Are You Being Wrongfully Charged for Medicare Costs?

Are You Being Wrongfully Charged for Medicare Costs?

People enrolled in the Qualified Medicare Beneficiary (QMB) program have their Medicare Part B premiums, deductibles and any copayments or coinsurance covered by Medicaid. Yet we continue to hear reports of beneficiaries being wrongfully charged for all or some of these costs. In many cases, debt collectors repeatedly attempt to collect these types of bills, or send this information to credit reporting companies. Below are a few helpful tips recently sent out by the Consumer Financial Protection Bureau (CFPB), on what to do if you, a client or loved one encounters this scenario.

1. Tell the provider or debt collector that you are enrolled in the QMB Program and can’t be charged for Medicare deductibles, coinsurance, and copayments.

Show your Medicare and QMB or Medicaid cards each time you get medical services or items. If the provider bills you anyway, explain that you are enrolled in QMB and can’t be charged for Medicare costs.  You have the right to a refund for any payments you’ve already made.

2. Call 1-800-MEDICARE (1-800-633-4227) if the medical provider won’t stop billing you, or refuses to issue a refund. TTY users can call 1-877-486-2048.

The agent can confirm that you are enrolled in the QMB Program. Medicare can also ask the provider to stop improper billing and to refund any incorrect payments you made.

3. If you have a problem with debt collection, you can submit a complaint online or call the CFPB at 1-855-411-2372. TTY/TDD users can call 1-855-729-2372.

They’ll forward your complaint to the company and work to get you a response from them.

You can also call our California Senior Medicare Patrol (SMP) at 1-855-613-0780 or contact your local Health Insurance Counseling and Advocacy Program (HICAP) to address and resolve this issue.

Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.