by Katie Ostini, State Health Insurance Program coordinator
Every year, Medicare Fraud Prevention Week shines a spotlight on one important message: protecting your Medicare benefits protects your health, identity, and financial security. Observed June 1–5, the week raises awareness about healthcare fraud and empowers older adults, caregivers, and family members to recognize and stop scams before they cause harm.
The timing is intentional. The date “6/5” symbolizes turning 65 — the age when most Americans become eligible for Medicare. It serves as a reminder that understanding Medicare and safeguarding your personal information should begin as soon as coverage starts.
Why Medicare Fraud Matters
Medicare fraud is far more than a financial issue. Each year, healthcare fraud costs Medicare billions of dollars, draining resources intended for legitimate medical care and services.
But the impact doesn’t stop there. Fraud can directly affect beneficiaries in serious ways, including:
- Medical identity theft
- Incorrect information added to health records
- Denial of medically necessary services
- Billing for services or equipment never received
- Exposure of personal and financial information
When scammers gain access to a Medicare number, they may use it to submit false claims or obtain medical services under someone else’s identity. This can create long-term problems that are difficult to correct.
Common Medicare Scams to Watch For
Scammers frequently target older adults because Medicare coverage can be confusing and highly valuable. Knowing the warning signs can help prevent fraud before it happens.
“Free” Genetic Testing Offers
One common scam involves unsolicited offers for “free” genetic testing kits. Scammers may approach beneficiaries at health fairs, by phone, online, or even door-to-door.
They often claim the test is covered by Medicare and may pressure individuals to hand over their Medicare number.
In many cases:
- The tests are medically unnecessary
- Providers bill Medicare for expensive services
- Personal health information is compromised
Remember: Medicare generally does not call beneficiaries offering free tests or screenings.
Durable Medical Equipment (DME) Scams
Fraudsters may contact beneficiaries about “free” braces, wheelchairs, walkers, or other medical equipment.
These scams often involve:
- Telemarketing calls
- Television advertisements
- Online forms requesting Medicare information
After obtaining a Medicare number, scammers bill Medicare for equipment that was never ordered or delivered.
Fake Medicare Card Renewal Calls
Another frequent scam involves callers pretending to represent Medicare.
They may claim:
- Your Medicare card is expiring
- A new card is required
- You must “verify” your Medicare number immediately
In reality, Medicare will not call unexpectedly to ask for personal information, banking details, or payment over the phone. If someone pressures you to act quickly or threatens loss of benefits, it is likely a scam.
Prevent, Detect, and Report Medicare Fraud
Protecting yourself starts with a few simple habits: Prevent, Detect, Report.
Prevent Fraud Before It Happens
Treat your Medicare card like a credit card.
That means:
- Never share your Medicare number with strangers
- Avoid giving information to unsolicited callers
- Be cautious of “free” offers requiring Medicare details
- Only share information with trusted healthcare providers
It’s also wise to hang up on suspicious calls and verify requests independently through official channels.
Detect Suspicious Activity Early
Review your healthcare statements regularly.
Beneficiaries should carefully examine:
- Medicare Summary Notices (MSNs) for Original Medicare
- Explanation of Benefits (EOBs) for Medicare Advantage or Part D plans
Look for:
- Charges for services you never received
- Duplicate billing
- Medical equipment you didn’t order
- Visits to providers you’ve never seen
Even small discrepancies can signal fraud or identity theft. Caregivers and family members can play an important role by helping loved ones review paperwork and identify unusual activity.
Report Suspected Fraud
If something seems suspicious, report it promptly.
You can:
- Contact your healthcare provider to clarify charges
- Call Medicare directly
- Reach out to your local Senior Medicare Patrol
Reporting fraud helps protect not only your benefits, but also other beneficiaries who may be targeted by the same scam.
How Caregivers and Families Can Help
Family members and caregivers are often the first line of defense against Medicare fraud.
You can help by:
- Organizing medical paperwork
- Monitoring statements and billing notices
- Discussing common scams with loved ones
- Encouraging skepticism about unsolicited offers
Open conversations about fraud prevention can reduce confusion and help older adults feel more confident handling suspicious situations.
Find Local Support and Resources
Older adults, caregivers, and family members are encouraged to contact their local Area Agency on Aging for educational programs, assistance, and fraud prevention support.
You can also visit the Senior Medicare Patrol Center at https://smpresource.org find local events, educational materials, and reporting resources in your area.