The Third One On This List Might Be The Most Devious Of Them All In How It Scams Social Security And Medicare Beneficiaries
Every year, the Social Security Administration pays out almost $1 trillion in benefits to American citizens. Let the sheer size of that number sink in for a second.
Specific details are impossible to pin down, but no matter how well guarded, any program that gets that big will attract scammers looking to make a quick — and easy — profit. And because Social Security also offers up identification — your Social Security number — that can be used to get money out of accounts that have nothing to do with the program, the incentive for scammers is through the roof.
Let’s examine five of the most dangerous scams dealing with Social Security and its companion program, Medicare. We’ll cover how to identify them, where to report them, and what to do if you fall victim. These scams include:
Attempts To Get You To Enter Sensitive Data Through A Website Link
With a little bit of effort, it’s very easy to make a fraudulent website appear legitimate. Sleek layouts, official logos, and well-written content are usually enough to convince the average person that a site is legitimate.
Unfortunately, all of that is easy to fake.
As we discussed, you should never click on a link that you receive from a suspicious email address. Even if you do, checking to be sure that the URL ends in “.gov” or “.gov/” is critical. Only legitimate government organizations can end their Internet address in “.gov” or have “.gov/” at the end. But remember: if “.gov” is followed by anything but a backslash, it’s likely to be a scam site.
If you still aren’t sure whether a website is legitimate, there’s a third workaround to check the validity: Simply cut and paste the address into a Google search and see what pops up. Often, people will have already posted about questionable or fraudulent people trying to contact them. Reading through these posts should give you a better idea as to whether you’re dealing with fraud.
While this method can be an easy way to identify fraudulent websites, it is not a reliable way to guarantee the site is safe. In other words, if you paste the URL into a search and no suspicious evidence is found, that alone is not enough to guarantee that a site is safe.
If you’d like to report fraudulent websites, you can visit USA.gov’s scam site here.
Information Needed To Check Medicare Eligibility
One must provide identification, and this includes a full name, address, date of birth, and Social Security number.
Some questions may involve the work history of the spouse or partner to see if one or both may be eligible for Social Security benefits and Medicare.
The terms spouse and partner will also include divorced and separated couples because the work history of one spouse or partner can benefit the other.
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When Can I Go For A Yearly Wellness Visit
You can start getting Medicare wellness visits after youve had Medicare Part B for at least 12 months. Keep in mind youll need to wait 12 months in between Medicare wellness visits.
Do I need to have a Welcome to Medicare visit first?
You dont need to have a Welcome to Medicare preventive visit before getting a yearly wellness visit.
If you choose to get the Welcome to Medicare visit during the first 12 months you have Medicare Part B, youll have to wait 12 months before you can get your first yearly wellness visit.
What about cost?
With Medicare Part B, you can get a wellness visit once a year at no cost to you. Check to make sure the doctor or nurse accepts Medicare when you schedule your appointment.
If you get any tests or services that arent included in the yearly wellness visit , you may have to pay some of those costs.
Write To Insurance Companies
You may write your insurance companies with questions that you have about your coverage. If possible, type up your letter and make sure to keep a copy that indicates the date on which you mailed it.
If you arent able to type up your questions, make sure to write in clear, concise print, leaving plenty of space in between your questions. Be sure to include your contact information in any correspondence that you mail to your healthcare provider.
Before sending mail that contains important documents or your private health information, call ahead and make sure that you have the correct contact information. Mail that is sent to the wrong address is not always forwarded to the right place, especially in places that receive a high volume of mail.
Addresses for major insurance companies that provide Medicare policies:
If your ability to talk on the phone is limited because of a health condition, you can still reach out to Medicare. TTY users can call 1-877-486-2048 to reach a hotline compatible with their devices.
Centers for Medicare & Medicaid ServicesOffices of Hearings and Inquiries 7500 Security Boulevard, Mail Stop S1-13-25Baltimore, MD 21244-1850
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Is There A Medicare Advantage Phone Number
Medicare Advantage plans are offered by private insurance companies, so you may want to call your plan provider directly with any questions about your Medicare Advantage plan. For general information about Medicare coverage, you can still call 1-800-MEDICARE, even if you are enrolled in a Medicare Advantage plan.
Are you considering switching to a Medicare Advantage plan, changing your current Medicare Advantage plan or enrolling in Medicare Advantage for your first time? A licensed insurance agent can help answer any questions you have about Medicare Advantage plans and can help you compare plans that may be available in your local area.
Speak with a licensed insurance agent today by calling 1-800-557-6059 TTY Users: 711 24 hours a day, 7 days a week.
About the author
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.
Where you’ve seen coverage of Christian’s research and reports:
Reporting A Medicare Scam
If someone has tried to scam you or if you have been scammed, use the phone numbers below to report the incident.
- Centers for Medicare and Medicaid Services: 1-800-MEDICARE
- South Dakota Attorney General: 1-800-300-1986
- Social Security Administration: 800-772-1213
- Iowa Senior Medicare Patrol: 800-351-4664
- Nebraska Senior Health Insurance Information Program : 800-234-7119
For information, you can visit the Medicare website.
If patients report any form of Medicare scam to you, kindly remind them:
- Sioux Center Health or insurance representatives do not make unsolicited calls asking for your Medicare ID number, bank or credit card details, Social Security number, or other personal information.
- The Social Security Administration and Centers for Medicare and Medicaid Services do not call customers to update their information. They will never ask for your financial information.
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Those Age 65 Typically Get Premium
Medicare Part A is premium-free to those 65 and older who are also eligible for monthly Railroad Retirement Board or Social Security retirement payments because they worked and paid taxes during all 40 Quarters of Coverage.
This is one basis of eligibility for premium-free Medicare Part A. However, some people receive Social Security benefits before they turn 65.
The Social Security system automatically enrolls in Part A those individuals who receive Social Security or disability benefits for at least four months before the month of their 65th birthday. When this is the case, Part A coverage begins on the first day of their 65th birthday month.
How To Protect Yourself From Medicare Scams
Guard your personal information and contact Medicare if you have any questions or concerns. A good rule of thumb is not to give out potentially sensitive information over the Internet or phone.
However, if you have called to join a Medicare Advantage Plan or Prescription Drug Plan , you may be legitimately asked to provide identifying information over the phone. You may also be asked for this information if you use the online Medicare Plan Finder tool to shop for or enroll in Part C or Part D Plans. Be aware that none of these entities should ever ask for financial information like credit card or bank account numbers over the phone.
According to Medicare.gov, beneficiaries should only give private information to their doctors, insurers acting on their behalf, and trusted people in the community who work with Medicare, such as State Health Insurance Assistance Program counselors.
You may always contact the customer service number on the back of your Medicare card if you have any questions or concerns. If you think you may have provided personal information to a fraudulent caller or believe you are a victim of identity theft, report it to the Federal Trade Commission online at IdentityTheft.gov or by calling the ID Theft Hotline at 1-877-438-4338.
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Understanding Medicare Based On Disability
Persons entitled to monthly Social Security or Railroad Retirement Board benefits are automatically entitled to Medicare Part A after twenty-four months of disability benefits.
If disabled government employees are not otherwise eligible for Social Security Benefits through their history of work or contribution to payroll taxes, they get automatic eligibility for Part A after twenty-nine months of receiving disability benefits.
There is a special rule for People with Lou Gehrigs disease. They get eligibility with no waiting period upon the first month of RRB or SSA benefits.
Child disability eligibility begins the month of the 20th birthday except for ALS which is set for age 18.
Those diagnosed with End-Stage Renal Disease are typically eligible to begin Medicare on the first day of the fourth month they receive dialysis treatments.
In addition, to get Part A premium-free, those with End-Stage Renal Disease must also meet one of three below-stated conditions:
How To Report A Medicare Call
You can report a fraudulent call from someone claiming they worked for Medicare by going to the FTC Complaint Assistant.
You can help protect yourself from fraudulent activities by never offering credit card or personal information to anyone. The more hands-on your personal information, the more likely you are to receive scam calls.
Many times, when you sign up for new websites, apps, or services, youre sharing personal information. Read the fine print when enrolling in services, some sites sell your phone number and email. Under no circumstances should you be giving out your personal or credit card information over the phone, especially when youre unsure of the person on the other end of the line.
Although it is daunting, looking at the privacy policies before you share your personal information can save you in the long run. Some websites sell your email address and phone number to third parties, so be careful!
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General Eligibility For Medicare
Medicare eligibility goes hand-in-hand with Social Security eligibility.
Individuals in the below-listed categories can get Medicare coverage.
- Persons age 65 or older eligibility begins four months before their 65th birthday
- Disabled persons 64 and under can qualify if receiving disability benefits from Social Security or the RRB for 24 months
- Persons with end-stage renal disease can get premium-free Medicare Part A. Eligibility based on End-Stage Renal Disease requires current dialysis treatment, a kidney transplant, and filing an application for Medicare.
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Protect Yourself From Insurance Billing Scams:
Review your Humana SmartSummary® and Explanation of Benefits carefully. If anything looks concerning, contact Humana immediately.
Current insurance billing scams include:
- Billing for healthcare services you never received
- Sending medical services or equipment, such as lab tests, knee or back braces, foot baths and pain creams that are unnecessary and were not ordered by your physician
- Billing for a different, more expensive service than the one you may have received
- Using your healthcare insurance information without your consent to obtain services for an uninsured person
- Attempting to enroll you in an insurance plan without your consent
Advantages Of Dual Eligibility
Dual Eligibility opens a path for Medicare savings programs such as the QMB for the benefit of low-income Medicare members. Medicaid pays expenses, premiums, and costs consistent with their budgets. The goal is to get the most favorable situation for a low-income person getting health benefits through Medicare.
A small boost from Medicaid can add a much larger amount of needed benefits from Medicare. Medicare Part B leaves a standard cost share amount of twenty percent for the consumers payment. Members with dual eligibility can get some coverage of the cost share gap from Medicaid.
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A Phishing Email To Get Your Information
One of the key tools the SSA has set up to manage your benefits is the mySocialSecurity portal. You can keep your information, manage your benefits, and contact officials using this single site. It’s incredibly convenient.
But it’s also easy to exploit — if scammers have the right details. If you haven’t set up such an account, an identity thief can use your information to set one up for you, make it impossible for you to sign in yourself, and start receiving benefits you’re entitled to — all without your knowledge.
Such scammers often using a technique called “phishing.” As the SSA says in its warning, phishing is “the practice of using social engineering techniques over email to trick a recipient into revealing personal information, clicking on a malicious link, or opening a malicious attachment.”
The phishers will send out an email telling you that there’s something wrong with your account. Perhaps they’ll say you’re entitled to extra benefits, or that your account will be frozen if you don’t respond immediately, or that you can only get your COLA-based increase in benefits by visiting a particular site. The bottom line is that they want to get your adrenaline flowing to induce you to act before thinking.
Often, such emails will ask you to send back one of the key pieces of information mentioned, or they’ll ask you to click on a link where you can input such information.
Already Disclosed Information To An Unknown Party
If you have already disclosed personal financial information to an unknown party, you may be at risk of identity theft. There are certain steps that you can take to further protect yourself including:
1. Place a one-call fraud alert on your credit report with Equifax, Experian, and TransUnion .
- With a fraud alert, a business must verify your identity before extending a new credit account.
- Fraud alerts are free and last for 90 days after being reported, which can then be renewed. If your identity has been stolen, you can opt for an extended fraud alert which lasts seven years.
- Fraud alerts need to only be reported to one of the three agencies who are required by law to notify the other two.
2. Consider placing a security freeze on your credit reports with Equifax, Experian, and TransUnion .
- With a credit freeze, no one can access your credit report to open a new account. As the one putting the freeze, you will receive a PIN number to use each time you want to freeze, unfreeze, or refreeze your account. Make sure you secure your PIN.
- To put a freeze, you need to contact each of the three agencies separately and provide all the information requested. You will then receive confirmations from each agency along with your PIN.
4. Register for the National Do Not Call List
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How The Scam Works
Medicare and Social Security beneficiaries across the country report receiving calls from scam operators , who claim to represent Medicare, Social Security, or an insurance company. These callers claim that new Medicare, Social Security, or supplemental insurance benefits cards are being issued or that the beneficiaryâs file must be updated. The scam artist asks the citizen to verify or provide their personal banking information, which is then used to commit theft.
The caller may be extremely aggressive, calling over and over, and at all times of the day, in an attempt to wear down the potential victim. These criminals will say anything to try to gain a personâs trust. In some cases, the criminals may have already obtained some limited personal information about the citizen, such as his or her name, address, or even Social Security number, which the criminal then uses to try to make the call seem legitimate. In other cases, the callers may claim that they can improve the benefits. Do not believe these claims, and do not carry on a conversation with the caller. Instead, if you receive a call asking you to disclose your bank account or other financial information, hang up immediately. These are criminals, and by speaking with the callers, even to ask them to stop calling, they may be encouraged to continue calling your telephone number.
Centers for Medicare and Medicaid Services7500 Security Boulevard