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California Health Advocates

You Can Help

Help keep criminals out of Medicare

Let’s make Medicare stronger for all of us and keep you and your loved ones safe.

Fraud costs Medicare billions of dollars each year and fundamentally damages theMedicare program by raising the cost of healthcare for everyone. It is vitally important to root out fraud, and Medicare needs your assistance!

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You Can Help By

Following the Prevent, Detect, Report guidelines below.

Sharing this informationwith your loved ones.

Volunteering withSenior Medicare Patrol (SMP)

Checking your Medicare Summary Notices regularly.

Subscribing to our newsletter, alerts& webinars (see below).

Visiting California Health Advocates for Medicare news.

Prevent

You can prevent Medicare fraud by protecting your personal information. Here are some tips.

Protect your personal information. Guard your Medicare, Social Security, and bank account numbers carefully. Only give these numbers to people you know and trust. Please don’t give these to anyone over the phone or in person unless you initiated the conversation, know the person, and write down their name, number and title.

Only take it to doctor’s appointments, visits to your hospital or clinic, or trips to the pharmacy. And don’t leave your Medicare number in a phone message or email.

Watch for incentives like “It’s free!” or “We know how to bill Medicare.”

Watch out for door-to-door salespeople trying to sell you medical supplies not ordered by your doctor. Medicare will never call or visit to sell you anything.

Don’t let anyone convince you to see a doctor for a service you don’t need.

Keep a healthcare journal or calendar.

Detect

Even when you do everything right, there is a chance that you could be a target of fraud. Detect fraud by examining both your Medicare Summary Notice (MSN) you receive from Medicare after your claims are paid and the Explanation of Benefits (EOB) you receive from your Part C and/or Part D plan. Access your Medicare account at medicare.gov.

  1. Did you receive all the services/prescriptions listed?
  2. Were you billed for something you didn’t get?
  3. Did your doctor order these services?
  4. Do the prescriptions listed match your medications?
  5. Were you billed for the same thing twice?
  6. Confirm the dates of the services/prescriptions are correct
  7. Are the dollar amounts shown the same as those on your bill?

Report

If you suspect fraud in your healthcare, report it!

  1. Call the health care provider listed on the Medicare Summary Notice or Explanation of Benefits and inquire about the questionable item(s). In many cases, it may result from a billing error, which can easily be corrected.
  2. If your question is not resolved and you still think the charges are fraudulent, call Senior Medicare Patrol: 1-855-613-7080.
  3. You can also contact the U.S. Department of Health and Human Services’ Office of Inspector General: 1-800-447-8477. Your SMP counselor will help you determine if this step is necessary.

Have your Medicare Summary Notice and/or Part D Explanation of Benefits ready when you call.