Taxpayers lose billions of dollars each year to Medicare fraud and medical identity theft. Medical identity theft is when your personal information (like your name, Social Security Number, or Medicare Number) is stolen and used to submit fraudulent claims to Medicare and other health insurers without your permission.
Protect yourself by guarding your personal information.
- Don’t share your Medicare Number or other personal information with anyone who contacts you.
- Medicare, or someone representing Medicare, will only call and ask for personal information in these situations:
- A Medicare health or drug plan can call you if you’re already a member of the plan.
- The agent who helped you join can also call you.
- A customer service representative from 1-800-MEDICARE can call you if you’ve called and left a message or a representative said that someone would call you back.
- If you filed a report of suspected fraud, you may get a call from someone representing Medicare to follow up on your investigation.
- Only give personal information, like your Medicare Number, to doctors, insurers acting on your behalf, or trusted people in the community who work with Medicare (like your State Health Insurance Assistance Program, or SHIP). Beware of people who make uninvited calls. If someone you don’t know calls you and asks for your Medicare Number or other personal information, hang up and call 1-800-MEDICARE.
If you think you gave your personal information to someone you shouldn’t have, call the Federal Trade Commission’s ID Theft Hotline at 1-877-438-4338. TTY users can call 1-866-653-4261. Visit ftc.gov/idtheft to learn more about identity theft and to file an online report.
If a doctor or healthcare professional ever tells you the following, be suspicious:
- The service or equipment is free, and they only need your Medicare Number for their records.
- Medicare wants you to have the item or service.
- They have a way to get Medicare to pay for the item or service.
- The more tests they provide, the cheaper the tests become.
Be wary of doctors or facilities that:
- Don’t charge copayments without checking on your ability to pay.
- Advertise “free” consultations to people with Medicare.
- Bill Medicare for services, supplies, or equipment you didn’t get.
- Put the wrong diagnosis on the claim.
- Bill Medicare for tests you got as a hospital inpatient or within 72 hours of your admission or discharge.
- Claim they represent Medicare or a branch of the federal government.
- Use pressure or scare tactics to sell you high-priced medical services or diagnostic tests or threaten to withhold services.
- Offer you money or kickbacks to use their services, join their plan, or let them use your Medicare Number.
- Use phone calls and door-to-door selling as marketing tools.
- Offer non-medical transportation, like trips to the grocery store, or housekeeping as Medicare-approved services.
- Bill home health services for patients who aren’t confined to their home, or for Medicare patients who still drive a car.
- Ask you to contact your doctor and ask for a service, supply, or equipment that you don’t need.
If you suspect Medicare fraud, do any of these, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.