Medicare Fraud refers to any individual, company or website who intentionally masks or hides their true intent to receive Medicare health care cost reimbursement when they are ineligible. Typically this is accomplished in one of three ways. The first way can be by providing false medical information. The second way can be by claiming a medical necessity when none exists. And the final way is by charging costs or receiving reimbursements when services were not rendered.
With Medicare Part D, the prescription drug benefit, be aware of potential Medicare plan fraud schemes. Here are some indications of potential Medicare fraud.
- When a website claiming to be a reputable company accepts payment online or over the phone for Medicare plans. No company offering a Medicare plan is allowed to collect payments online or over the telephone. But, you can enroll online and compare available plans.
- Don’t give your social security number, Medicare ID or Medicare Health Insurance Claim Number to any person, company, or website who telephones, visits your home, or emails for your information that is not your doctor or provider. Medicare Part D approved companies can telephone to give you information about their available plans but they aren’t allowed to register you in their program unless you telephone them. They also aren't allowed to visit your home unless you invite them. And, they are not allowed to send unsolicited emails.
- Legitimate plans have premiums, co-payments, and/or deductibles. Don’t respond to telephone calls or emails that advertise or claim “free” coverage.
- There is no charge or fee to enroll in a Medicare plan.
- Do not be pressured to enroll in a Medicare plan “NOW!” by an individual, company or website. Pay attention to Medicare plan deadlines that apply to you.
- Be very cautious when the phrase “Medicare wants” is used in relationship to you needing or having the service or product. Medicare is an insurance agency. Medicare does not diagnose, treat or recommend treatments.
Information about Medicare Part D plans approved in your location is available at the official Medicare website. If you would like to file a complaint about possible Medicare fraud, contact the Federal Trade Commission.