Watch Out for These Scams During Medicare Open Enrollment!

Joanna received a call last week from a man claiming to be from the Centers for Medicare and Medicaid Services (CMS). Joanna was told that she was entitled to money back because of “changes” that were made by Medicare. The man on the phone asked for not only Joanna’s Medicare number, but also her bank account information, for a supposed direct deposit. Joanna knew that it didn’t sound legitimate, so she hung up. However, many who receive these phone calls are duped by these unscrupulous tricksters.

For those on Medicare, Oct. 15 to Dec. 7 means open enrollment. For scammers, it has unfortunately become a time to steal unsuspecting seniors’ money and identities. Although Medicare scams occur year-round, the Federal Trade Commission (FTC) warns that they dramatically increase in the weeks leading up to and throughout the annual window for participants to make changes to their health and prescription coverage.

The con artists associated with these scams are not necessarily bent on taking cash directly from their victims. This time around, they are looking to extract social security numbers from seniors.

Keep an eye out for these open enrollment scams:

1. New card cons. In phone calls, emails, or front-door visits, you’re told that Medicare is issuing new cards, and to get yours, you need to provide identifying information such as your Medicare number, birth date or even financial account numbers. Identity theft is the real goal.

What to know: Medicare isn’t issuing new cards and its employees don’t contact participants through unsolicited calls, emails, or visits. They won’t ask for personal identifiers unless you contact the agency yourself.

2. Refund rip-offs. Scammers claim you’re entitled to money back because of “changes” or “enhancements” by Medicare or private insurers, or because of purported lawsuits or actions by government agencies. In these schemes, the goal is to get not only your Medicare number, but your bank account information for a supposed direct deposit.

What to know: If you’re really entitled to a refund, a check will be sent directly to you. You won’t have to “prove” or provide anything. If you get Social Security, CMS already has your direct-deposit account on file, so Medicare wouldn’t ask for it.

3. Pretending to be someone they are not. In seeking your personal information, con artists may also claim to be from state or local health agencies, doctor’s offices or hospitals, or an official-sounding but fake organization, such as the National Medical Office. And they may try to trick you by manipulating your caller ID screen.

What to know: Never trust caller ID. Scammers can easily make it display whatever identity and phone number they choose, thanks to “spoofing” products that are now available. Also, don’t be taken in if callers have personal info about you. Scammers have been known to contact Medicare patients and accurately give the names and addresses of their doctors. It’s unclear how they get the information. If you think a call may be genuine, hang up, look up the agency’s number yourself and call it back. For Medicare, it’s 800-633-4227 (for TTY callers, dial 877-486-2048 toll-free).

4. False freebies. You get a call offering you free medical supplies or a health checkup. The caller may even know something about your medical condition. Or, you’re invited to go somewhere for a complimentary checkup.

What to know: Assume that an unsolicited call promising supplies for diabetes or other medical conditions is another attempt to collect your Medicare/Social Security number. Or to soften you up for pitches for overpriced goods later. Plus, you may be told your credit card is needed for “shipping charges.”

5. Complimentary checkups — offered by traveling clinics or temporary storefronts — can also be just an effort to get you to reveal personal identifiers. There are legitimate ones too, of course, so if you’re thinking of going, first check out the organization that’s offering them.

6. Supplemental swindles. Open enrollment is prime time for insurance sales people to pitch supplemental policies that they promise will save you thousands in out-of-pocket costs. While there are many legitimate policies on the market, not all make sense for everyone. And it’s not unknown for sales people to push this kind of insurance with scare tactics, free lunch seminars, and false claims of being with a government agency.

What to know: As with investment scams, “free lunch seminars” are often a high-pressure pitch for insurance that may be wrong for you but right for the salesman. Be aware that private companies — not the government — sell Medicare Advantage and Medicare Supplement plans (also called Medigap plans).

7. Billing bilking. Told that something isn’t “usually” covered by Medicare, but there’s a way around the rule? Or that you can get a kickback for providing your Medicare number or undergoing unnecessary treatment? You may get this kind of offer if you go to a “free” medical checkup offered by a shady group.

What to know: No matter how it’s said, this is fraud, and possible criminal charges can be filed against both you and the other person. Medicare fraud is a huge problem, costing taxpayers about $60 billion a year. When in doubt, check with Medicare or your supplemental insurance provider. You should only sign a release form allowing others to make Medicare decisions on your behalf if the form’s been carefully reviewed by you, a trusted family member or friend, or an attorney.

8. Bogus Medigap plans sold by con artists. They will call you and claim that supplemental coverage is mandatory.

What to know: Supplemental plans and prescription drug benefits are not mandatory. They are completely voluntary, and they are not marketed via calling campaigns or in-home visits. You can sign up for supplemental coverage yourself during your initial enrollment period. For most Medicare enrollees, initial enrollment starts three months before your 65th birthday.

How to Avoid Medicare Scams

During the next couple of weeks, be on the alert for anyone who claims to be a Medicare sales representative, because that job does not exist. Medicare officials don’t go to door-to-door and will only correspond with recipients via phone or email, if prompted to first. Official insurance communication is always mailed.

Also remember the easiest step to avoid a Medicare scam: never reveal your card number or other personal health and financial information to anyone who’s not a bona fide member of your health care team.

Ignore the scammers by hanging up on suspicious phone calls, as Joanna in our example did, and by disregarding door-to-door visits. A “No Soliciting” sign for your door is a good deterrent for door to door fraudsters and people trying to sell you goods and services, if you find them to be bothersome.

In the end, seniors who believe that they’re are being targeted by con artists in connection with Medicare should call 1-800-MEDICARE to report the activity.

Planning to Protect Loved Ones

Protecting seniors from scams is very important, which is why we continually share information about current scams and how you can protect yourself. It is also very important to plan for your future and for your loved ones. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long- term care, please contact us to make an appointment for a no-cost introductory consultation.

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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