider’s Explanation of Benefit statement).

Jeremy Rodriguez is a freelance journalist, blogger, editor and podcaster.

Categories: Elder Abuse Finances Milestones eNews


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