Senior Medicare Patrol volunteers are often the first to identify new Medicare scams because they meet one-on-one with Medicare beneficiaries. Here are some of the top scams they’re seeing and what you can do to protect yourself:
1. A new round of COVID fraud
During the height of COVID-19, criminals offered free coronavirus tests as a way to gather people’s Medicare numbers and other personal information and file fake claims in their name.
“Somebody calls unsolicited, offering to send a COVID test,” says Tiffany Erhard, New York state Senior Medicare Patrol director. “They aren’t sending real tests, but they’re billing as if they are, and they’re taking the person’s information to use it unscrupulously or sell it.”
After a major investigation, the Department of Health and Human Services Office of Inspector General charged 18 defendants in nine federal districts across the U.S. for making more than $490 million in COVID-related false billings.
The scam died down but resurfaced near the end of the public health emergency, which officially expired May 11, 2023. Senior Medicare Patrols reported seven COVID complaints in January 2023, then suddenly had 72 in April.
“They’re using the end of the public health emergency to try to get personal information and Medicare numbers,” says Director Rebecca Kinney of the Administration for Community Living’s office of health care information and counseling. Her division of the U.S. Department of Health and Human Services (HHS) finances the Senior Medicare Patrol program.
2. Bills for diabetes supplies
Volunteers in the Lone Star State report an increase in diabetes supply scams, says Diane Nguyen, program director for the Texas Senior Medicare Patrol.
Claims for continuous glucose monitoring devices are showing up on Medicare summary notices for people who don’t have diabetes and didn’t receive the device, she says. The scammers charge Medicare.
“The only reason we are seeing these cases is that people are checking their Medicare summary notices,” Nguyen says.
3. Flimsy medical equipment
This is a long-standing Medicare problem.
Con artists offer you a knee brace or other medical equipment if you give them your Medicare number. You’ll get a cheap brace in the mail that you could have purchased at a drugstore, or you might receive no brace at all.
The criminals charge Medicare for an expensive brace and make other unauthorized charges with your number. In 2019, Senior Medicare Patrol volunteers helped uncover an international fraud ring that had charged Medicare $1.2 billion in false durable medical equipment claims.
4. Bogus genetic testing
Even though the Senior Medicare Patrol helped uncover a $2.1 billion genetic testing scam, phony pitches are still an issue.
Someone at a health fair might offer to swab your cheek and test the sample to determine whether you have a genetic propensity for cancer. You need to give your Medicare number to cover the test, the con artist says.
In reality, Medicare rarely covers genetic testing. Scammers use the ploy to get your Medicare number and make all sorts of fraudulent charges in your name.
“Many times, they would not get the test [results] at all,” Maria Alvarez, executive director of New York Statewide Senior Action Council, says of Medicare beneficiaries. The nonprofit runs New York’s Senior Medicare Patrol program. “They [the scammers] would just discard the swabs and use the Medicare number.”
5. Hospice fraud
Much like a 2021 California case, scammers enroll people who aren’t terminally ill in hospice without their knowledge. The Medicare beneficiaries instead may believe they are signing up for extra benefits programs, such as home cleaning, in-home nurse visits or a shower chair.
“They have a doctor that works with them and is ‘diagnosing people’ and sending paperwork to Medicare and claiming thousands of dollars that Medicare pays for in hospice,” says Carolina Oehler, the Senior Medicare Patrol liaison for the Kern County Aging & Adult Services Department in California.
The criminals receive payment from Medicare for hospice services never delivered. The Medicare beneficiary has legitimate nonhospice claims denied.
6. Medicaid ‘unwinding’
“Scammers are using that as a way to get to people,” Kinney says. “We’ve heard cases of scammers calling Medicaid beneficiaries and telling them they need to pay them, so they don’t lose Medicaid. Or they’re using it to get [beneficiaries’] personal information.”
7. Next generation Medicare cards
Medicare saw a big increase in card scams in 2018 when the government sent every beneficiary new cards that didn’t include Social Security numbers. Senior Medicare Patrol volunteers are seeing some card scams resurfacing.
“We had an influx of people reporting to the SMP volunteers that they were receiving unsolicited calls from people who were falsely claiming to be a Medicare representative and offering a new card, maybe a plastic card with a chip,” Erhard says.
The scammers ask for money for the new card or ask for your Medicare number. Medicare won’t call you to offer a new card, its cards are paper stock and you can print an official card from your online Medicare account anytime.
What’s more, Medicare won’t ever call you without scheduling an appointment ahead of time.
8. Telemedicine sessions
“You may get a call from somebody who is trying to sell you something, and then you’ll get billed for a telehealth consult,” says Jean Stone, a 40-year Centers for Medicare & Medicaid Services employee who in retirement is a New York Senior Medicare Patrol volunteer.
Sometimes the fraud is tied to fake genetic testing or flimsy medical equipment, and the criminals will add a telemedicine appointment to the Medicare bill.