Blue Shield of California Warns Consumers About Medicare Scams and Fraudsters

It’s important to be on the lookout for scams every day of the year, but during Medicare Fraud Prevention Week June 3-9, Blue Shield of California warns its Medicare beneficiaries about scammers who want their personal, financial, and health plan information.

Healthcare fraud in the U.S. is an enormous, expensive problem — costing up to $300 billion, according to the National Health Care Anti-Fraud Association. Additionally, the FBI’s Internet Crime Complaint Center reported that in 2023, almost half of the victims of call center schemes were over 60 years old. These scams target older adults, who accounted for 40% of complainants and 58% of losses, or nearly $770 million. Older adults lost more money to these scams than all other age groups combined.

To reduce instances of phone scams for Medicare recipients, Blue Shield recommends that seniors avoid sharing personal information in situations like these example scenarios:

  • An imposter pretends to be a health plan employee gathering personal information to send you a fake gift card.
  • A person phishing for your information calls to say that your Medicare benefits are expiring, and you need to confirm your account ID number for a new card.
  • You receive medical equipment, such as catheters, that you did not order.

“Elder health care fraud continues to plague our community, with far-reaching effects on the cost and quality of health care provided to patients,” said Alex Uhm, Medicare vice president and general manager at Blue Shield. We have a strong focus on protecting Medicare beneficiaries, who can be a vulnerable target for phone or other types of fraud.”

The Federal Communications Commission recommends Medicare beneficiaries protect themselves by following these practices:

  • Never give your Medicare card, Medicare number, Social Security card, or Social Security number to anyone except those authorized to have them, such as your medical professional’s office or insurers acting on your behalf such as your State Health Insurance Assistance Program (SHIP).
  • Don’t accept offers of money or gifts for free medical care.
  • Don’t allow anyone, except your doctor or other Medicare providers, to review your medical records or recommend services.
  • Never join a Medicare health or drug plan over the phone unless you initiated the call to Medicare.
  • If someone asks you for your information, for money or gift cards or threatens to cancel your health benefits if you don’t share your personal details, hang up and call 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov.

Additionally, Uhm advises Medicare beneficiaries who suspect fraud or scams to take these actions:

  • Contact your trusted health plan, using the phone number on your health plan card.
  • Report lost or stolen ID cards to your health plan and request a new card and ID number.
  • Carefully review your Explanation of Benefits from your health plan for any services you do not recognize.
  • When answering the phone, even if the number looks legitimate, do not confirm any personal information such as your Medicare number or Social Security number.
  • Never loan your health plan card to anyone.

For more tips to stay safe from healthcare fraud, visit:

https://www.blueshieldca.com/en/home/about-blue-shield/preventing-fraud

 

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