insurance

Don't get scammed by Medicare fraud

While Medicare does provide $250 to help with the "doughnut hole," the money is sent directly to the beneficiary, and no one from the government calls to request Medicare or bank account information. "Remember -- there are no forms to fill out to receive this benefit once you qualify for it," it says on Medicare's website. "Don't give your personal information to anyone who calls you about the $250 rebate check."

People often "come into the program without really knowing much about the program and how it works," says Sandra Colon, the South Florida specialist with Senior Medicare Patrol, or SMP. SMP is funded by the Agency on Aging and is tasked with fraud detection and prevention.

Even when they aren't getting scammed, seniors may unwittingly be participating in one. Fraudsters may offer money, gifts or a free lunch, provided they go to a clinic for medical tests, says Robert Targ, a partner with Diaz Reus Attorneys & Counselors in Miami, the city considered "ground zero" for Medicare fraud. "Medicare is billed for all sorts of sophisticated tests they don't need."

Protect yourself

The first defense for seniors is protecting their Medicare number. Dieker says typically no one from Medicare will call a beneficiary, and a legitimate Medicare representative won't ask for someone's number -- he or she should already have it at hand.

She advises beneficiaries to keep a personal health care journal, tracking medical appointment dates, medications received and tests and procedures conducted. That information should then be compared with the Medicare Summary Notice that comes in the mail each quarter. Charges also can be tracked in real time on Medicare's website.

If something is incorrect, it could be an innocent error -- or it could be fraud. At that point she recommends contacting the SMP, which has offices in each state.

Dieker also cautions beneficiaries to resist the badgering of potential fraudsters. Often Medicare beneficiaries are "isolated, vulnerable and confused. If someone is persistent they feel like they have to act, and feel irresponsible and stupid if they don't."

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