Thursday, May 16, 2024

Does Medicare Make Phone Calls

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Navigating Medicare can be complicated, but one big change recently introduced requires that you do absolutely nothing beyond opening an envelope. In fact, doing just about anything else could open the door to a damaging identity-fraud scam.

Medicare is mailing out new identification cards to 59 million Americans this year and in early 2019. The old Medicare cards use Social Security numbers as identifiers the new cards use a unique, randomly assigned number. The changeover is part of a sweeping federal initiative to bolster defenses against fraud by reducing the widespread use of Social Security numbers as identifiers throughout the government.

Trouble is, phone scammers are taking the card replacement program as an opportunity to target seniors. The most common trick is to call Medicare enrollees and tell them they must pay for their new cards, then request their bank account information or Social Security numbers.

That opens the door to identity theft.

We are hearing from people who have been told their Social Security payments will stop coming unless they give the caller their personal information, or that they cant send the new Medicare card unless they get a payment, said Amy Nofziger, a fraud expert with AARP.

Simple, right?

Unfortunately, weve got a failure to communicate, to paraphrase the 1967 film classic Cool Hand Luke.

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Before You Call The Medicare Phone Number

Before calling 1-800-MEDICARE, have your Medicare card ready in case the representative needs to know your Medicare number. If you are calling with a question about a claim or a bill, have the bill or the Explanation of Benefits handy for reference.

It can also be helpful to keep a pen and paper ready to write down any important information your Medicare representative may share, such as additional phone numbers, dollar amounts, dates and more.

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What You Should Know:

  • MANA records have not been breached.
  • Scammers can appear to be calling from a MANA number.
  • Medicare will not contact you over the phone to sell you drug plans or services.

The phone call can even appear with your doctors office phone number and they may use persuasive language like, your doctor ordered this test or service. The caller attempts to get your social security number, bank information, or Medicare numbers to use to make fraudulent charges.

You Can Receive Early Access To Special Vaccines

Another Medicare Fraud: Calling Seniors

Pandemic-related Medicare scams have run rampant since the introduction of COVID-19 vaccines and testing kits.

In these scam calls, fraudsters claim that youâre eligible for a special vaccine or can be sent home testing kits â if you provide your Medicare number and other personal information first. Many of these scam calls start off as robocalls or text message scams, meaning that scammers can target thousands of people every single day.

ð How to identify a COVID-19 Medicare scam call:
  • Callers offer you âspecialâ medical treatments or COVID-19 vaccines that arenât available to the general public. This is a classic social engineering tactic in which scammers use your fear of the pandemic to get you to act without thinking.
  • Youâre asked to pay out of pocket for early access to a vaccine or treatment. Medicare doesnât offer special treatment for people who pay extra. If anyone claiming to be from Medicare asks for payment, itâs a scam.

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Medical Alert Device Scam

How the Medical Device Scam Works: Medical alert systems with fall detection are now the subject of a new scam: the Medical Alert Device trap aka the Emergency Alert System Rip-off. Beware, the best medical alert systems for seniors never come with a hook. This fraudulent activity occurs mostly in the United States, but there Medical Alert Device Scam Read More »

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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How Do Medicare Scam Calls Work

Medicare scam calls occur when criminals call you pretending to be from Medicare or a legitimate healthcare insurance provider. Theyâll often use phone spoofing technology to manipulate your Caller ID into displaying that theyâre calling from Medicare or a local phone number.

If you answer the phone, hereâs what happens:

  • First, scammers use your personal information that they found online to build trust. They could have your name, address, date of birth, or even your SSN.
  • Next, theyâll create a sense of urgency to try and get you to act emotionally. Scammers might claim your Medicare card is going to expire or that youâre eligible for a special plan with lower premiums.
  • Finally, theyâll ask you to âverifyâ your Medicare number or other sensitive information. They might also pressure you to enroll in a fake or misrepresented plan, or convince you to send them money to pay for services.

Even worse, criminals can use your information to steal your identity, target you with further scams, or drain your bank account through financial fraud.

Always remember: Medicare will never call you directly unless you have called them with a request. If you get an unsolicited call from someone claiming to be from Medicare, itâs a scam.

Medicare scam calls are getting more sophisticated. If you hear any of the following pitches, youâre dealing with a scam.

Does Medicare Call Your House Or Is This Medicare Fraud

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Hello Toni:

I have a problem and I need your help. I am a 79-year-old female who lives alone in Meyerland. Yesterday, a representative from Medicare called me asking all types of personal questions. I told them, I did not give personal information over the phone. Im concerned this could be a scam, but then if it was Medicare, Im concerned I could have made a mistake. Can you please advise me what I should do or where I could call to see if Medicare is trying to contact me? Thanks in advance Alice from Houston, TX

Dont Worry Alice:

You can relax because you were correct not to give your personal information over the phone due to the fact that Medicare or even Social Security does not randomly call your home or office and ask for your personal information. Medicare already has all of the information they need about you. Medicare or Social Security will never call you! They generally will send you a letter to let you know you need to contact them.

Here are a few tips to help protect you against Medicare fraud:

Do not carry your Medicare card with you. Keep it in a safe place.

Never give your Medicare or Social Security number to strangers, especially those who call you on the phone or come to your door. Just like you tell your grandkids not to talk to stranger, you need not talk to them either. Play the Stranger Danger game.

Do not accept offers from door to door sales people. Watch out who you let in your house.

Never sign a blank form.

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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:

Aetna Inc.

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

How To Report Medicare Fraud

The first thing to do when you suspect fraud is to check with your Medicare plan provider. It may be a simple mistake or misunderstanding.

If you still think that the charge to Medicare is for a service or supply you did not receive, then you can call the Medicare helpline to report it . also offers some more tips for preventing fraud online.

You can also . SMP workers and volunteers can help you determine if you have been a victim of fraud. If you have, they will forward your complaint to government investigators.

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The Menu Of Options At 1

Before you dial, be prepared with a list of the topics you want to talk about and questions you need answered. Make sure to have your Medicare number and if you are inquiring about a claim or appeal, its helpful to have your most recent Medicare Summary Notice available.

The representatives at 1-800-Medicare can help you with claims and appeals issues if you have Original Medicare. You should contact your insurer directly about claims or billing issues if you have Medicare Advantage or Part D coverage, or if you need to check on claims that are being processed by your Medigap supplement. If you would like someone else to speak on your behalf or represent you in an appeal, you will need to give a verbal authorization to the Medicare agent.

When you reach the menu, you will be greeted by a Yes or No question asking whether you are calling about a processed or denied claim. If you reply Yes you will be prompted to supply your date of birth and other identifying information. If No, you will hear the following menu that will route your call to an agent based on the reason youre calling.

Do Medicare Providers Make House Calls

Does Medicare Call You at Home

House calls are making a reappearance in many regions of the United States, according to the Washington Post. A growing number of these house calls are from Medicare providers â like nurse practitioners, home health aides, physical and speech therapists, and doctors. Normally, of course, you either go to a doctorâs office or clinic, or stay in a nursing home or other facility, to see a Medicare provider.

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Beware Of Medicare Scams

Please be aware of growing national scams targeting Medicare patients. MANA clinics have had several reports from patients about calls they are receiving in regards to free genetic testing in relation to cardiac/hypertension, as well as offers for free back braces. These are known national scams and MANA records have not been breached.

Medicare Scam Phone Calls That Seniors Should Avoid

While we choose to believe in the good in people, itâs always best to be cautious just in case. Seniors receiving Medicare are commonly targeted by scammers who are on the hunt to steal identities, money, or more. Medicare scam phone calls specifically ramp up during Medicare Open Enrollment, which takes place annually, October 15 â December 7.

As we approach this important time, it is vital that you are aware of what Medicare scam phone calls are out there and what to do if you receive them, so that you can better protect yourself and your loved ones.

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Full List Of Medicare Scams Below

The range of schemes could be: Medicare scam calls, Medicare genetic testing, bogus medical alert systems, Medicare Advantage scam, fake medical alert devices, Medicare Coverage Helpline scam, and many other types of Medicare abuse.

There are many cases where patients like yourself dont know the whole story, yet official-looking authorities make you into a victim without you realizing. Read the full list of Medicare scams below and comment.

Report Medicare Fraud Or Abuse

Medicare Fraud: Shut It Down (:30 seconds)

If you suspect you have been contacted by a scammer, or have any concerns about possible fraud, report the fraud to Medicare at 1-800-MEDICARE or your local Senior Medicare Patrol . The SMP program, funded by the U.S. Administration for Community Living, helps Medicare beneficiaries protect themselves from Medicare fraud, errors, and abuse and detect and report them when they occur. To find your local SMP visit: or call 1-877-808-2468.

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Hard Facts About Medicare

Here are some important things for seniors to know about how Medicare and the Social Security Administration function.

  • Medicare generally wont call you, except in limited circumstances. One such exception is if you have called 1-800-MEDICARE and requested a return call.
  • Medicare will never call or come to your home uninvited to sell products or services.
  • SSA representatives may call Medicare beneficiaries if they need more information to process applications for Social Security benefits or enrollment in certain Medicare Plans, but, again, this is rare.
  • If a phone call is needed, youll receive an official letter from the SSA to arrange a telephone interview.
  • Medicare cards do not expire, so be wary of someone saying they need to send you a new one.
  • If your card is lost or destroyed, contact the SSA directly to request a replacement. If you think someone else is fraudulently using your Medicare card, then call Medicare directly at 1-800-MEDICARE .

Watch Out For Bogus Medicare Plans

Criminals may try to entice you with phony Medicare plans, products, benefits and services. The real aim is to get your Medicare number. Check directly with the plan provider or use the Plan Finder at to verify any plan you are considering. If its not there, it may not be legitimate.

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Can I Call Medicare For Help With My Coverage

You can call Medicare anytime for help with your coverage. The number to call is 1-800-MEDICARE . The TTY number is 1-877-486-2048.

This phone number is meant to be a general resource for questions you have about your Medicare coverage. You can check the status of your claims, inquire about your premium and deductible costs, and more.

Here are other important phone numbers for issues relating to Medicare benefits:

  • Your State Health Insurance Assistance Program can give you personalized counseling as you choose the Medicare and health insurance options that are right for you. These programs give advice based specifically on the state in which you live. The SHIP national hotline is 1–701-0501.
  • To report a lost Medicare card or if you are trying to change your address with Medicare, you may need to call the Social Security Administration office. Their national hotline is 1 772-1213.

Youre Eligible For A Refund For Overpayment Of Benefits

Medicare Scam Phone Calls That Seniors Should Avoid

A common phone and text scam used by fraudsters entails claiming that youâre owed a refund due to overpayment. Medicare scammers wonât hesitate to contact you at home and say that Medicare owes you hundreds or even thousands of dollars. But this is almost always a scam.

ð How to identify a Medicare âoverpaymentâ scam call:
  • The caller claims youâre owed money from Medicare but needs your bank account number and personal identification to send you the funds. Giving a scammer this information could make you the victim of identity theft.
  • The caller pressures you into giving them sensitive information by saying youâll âloseâ the money if you donât act now. Medicare or an insurance company will never ask you to verify your information before issuing you a refund. They will certainly never ask for your banking details. Donât feel pressured into giving up your information.

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How Do I Know If I Qualify For Home Health Care Coverage Outside The Pilot Program

To use your Medicare home health benefits, you must be homebound â that is, unable to leave home without considerable effort, unaided or at all. Your doctor must certify that you need home-based professional services from a Medicare provider and you must have a treatment plan that is regularly reviewed by a doctor.

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