Covering the Cost: How to protect yourself from Medicare fraud
HONOLULU (HawaiiNewsNow) – Medicare fraud costs American taxpayers at least $60 billion each year.
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But that number is likely underreported.
“When you think about culturally here in Hawaii, the shame, the embarrassment, the guilt, a lot of people don’t report their losses or their claims,” said Norma Kop, director of the federally-funded Senior Medicare Patrol (SMP) of Hawaii.
Medicare is a federal health insurance program that covers people age 65 and older, and individuals with certain disabilities. While every worker pays into the system, scammers file false claims and abuse the system for profit.
Monday kicks off National Medicare Fraud Prevention Week, and experts say protecting your hard-earned healthcare benefits starts with education.
Trained volunteers with SMP Hawaii hold regular workshops to teach beneficiaries, families and caregivers how to read Medicare benefit statements and detect potential fraud.
“If you’re on original Medicare, you have what’s called Medicare Summary Notices or for short MSN. If you’re on, like a lot of people here are on one of the Medicare Advantage plans, it’s called the Explanation of Benefits, so EOB,” Kop said.
“Many people just sort of open it and go, oh, this is not a bill, and they leave it alone. But in those statements are things that could be suspicious, things that services or procedures you never approved or even discussed with your physician, let alone the physician approving itself.”
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Scammers will get hold of your Medicare number, file false claims and use certain codes to cash in on a higher reimbursement, anything from a pricey prescription to a procedure like chemo therapy to hospice care.
“When you authentically need hospice care, guess what? You don’t qualify for it. It’s done. Medicare says you’ve put in the claim,” Kop explained.
“Gift card, romance, cryptocurrency, imposter scams, Social Security scams are all inroads to getting your Medicare card number. And any of these scams can wreak havoc on our mental, psychological, emotional, physical, financial health, our spiritual health.”
Here are more ways to protect yourself and your loved ones from scammers:
The next “Malama Your Medicare: Track It to Protect It” free Zoom presentation led by SMP Hawaii, will be on Thursday, June 4, from 10-11:30 a.m. Learn how to read your medical statements, identify red flags and volunteer to help protect others from Medicare fraud, errors and abuse. Click here to register.
Contact SMP Hawaii to receive a free “My Health Care Tracker” booklet to compare doctor visits, lab tests, procedures and prescriptions with your MSN or EOB notices. You can also download the SMP Medicare Tracker App for your device.
Follow the SMP National Facebook page for more tips and resources.
Contact SMP Hawaii to find out more about free one-on-one counseling, presentations and resources to increase your awareness. Visit smphawaii.org or email [email protected]. Call 808-586-7281 on Oahu or toll free at 1-800-296-9422.
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