It is no secret that health care services for the elderly have remained lucrative despite the current economic crisis. Not only are legitimate service providers continuing to grow, but scam artists are also on the rise.
Medicare scams are growing. Coupled with legitimate senior service marketing are scams that defraud Medicare, overcharge seniors, and even scams that use false Medicare marketing to commit identity theft.
Seniors will become victims of Medicare scams in your community, and many could be your clients or potential clients. With their savings drained and trust broken, they may be inclined to refuse any kind of senior care, and influence their friends to do the same.
Educate your caregivers and care managers on how to help your clients avoid Medicare scams. There are some common red flags that may indicate a Medicare scam.
• Charged co-payments on clinical laboratory tests, and on Medicare covered preventive services such as PAP smears, prostate specific antigen (PSA) tests, or flu and pneumonia shots.
• Routinely waived co-payments on any services, other than those previously mentioned, without checking your ability to pay.
• Advertised “free” consultations to People with Medicare.
• Claimed they represent Medicare.
• Used pressure or scare tactics to sell you high priced medical services or diagnostic tests.
• Billed Medicare for services you did not receive.
• Used telemarketing and door-to-door selling as marketing tools
It is also prohibited for Medicare marketers to approach your senior in any of the following situations:
• Door to door solicitation – coming to your home without an invite
• Approaching you in a parking lot, hallway, lobby, etc.
• Unsolicited telephone contact
• Unsolicited emails (unless you have given out your email address)
Direct mail marketing is legal. Legitimate Medicare marketers will use the following language in their printed promotional material.
• Advertising pieces – “This is an advertisement;”
• Plan information – “Important plan information about your enrollment”
• Health – “Health or wellness or prevention information”
If your client feels they may have been a victim of a Medicare scam, refer them to the Office of Inspector General Hotline. This hotline is confidential.
The Hotline can be contacted:
By Phone: 1-800-HHS-TIPS (1-800-447-8477)
By Fax: 1-800-223-8164
(no more than 10 pages please)
By E-Mail: HHSTips@oig.hhs.gov
By Mail: Office of the Inspector General
HHS TIPS Hotline
P.O. Box 23489
Washington, DC 20026
If any client or caregiver feels they have suspicions of fraud they can contact the Medicare’s Customer Service Center at 1-800-MEDICARE (1-800-633-4227).