Preventing Medicare Fraud: Tips for Seniors and Caregivers

As healthcare costs continue to rise, Medicare and Medicaid have become an essential resource for seniors and their caregivers. Unfortunately, fraud is also on the rise, with scammers and unscrupulous healthcare providers looking to take advantage of vulnerable seniors. In fact, Medicare fraud costs taxpayers billions of dollars every year, which is why it’s essential for seniors and caregivers to be aware of how to protect themselves from fraud. In this blog post, we’ll outline some tips on how to prevent Medicare fraud using a Medicare fraud whistleblower lawyer and protect your healthcare benefits.

What is Medicare Fraud & Medicaid Fraud?

Before we dive into tips for preventing Medicare fraud, it’s essential to understand what it is. Medicare fraud refers to any intentional deception or misrepresentation made by an individual or healthcare provider to obtain benefits or payments from Medicare. This can include billing for services that were never provided, submitting claims for unnecessary medical procedures, and even theft of a patient’s Medicare number.

Medicaid fraud is similar to Medicare fraud, but it involves the Medicaid program. Medicaid fraud can occur when an individual or healthcare provider intentionally submits false claims to obtain benefits or payments from Medicaid. This type of fraud can include billing for services that were never provided, submitting claims for unnecessary medical procedures, and even charging for services that should be covered by Medicaid.

How to Prevent Medicare Fraud

Now that you understand what Medicare fraud and Medicaid fraud are, let’s look at some tips for preventing it.

Protect Your Medicare Number

Your Medicare number is your personal identification number for Medicare, and it’s important to protect it from fraudsters. Don’t give your Medicare number to anyone who doesn’t need it, and never give it out over the phone or through email. If someone calls or emails you asking for your Medicare number, hang up or delete the email immediately. Only give your Medicare number to healthcare providers or insurers when you’re sure they need it.

Review Your Medicare Statements

Review your Medicare statements regularly to ensure that all charges are accurate. If you notice any charges that you don’t recognize or that seem suspicious, contact Medicare immediately to report the potential fraud. You can also check your Medicare Summary Notice (MSN) online to review all claims and payments.

Be wary of any unsolicited offers for medical services or supplies, especially those that require your Medicare number. Scammers may offer free medical equipment or supplies to seniors, but they’re often just trying to steal your Medicare number. Never accept any unsolicited medical services or supplies without verifying the provider’s legitimacy first.

Ask Questions

If you’re unsure about a healthcare provider or service, ask questions. Be sure to ask about any costs associated with the service and whether it’s covered by Medicare. If the provider can’t give you a straight answer, it may be a red flag for potential fraud.

Check the Provider’s Credentials

Before receiving any medical services, make sure to check the provider’s credentials. This includes verifying that they are licensed and that their credentials are up to date. You can check this information on the provider’s website, state licensing board website, or by contacting Medicare directly.

Don’t Share Your Personal Information

Be cautious of anyone who asks for your personal information, including your Social Security number or banking information. Scammers may use this information to commit identity theft or steal your Medicare benefits. If a healthcare provider requests this information, be sure to verify their legitimacy first.

Keep Records of Your Medical Services

Keep a detailed record of all medical services you receive, including the date, provider, and cost. This can help you identify any potential fraudulent charges on your Medicare statements. Additionally, keep all receipts and documentation related to your medical services.

Be Aware of Common Scams

There are several common scams that fraudsters may use to steal Medicare benefits, including:

• Unsolicited calls or emails offering free medical equipment or services
• Offers for genetic testing that are not medically necessary
• Billing for unnecessary medical procedures or equipment
• Theft of your Medicare number or personal information

If you’re aware of these common scams, you’re more likely to spot potential fraud and protect yourself from becoming a victim.

Know Your Rights as a Patient

As a Medicare patient, you have certain rights, including the right to receive services that are medically necessary and the right to know what services will be covered by Medicare. If you feel that your rights as a patient have been violated, don’t hesitate to report it.

How to Report Medicare Fraud

If you suspect that you’ve been the victim of Medicare fraud, you should speak with a Medicare Fraud whistleblower law firm.  If you’re just aware of a fraud that has been perpetrated on you and not aware if it happens to others, you most likely will not be able to qualify for a whistleblower award, but you can contact the authorities to make sure it doesn’t happen to others.  

Frequently Asked Questions

What should I do if I suspect Medicare fraud?

If you suspect systemic Medicare fraud, you can speak with a Medicare Fraud lawyer. If it’s just occurring to you, you can report it immediately to Medicare, or the HHS Office of Inspector General Hotline. 

Can I be held liable for Medicare fraud committed by my healthcare provider?

While patients are not typically held liable for Medicare fraud committed by their healthcare providers, it’s important to report any potential fraud to Medicare to protect yourself and other patients from future fraud.

How can I protect my Medicare benefits from fraud?

To protect your Medicare benefits from fraud, keep your Medicare number and personal information safe, review your Medicare statements regularly, and be aware of common scams. Additionally, ask questions and verify the legitimacy of healthcare providers and services before accepting any medical services or supplies.

How can I protect my Medicare number from fraudsters?

You can protect your Medicare number by not giving it out to anyone who doesn’t need it, never giving it out over the phone or through email, and only giving it to healthcare providers or insurers when you’re sure they need it.

How can I check my Medicare statements for accuracy?

You can review your Medicare statements regularly to ensure that all charges are accurate. 

What should I do if I receive an unsolicited offer for medical services or supplies?

Be wary of any unsolicited offers for medical services or supplies, especially those that require your Medicare number. Scammers may offer free medical equipment or supplies to seniors, but they’re often just trying to steal your Medicare number. Never accept any unsolicited medical services or supplies without verifying the provider’s legitimacy first.

What are my rights as a Medicare patient?

As a Medicare patient, you have certain rights, including the right to receive services that are medically necessary and the right to know what services will be covered by Medicare. If you feel that your rights as a patient have been violated, don’t hesitate to report it.