How to Steer Clear of Outright Medicare Scams

By Patricia Barry

Copyright © 2015 AARP. All rights reserved.

An outright scam is when some thief pretends to be from Medicare, Social Security, a Medicare health or drug plan, or anything that sounds official and asks for sensitive information — such as your Social Security, credit card, or bank account number — in an attempt to steal your identity or money.

Outright scammers have nothing to do with Medicare. They’re just using it as a pretext to cheat you. The scam may be relatively simple, such as trying to con you into paying for something that doesn’t exist, or it may be a much more serious attempt to commit identity theft. Identity thieves hunt for key pieces of personal information, which they use to buy merchandise, apply for new credit cards in your name, or make a profit by selling it to other identity thieves.

This crime also robs people of their good credit ratings — which can take years to restore. This nightmare is one you want to avoid at all costs.

Watching out for red flags

Scams happen unexpectedly. You answer the phone or the doorbell and find someone who sounds or looks perfectly respectable offering help. How can you tell whether to trust this person? Here are some instant warning signals:

  • A person at your door claiming to be from Medicare or Social Security: The real agencies never send anyone to your home on official business without an appointment.

  • A person claiming to represent a particular Part D, Medicare Advantage, or Medigap plan: Medicare prohibits anybody from coming to your home uninvited to sell any kind of Medicare insurance. It also prohibits plans from cold-calling you on the phone unless you request it.

  • A person asking for an enrollment fee or an advance premium: Neither the enrollment fee nor the advance premium exists. You never have to pay someone to enroll you in a Medicare health or drug plan, nor pay any one-time payment that supposedly takes care of your premiums for months, years, or forever. Asking for either charge is illegal.

  • A person requesting your personal financial or identification information: Never give out your Social Security or Medicare ID number (actually, both are the same number), any details about your credit cards or bank accounts, or any other financial information, especially on the phone. Legitimate callers don’t ask for this info.

Surveying some common scams targeting seniors

Con artists dream up new and creative ideas all the time for ways to target older Americans and steal their money and/or identities. The following are some typical scams involving Medicare that seniors have reported in addition to those noted earlier:

  • The loss-of-Medicare-coverage threat: The caller claims to be a government official needing to check your Social Security (or Medicare) ID number and implies that if you don’t provide it, you’ll lose your Medicare coverage. Remember: The government has your number on file. You can’t lose Medicare benefits by refusing to give it out.

  • The Medicare-refund tactic: The caller claims to be from Medicare or Social Security, says you’re due for a refund, and asks for your bank account info in order to deposit the money. Remember: This refund doesn’t exist. If it did, officials wouldn’t contact you in this way.

  • The no-more-cash routine: The caller says that under a new rule, you’ll no longer be able to pay cash for your Part D drug co-pays at the pharmacy. Instead, you must pay by credit or debit card, so the caller needs your card number on file for “security” purposes. Remember: No such rule exists. You can pay for your drugs any way you want.

  • The ol’ “Medicare is going out of business” line: The caller claims to be a federal official and says that Medicare is being discontinued (maybe as a result of so-called ObamaCare) but that you can buy a plan that provides similar services. Remember: This scam’s a real whopper! Medicare isn’t going away.

You’re probably not going to encounter any of these scenarios. And what if one of these situations does happen? You can hang up the phone or shut the door. Yes, you can! Don’t be deceived by a friendly voice or a willingness to chat. Con artists are experts at controlling the conversation to win your confidence and keep you on the phone or get invited inside. These people don’t care about you. They’re criminals who see you as a potential sucker. So show them you’re not.

Reporting a scam

Authorities who receive reports of scam attempts send out alerts to put consumers on their guard. So if someone tries to scam you, do everyone a favor by reporting the incident to any of these offices:

  • Your state’s attorney general or insurance commissioner. Find contact information in the phone book or on your state’s website.

  • The Federal Trade Commission (FTC), the official consumer protection agency.

    • Call its toll-free help line at 877-382-4357.

    • Write to FTC Consumer Response Center, 600 Pennsylvania Avenue NW, Washington, DC 20580.

    • File a complaint online.

  • The Inspector General of the U.S. Department of Health and Human Services.

    • Call its toll-free hot line at 800-447-8477.

    • Write to DHHS, Office of the Inspector General, Attention: OIG Hotline Operations, P.O. Box 23489, Washington, DC 20026.

    • Go to the Hotline Operations website.

    • Contact the agency’s Senior Medicare Patrol, which fights fraud locally. Call 877-808-2468 or email info@smpresource.org.

Taking steps if you’re ripped off

Suppose you fall for a scam despite your best intentions. You can probably stop a payment (or be reimbursed for merchandise a thief has purchased with your card) by informing your bank or credit card company immediately.

If you give out any personal information — such as your Social Security or Medicare ID number or your credit card or bank account numbers — you should seriously assume that you may be a victim of identity theft. The following can give you excellent advice on what to do next:

  • The Privacy Rights Clearinghouse: This California-based nonprofit consumer organization provides assistance and information to likely or actual victims of ID theft.

  • The Federal Trade Commission: This agency provides guidance on dealing with identify theft (available in English and Spanish).