A woman we’ll call “Victim One” (whose name I can’t use because of health privacy rules) went to a free stroke prevention screening given by a mobile medical clinic. She ended up on the hook for an extra exam fee when she later went to her own doctor.She was the victim of a scam that has been preying on seniors who depend on Medicare for their health coverage. If you receive Medicare benefits or know someone who does, you need to know about this scam and others currently defrauding seniors and the Medicare program.
For Victim One, the call from the mobile health clinic was hard to resist, offering the free screening at a nearby church. As a Medicare beneficiary on a fixed income, she thought she should take advantage of it.
Once she got to the church, the mobile clinic staff asked for her Medicare number, took her blood pressure, and told her she was overweight. They aggressively tried to get her to pay extra for other services, which she refused.
In December, she went to her regular doctor for her annual wellness visit. That’s a special exam which Medicare covers once every 12 months. However, this time Medicare refused to pay. The reason is that it had already paid the mobile health clinic which claimed it had performed her annual wellness exam. And since Medicare now won’t pay her doctor, she has a bill from him for that appointment.
Victim One lives in Pennsylvania, but a recent alert from the New York Senior Medicare Patrol, a fraud prevention organization, suggests this scam is spreading. According to that alert, these temporary clinics set up at churches, hotels or banquet halls and offer supposedly free preventative services. But the services are not free. The clinics collect insurance information and then bill Medicare. They often pressure their victims to take additional services for which they’re later billed.
That’s not the only scam that’s costing Medicare and its beneficiaries. Here are some others:
A newspaper ad offered a free back brace that would be covered by Medicare. Victim Two called the toll-free number. Trying to be careful, she asked how much Medicare would be charged and was told $199. So she ordered the brace and gave them her Medicare number. When the product arrived, she realized that it was just like a back belt she had seen at the hardware store for $20. Then she got Medicare’s notice of charges on her account and saw that it had been billed $1300 and paid $1100 for that supposed back brace. What do you think will happen if she actually needs a real back brace and expects Medicare to cover it?
Similar scams, often driven by newspaper ads and flyers, offer a variety of medical equipment such as free motorized wheelchairs, knee braces, and incontinence products as bait. All they need is that Medicare number. But Medicare often won’t pay the full amount to the scammer. So the victim gets billed for the balance. Sometimes the victim’s Medicare account may be flagged “Do Not Pay.”
If you have Medicare or know someone who does, it’s important to understand that theft of Medicare numbers leads to identity theft, false claims, and overbilling, cheating Medicare out of a lot of money.
How big is the problem? The Government Accountability Office estimates that about one dollar out of every ten paid out by Medicare is lost to fraud, abuse, or waste. In 2015, the most recent year for which the GAO estimate is available, that loss was almost $60 billion.
If someone offered you a free service in exchange for your social security number, would you take it? I hope you answered “Of course not” because that sets you up for identity theft. Yet Medicare beneficiaries run that risk because their Medicare number is the same as their social security number.
That’s a long-standing problem the government is targeting to fix with a plan to issue new Medicare cards next year with different, more secure numbers.
And that leads to the latest Medicare scam alert issued in March by California Health Advocates. Scammers have started calling recipients claiming to be from Medicare, saying they need to verify the current number and other information before sending out a new card. In some cases, the caller says there is a fee that needs to be paid before the new card can be sent, which is not true.
Here are some key points to remember and to pass on to family members on Medicare:
- Medicare will never call a recipient requesting their information. Don’t give out your Medicare number over the phone to anyone who calls you. It’s your social security number.
- Medicare beneficiaries should not carry their Medicare card. The only time they need it is when seeing a new doctor or medical provider for the very first time. Keep that card in a safe place with other important documents.
- Beware of providers who advertise free services or products but request a Medicare number. If it’s really free, they do not need a Medicare number.
Being aware of these scams can help you and people you know avoid losing money. There’s also a bigger picture. In the current political climate, with potential limits on Medicare funding, it’s important to make sure Medicare dollars are available to provide needed health care for seniors instead of lining the pockets of crooks.