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How to Avoid Medicare Fraud

How to Avoid Medicare Fraud

Medicare Fall Open Enrollment is October 15 through December 7, 2017.  Use this opportunity to evaluate your Medicare options and compare plans. Decide whether you want to enroll in Original Medicare or a Medicare Advantage Plan and compare Medicare Advantage Plans and Part D drug plans.

Be aware of enrollment fraud. If you find yourself in one of the following situations, remember that you have rights as a Medicare beneficiary:

  • Are you being pressured to join a plan? If you are feeling a lot of pressure to join a plan, remember that you have a right to choose how you receive Medicare coverage. You can choose between a Medicare Advantage Plan and Original Medicare, and you can enroll in any Medicare Advantage Plan or Part D plan that is offered in your area. You have the whole length of Fall Open Enrollment to make choices about your health coverage, and you will not receive extra benefits for enrolling early. If a plan representative is pressuring you, or if you just need more time to review your options, tell them that you will follow up with them later to make a decision. You can receive unbiased counseling about your plan options from your State Health Insurance Assistance Program (SHIP). To find and contact your SHIP, visit www.shiptacenter.org or call 877-839-2675.
  • Do you believe you might be receiving false information? Plans cannot falsely represent themselves to get you to enroll. Before making a final choice about your coverage, confirm all the information a plan has given you. For example, if a plan agent tells you that all of your providers are in-network, check with your providers to see if this is true. Whenever possible, rely on information from government websites ( a website that ends in .gov) and emails, seek unbiased counseling from your SHIP, and get information about the full range of plans available in your area by calling 1-800-MEDICARE. Additionally, remember that a plan cannot claim to be endorsed by Medicare or to represent Medicare, and cannot threaten you with the loss of your Medicare benefits if you do not enroll in their plan.
  • Is someone asking you for confidential/personal information? Plans do not need to, and should not ask for your Medicare number, Social Security number, or bank information just to provide you with information. Plans should not call you at home to ask for this information, and should not ask you to give it to them at educational events. With this information, a plan can enroll you without your consent. Plans also cannot call you and ask you for a payment over the phone, but rather they have to send a bill. Additionally, know that there will be new cards issued for Medicare beneficiaries starting in 2018, but you do not need to take action or pay anything to get your new card or retain your Medicare benefits. Be wary of situations where people ask for your Medicare information or some form of payment related to this card.

If you find yourself in one of these situations, protect your Medicare and Social Security information and remember that you have the right to make your own decisions about your Medicare coverage. If you believe a plan representative has violated Medicare’s marketing guidelines, or if you think you were enrolled in a plan without your permission, you can contact your Senior Medicare Patrol (SMP). You can find and contact your SMP by visiting www.smpresource.org or calling 877-808-2468.

-from MedicareRights.org