Safeguard Your Medicare and Insurance Information from Scammers: Internet Scambusters #1,148
Spotting the signs of Medicare and insurance fraud to protect vulnerable adults and seniors is critical. It is important to stay one step ahead of scammers and learn their new tactics.
Medicare and Insurance Scams: How to Protect Your Health Benefits
It is that time of year again for holidays, family, and fun. However, don’t forget that scams and fraud can also occur with all this fun.
Health insurance, especially Medicare, is designed to provide security and peace of mind. Unfortunately, scammers and fraudsters have found ways to exploit these systems, preying mainly on seniors and vulnerable individuals. The consequences can be financially devastating and emotionally overwhelming for victims.
When scammers are looking for their next victim, they often target vulnerable populations, such as seniors, because they depend on essential healthcare coverage and their inclination to trust authority figures. But how do they identify potential victims?
- Scammers can obtain publicly available information, such as voter registration databases and social media profiles.
- Sensitive personal information can be leaked or stolen during data breaches at trusted organizations.
- Scam organizations often illegally obtain contact information or use automated tools to continuously call numbers until they find a potential target.
- Scammers often pose as representatives of Medicare, insurance companies, or healthcare providers to create a false sense of credibility.
Scammers Use Various Strategies to Contact Seniors Directly
- Cold calling is often exploited by scammers who run high-volume robocall campaigns that randomly dial numbers. Seniors frequently answer these calls because they associate unknown numbers with legitimate concerns such as medical appointments or insurance issues.
- Fraudulent entities may obtain phone numbers and personal information from dubious third-party companies that sell consumer data.
- Spoofing Trusted Numbers – Scammers can alter the Caller ID to make it seem like they’re calling from Medicare or a reliable insurance company, thereby increasing their credibility.
- Fraudsters often collect personal information by pretending to conduct surveys or offering free services to obtain contact numbers.
Red Flags That Signal a Scam
Being aware of these signs can help you protect yourself from fraud. Possible signs are:
- Unsolicited Calls or Emails – Real organizations do not usually contact you unexpectedly to demand immediate action or ask for personal information.
- Requests for Personal Information – Be careful if someone asks for your Medicare number, Social Security number, or financial details.
- Promises of Guaranteed Benefits or Urgent Decisions – If someone makes a promise that seems too good to be true or pressures you for a quick response, it is probably a scam.
- Offers of Free Services or Gifts – Scammers may try to lure you with free medical equipment or services in exchange for your insurance number or personal information.
- Suspicious Billing – Look for charges on your Explanation of Benefits (EOB) statements for services you did not receive, which may alert you to fraud.
- Impersonation – Scammers often pretend to be from Medicare or your insurance company. Always check their credentials before sharing any information.
The effects of scams on seniors occur in multiple ways. Many may face out-of-pocket expenses due to fraudulent charges or their legitimate coverage may be exhausted by scam-related claims. Some lose coverage due to fraudulent activities, leaving victims unable to afford healthcare.
When scammers access personal information, they may use it for fraudulent activities like opening credit accounts or filing false tax returns. The emotional and psychological stress of realizing one has been scammed can contribute to overall health and well-being.
By following the steps below, you can better protect yourself from Medicare and insurance scams:
- Protect Your Personal Information – Do not share your Medicare number, Social Security number, or financial details unless you have verified the identity of the person requesting this information.
- Be Wary of Unsolicited Contact – Hang up on suspicious calls and avoid engaging with unsolicited offers received via email, phone, or text message.
- Verify Credentials – If someone claims to represent Medicare, your insurance provider, or a healthcare agency, ask for their name, ID, and callback number. Make sure to verify this information by contacting the organization directly.
- Shred Documents – Shred any medical statements, billing records, or documents containing personal information before disposing of them.
- Check Your Statements Regularly – Review your Medicare Summary Notices (MSNs) and Explanation of Benefits (EOBs) for suspicious claims or services. Report any discrepancies immediately.
Special Note to Family and Caregivers! No matter how independent a vulnerable or senior person might be, it is important to review their insurance claims and financials to be sure things are correct. Scammers are very good at scamming and use fear to act immediately, so periodic check-ins are good to have.
If you realize you’ve fallen victim to fraud, take action quickly:
- Contact Your Insurance Provider or Medicare – Report any suspected fraudulent activity immediately to your insurance company or Medicare. The sooner they know, the better the chance of limiting the damage.
- Report the Fraud – You can file a report with your state insurance department, the Federal Trade Commission (FTC), or Medicare through 1-800-MEDICARE.
- Place Fraud Alerts – Notify credit bureaus to place a fraud alert on your account to prevent further misuse of your identity.
- File a Police Report – Reporting the fraud to local law enforcement can help establish a record and possibly recover lost funds.
- Seek Support – Fraud victims often experience guilt or stress. Reach out to support groups or your local senior center for emotional help.
There are several organizations and resources to help victims and prevent further fraud. Be sure to check out the resources below to learn of your options:
- Medicare.gov – Fact Sheet on 4R’s for Fighting Medicare Fraud (PDF)
- Senior Medicare Patrol – Spot Medicare Scams
Insurance and Medicare scams can affect your life and the lives of your loved ones. To protect yourself, stay informed and alert. Know the common tricks scammers use and watch for warning signs. Use resources that can help you. Being careful is essential. Make sure to educate yourself and stay updated on the latest scams.
Stay vigilant and stay safe!