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Protect Yourself From Medicare Fraud: A Guide To Prevention

Medicare Fraud is the collection of Medicare healthcare reimbursement by use of false pretenses.  There are many different types of fraud, all of which have the same goals, to collect money from the Medicare program illegally. Medicare fraud accounts for a large misuse of money each year, and the end result is higher healthcare cost and taxes for everyone.  Here are some common types of Medicare fraud. 

  • Fraudulent Billing:  this is when a practice or an individual bills for tests, procedures and/or medical supplies that were never given, or were medically unnecessary.  Some other examples of this would be billing for brand name prescriptions when generics were dispensed.  
  • Someone using your Medicare card to get medical care, medical supplies or treatment.  
  • A company who uses false information to lure or mislead you into joining a Medicare plan. 
  • Misrepresentation of dates/times/places of service.    

There are ways you can help guard yourself and your loved ones from Medicare fraud.   

  • Make sure to protect your Medicare number as well as your Social Security number.  These are important bits of information that could cause you some serious trouble if placed in the wrong hands.  Do not give this information to anyone unless it is your doctor or an authorized Medicare provider. 
  • Make sure you keep record of any appointments or treatments and medical supplies you receive.  When you receive your Medicare statements it will be easier to check for mistakes and discrepancies if you have kept records of these things. You will want to carefully check to make sure all the information on your statements and bills are correct.  If you have recently be hospitalized you will want to check and make sure that the admission date, discharge date and diagnosis are all correct.   
  • Make sure you always check your prescriptions to make sure everything is correct before you leave the pharmacy. If you find something to be incorrect ( such as being given a generic when you were supposed to be given a brand name, or you do not have the full amount your prescription calls for) bring it to the pharmacies attention immediately.   
  • Do not speak to or accept anything from someone coming door to door claiming to be from Medicare and/or Medicaid.  Medicare and Medicaid DO NOT send anyone door to door to sell or hand out anything for their services.   
  • Do not let anyone persuade you to receive tests or services that you do not need.    
  • Last but not least, make sure that you that you understand how a plan works before you join.  And ask questions. You have every right to know everything about a plan, and what can and cannot be billed to Medicare, and what will be covered in regard to your healthcare needs.  It is very important to educate yourself when it comes to Medicare.   
  • And always make sure to report any suspected Medicare fraud.   

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