Medicare Advice: Learn About Medicare Fraud

Are you tired of rising health care costs? One contributing factor is Medicare fraud.

Most health care professionals who work with Medicare are honest. Unfortunately, a handful of dishonest providers and individuals cost the Medicare system millions of dollars every year. These costs are passed on to you in the form of higher co-payments and health care costs.

What You Don’t Know About Medicare Can Hurt You

  1. You shouldn’t receive unsolicited calls or visits from people who are trying to sell or endorse any Medicare-related product.
  2. No one should ask you for your Medicare number or other personal information over the phone. Unless you initiated the call, don’t give personal information over the phone, and never send it by email.
  3. Medicare won’t specifically request a service for you unless your doctor orders it.
  4. It is important to review your Medicare Summary Notice for errors. Any misinformation could be Medicare fraud, but it could simply be an error that needs to be corrected. Undetected errors also cost Medicare- and eventually you – extra money.
  5. When someone uses your Medicare card or number to obtain treatment or services for themselves, they have not only committed Medicare fraud, they have also committed identity theft. Anyone who has access to your Medicare number knows your Social Security number; that opens the door to other types of identity theft.
  6. Although you won’t be held liable for Medicare fraud if someone uses your card without your knowledge, you may be required to prove you weren’t involved.

When Should You Suspect Medicare Fraud?

If any health care provider offers “free” services or equipment and tells you they need your Medicare number for their records that should raise a red flag in your mind. You also have cause to be concerned if someone who already has your number offers free services.

medicare-fraudUnsolicited sales calls from telemarketers or door to door sales people who claim they know how to get Medicare to pay for services that aren’t ordinarily covered should also alert you to the possibility of fraud. These people will often use high pressure tactics and suggest you contact your doctor to request services or supplies you know you don’t need. They may offer free consultations or offer to waive your co-payment without verifying your financial need or try to convince you to have unnecessary diagnostic tests, telling you that you can get a discount by having multiple tests done at one time.

You should also be concerned if your Medicare Summary Notice contains errors such as a wrong diagnosis or charges for a service you never received. Watch for charges for equipment that you either never received or have already returned.

How Do You Protect Yourself Against Medicare Fraud?

  • Watch for any suspicious activity like the things mentioned here.
  • Take charge of your medical treatment. Make sure you understand what you’re being treated for. Always check your prescription before leaving the pharmacy to be sure you received the full amount. Monitor your Medicare Summary Notice.
  • Don’t allow anyone except your personal health care providers to review your medical records or recommend treatment.
  • Guard your Medicare card and your number. Report lost or stolen cards immediately by calling 1-800-772-1213 or by visiting

If you suspect fraud, always contact your health care provider first. They may be able to clear up a misunderstanding. Or you may be able to point out an error they missed. Honest health care professionals will be happy to help set things straight. If your doctor or other health care provider doesn’t help you with your concerns, call 1-800-MEDICARE. You can report your concern to them anonymously.