It is Medicare open enrollment, and that brings out the fraudsters.
Medicare fraud and abuse are serious issues that impact the healthcare system and beneficiaries. Proactive vigilance is essential for protecting your benefits and personal information.
Protect Your Information and Claims
To help spot and prevent Medicare fraud and abuse, adopt the following practices:
- Secure Your Data: Always protect your Medicare card, Medicare Number, and other personal identifiers. Never provide this information to unsolicited callers or visitors. Only share it with your doctor, trusted Medicare providers, or organizations acting on your behalf (e.g., your State Health Insurance Assistance Program – SHIP).
- Verify Services: Regularly compare the dates and services on your personal calendar with your official Medicare statements (such as the Medicare Summary Notice) or plan Explanation of Benefits (EOB). Ensure you received every service listed and that the details are accurate.
- Be Skeptical of Offers: Never accept offers of money or gifts in exchange for “free” medical care, and do not allow anyone other than your healthcare provider to review your medical records or recommend services.
- Know Medicare’s Limits: Understand that Medicare will never call you to sell you anything or visit you at your home. Medicare representatives will only call to request personal information in limited situations, such as to return a call you initiated.
- Plan Enrollment Caution: Do not join a Medicare health or drug plan over the phone unless you initiated contact.
Reporting Suspected Fraud and Abuse
If you suspect fraud, abuse, or medical identity theft, report it immediately.
| Contact | Purpose | Number |
| Medicare (CMS) | General fraud reporting | 1-800-MEDICARE (1-800-633-4227) |
| I-MEDIC | For Medicare Advantage (Part C) or drug plan (Part D) fraud | 1-877-7SAFERX (1-877-772-3379) |
| Online Reporting | Report Medicare Fraud online | Use the official online reporting portal |
Before reporting, review your provider receipts and statements, and call the provider’s office if you believe a charge is incorrect to rule out a simple billing error.
When reporting, be prepared to provide information regarding the suspected provider or company, the service or item in question, the date(s) of service, and the reason for your suspicion.
Would you like me to find the SHIP (State Health Insurance Assistance Program) contact information for your state?
Source: Medicare.gov
Disclaimer: Investment advice offered through Stratos Wealth Advisors, LLC, a registered investment advisor. Stratos Wealth Advisors and Synergy Wealth Management are separate entities.
