A publication of the Kentucky Center for Public Service Journalism

BBB Trends: It’s Medicare enrollment time — be aware of fraudsters and the common tactics they use

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By Sandra Guile
Better Business Bureau

Medical identity theft is different than regular identity theft in that someone uses your personal information to obtain medical care, buy prescription drugs, or submit fake billings in your name instead of setting up false credit cards or withdrawing cash. While there are a number of scams related to medical care, Medicaid or Medicare beneficiaries should be alert to a few common tactics criminals use when conducting a Medicare scam.

One frequent method fraudsters use is to pose as employees from the Centers for Medicare and Medicaid Services (CMS) or some other false agency with a similar-sounding name. They’ll typically claim Medicare card holders are being issued new cards and they need to replace their current cards. The scammer states that in order to receive the new card, the recipient has to verify or update sensitive information, including their Medicare number which is associated with a Social Security Number. Medicare officials have stated they don’t contact patients and ask for personal information like their Medicare or Social Security number via phone or email.

Another strategy scammers employ is to go door to door acting as an official Medicare agent. The person approaches a senior citizen and pretends as though they are selling Medicare insurance. They claim to be able to save the senior thousands of dollars on healthcare costs but says that the offer they are proposing is only good during Medicare’s open enrollment period. Any mention of an early bird discount or limited time offer indicates a high-pressure sales pitch and should raise a red flag, especially if they’re pushing to obtain personal information.

Unsolicited, unexpected phone calls are one more way scammers use to try and obtain seniors’ Medicare information. These calls are usually characterized by an insistent sales pitch for medical services or prescription drug coverage. If the sales pitch is denied, the caller claims that because the person did not take advantage of the deal, their Medicare benefits will be terminated. Medicare services like prescription drug coverage are supplemental to Medicare benefits and are a voluntary service, meaning that it’s not necessary to sign up or renew them in order to continue receiving benefits. Any phone calls or allegations otherwise are a scam.

It should also be noted that come Spring, 2018 everyone who is enrolled in Medicare will automatically receive a new Medicare card in the mail that will have a new Medicare Number that’s unique to the cardholder instead of using Social Security numbers. No action is required by enrollees. These cards will be automatically sent through the U.S. Postal Service.

If you haven’t requested information from the organization or haven’t asked for an agent to contact you, BBB advises against reacting to a sales pitch from an uninvited source. Federal law prohibits sales communication of any kind – this includes phone calls, emails, or door-to-door drop-ins – with someone if they have requested not to be approached with solicitation messages.

If someone tries to sell you something on behalf of Medicare or is requesting your personal information, contact the Office of the Inspector General and report that person. BBB also recommends reporting any Medicare fraud to Medicare.gov/fraud and to BBB’s Scam Tracker.

Sandra Guile is the Community Outreach Specialist for BBB. She promotes BBB’s message of marketplace ethics through public speaking engagements, presentations, media relations, press releases, web content, and other written materials. Contact Sandra at (513) 639-9126 or sguile@cincinnati.bbb.org. Your BBB is located at 1 East 4th Street Suite 600 Cincinnati, Ohio 45202 – to reach the office, call (513) 421-3015.

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