Spotting Medicare Fraud


By Vee Daniel, President/CEO, Better Business Bureau of the Upstate

It was a perfect storm. The launch of the Affordable Care Act in October 2013 was wrought with computer glitches, twisted information and then stymied with an ultimate government shut down and concerns over data security.

Scammers, who feed on confusion, wasted no time to prey. Callers from across the country contacted the BBB to report being contacted by someone posing as a government official or Affordable Care Act adviser about signing up for a new Medicare card before the end of the year deadline. Some used fear tactics by urging consumers to sign up for a new Medical Discount Plan to avoid penalties for the lack of coverage.

Fortunately, Upstate area residents, who have contacted us so far, have not fallen for the scam. Instead, they hung up on the caller and immediately reported the incidence to the BBB.

This is a scam that’s not going away any time soon and the best way to protect yourself is by staying informed. Here are a few BBB tips to help you spot health insurance fraud:

  • Never give out Medicare number or any personal information. Never give out your bank account numbers, date of birth, credit card number or Social Security number to people you do not know.
  • Be suspicious of any door-to-door or telephone solicitations claiming to be affiliated with Medicare. Medicare or Medicaid will not call consumers to update information or issue new cards.
  • Don’t rely on caller ID. Don’t trust that the information you see is true. Some scammers are able to display a company’s name or bogus phone number on the caller ID screen that can’t be traced.
  • Be suspicious of free services. Be wary of anyone offering you something for “free” in exchange for your Medicare number. Remember, Medicare will not pay for medical equipment without a physician’s signature certifying that it is necessary.
  • Review your invoices and notices closely. Watch for red flags on your medical bills, Medicare Summary notices and insurance Explanation of Benefits for medical equipment or service charges that you never received. If you find unusual charges, contact your healthcare provider immediately.
  • Get informed. Find out how the healthcare reform affects you. Visit the Center for Medicare and Medicaid Service’s

You can also get more information and order publications by contacting the Medicare office at 1-800-MEDICARE (633-4227). A customer services representative is available 24 hours a day, seven days a week and can provide you with detailed information about the medical health and prescription drug plans in your area.

Get help. In the event that you give your personal information to a fraudster, inform your banks, credit card providers and the three major credit bureaus, TransUnion, Experian and Equifax so that they can be on the lookout for potential identity thieves.

We want you to be safe. If you do receive a suspicious call, please report it to your Better Business Bureau at (864) 242-5052 or if you want to check out a business, please visit the BBB or visit