As Americans above the age of 65 diligently sift through their options for Medicare coverage during the Open Enrollment season of 2024, another group is on the prowl: fraudsters.
While seniors are seeking the best healthcare plans, scammers are devising schemes to exploit and defraud them, threatening financial security and well-being.
Guarding Against Fraud
Tatiana Fassieux, a Medicare education and training specialist with California Health Advocates and Senior Medicare Patrol watchdog groups, emphasizes the heightened risk during Open Enrollment. “Now is the time where Medicare beneficiaries have to be very, very careful regarding who they’re divulging their information to and to investigate exactly what a particular Medicare plan is offering,” she warns.
Kathy Stokes, director of fraud prevention programs at AARP, echoes this sentiment, noting the pervasive nature of Medicare discussions during Open Enrollment, which scammers exploit to their advantage.
Various scams, predominantly centered around identity fraud, plague seniors through texts, phishing emails, social media, and even in-person encounters.
Fassieux highlights the targeting of individuals with limited English proficiency, often through encounters with recruiters in public spaces like mall parking lots.
The magnitude of Medicare fraud remains uncertain, but estimates suggest it surpasses $100 billion annually, fueled by an expanding pool of potential victims.
With 18% of the US population now enrolled in Medicare, up from 13% in 1990, the opportunities for exploitation have grown exponentially.
To combat these threats, the Medicare Fraud Strike Force, a collaboration between the U.S. Department of Health and Human Services and the Justice Department, diligently works to dismantle fraudulent schemes.
Here are some prevalent scams seniors need to be vigilant about during Medicare Open Enrollment:
1. The Medicare Imposter Scam: Fraudsters impersonate Medicare representatives, offering assistance with enrollment or surveys, often via phone calls or texts.
They may spoof Medicare’s official number or claim to represent the agency. Seniors should refrain from engaging with unsolicited callers and promptly block suspicious numbers.
2. The Medicare Flex Card Scam: Some scammers promote prepaid debit cards, purportedly for covering Medicare expenses, particularly targeting Traditional Medicare beneficiaries.
However, Medicare does not issue such cards for Traditional Medicare. Seniors should be wary of any offers suggesting otherwise.
3. The Free Medical Equipment Scam: Scammers promise free durable medical equipment, exploiting Medicare coverage. Victims may receive substandard or nonexistent items, hindering legitimate claims in the future. Vigilance is crucial when approached with unsolicited offers for medical equipment.
4. The Free Lab Test Scam: Perpetrators offer free lab tests, claiming Medicare coverage, often deceiving seniors by asserting physician approval. These tests are billed to Medicare without legitimate medical necessity, potentially resulting in financial loss and compromised healthcare.
5. The Medicare Advantage Sales Call Scam: Fraudulent calls offering assistance with Medicare Advantage plans are illegal. Seniors should be cautious of unsolicited calls or messages promoting Medicare Advantage options.
Protect Your Medicare Against Scams
To prevent falling victim to these scams, seniors can take proactive measures:
Educate oneself on common fraud tactics through resources like the Centers for Medicare & Medicaid Services’ “Protecting Yourself & Medicare from Fraud” booklet.
Seek guidance from local Senior Medicare Patrol offices or State Health Insurance Assistance Programs to stay informed about prevalent scams.
Utilize resources provided by organizations like AARP, such as the Fraud Watch Network, for additional support and alerts on emerging scams.
Safeguard Medicare information akin to credit card details and monitor statements regularly for discrepancies.
In case of suspected fraud, seniors should:
Review Medicare statements diligently for unauthorized services.
Report suspected fraud to Medicare, relevant authorities, and organizations like AARP for assistance and guidance.
Amid the complexities of Medicare enrollment, safeguarding against fraud is paramount. With vigilance and awareness, seniors can navigate Open Enrollment season securely, ensuring access to legitimate healthcare services without falling prey to fraudulent schemes.
