Empowering Seniors To Prevent Healthcare Fraud
How do I know if a phone call is legitimate?
- Ask the caller for his or her name, company name, and callback number. You can call back later to verify the legitimacy of the source and the offer.
- If the call is from a charity, tell them to send you information in writing. Be sure to add that you do not give money to strangers over the telephone.
- If they are selling something and you are interested, ask for information in writing. If this is a one-time opportunity, tell them you do not make decisions over the phone.
- Most importantly, LISTEN for these red flags:
- Are they asking for credit card information?
- Are they asking for banking information?
- Are they asking for personal information like your Medicare or Social Security number?
- Do they say the offer is only good today? A real company will give you time to think and verify.
- Do they know something about you but ask to verify that the information is correct?
If any of these are happening, HANG UP!
What if I accidentally gave out my Medicare number to someone other than a provider?
- Contact your Senior Medicare Patrol for help. To find yours, call 1 877 808-2468 or visit https://www.smpresource.org/Default.aspx and Click on “Find Help in your State”
- Alert your health care providers so they can be aware of suspicious activity.
- If you notice suspicious activity on your Medicare or health plan statements, contact them and let them know.
What if I lost my Medicare card?
- Call 1-800-Medicare (1-800-633-4227)
I was billed for a medical service I didn’t receive. What should I do?
- Contact the health care provider or the company that issued the bill.
- Contact your state’s Senior Medicare Patrol. Call 1 877 808-2468 or visit
What if I suspect Medicare fraud?
Address it immediately by taking these steps:
- Rule out error:
If you have questions about information on yours or your loved one’s Medicare Summary Notice (MSN) or Explanation of Benefits (EOB), call the provider or plan and ask for an explanation.
- Get help from your SMP:
If you are not comfortable calling the provider or plan or if you are not satisfied with their response, your local SMP can help you:
- Identify and report fraud schemes and deceptive health care practices, such as illegal marketing or billing for services that were never provided.
- Refer complaints of potential fraud and abuse to the appropriate entity, who can intervene
- Get help from other sources:
- Contact local law enforcement.
- Call 1-800-Medicare.
- Report directly to the OIG Hotline: 1-800-HHS-TIPS (800-447-8477).
Who can I contact if I have Medicare questions that do not involve Medicare fraud, abuse, or error?
- Contact your local State Health Insurance Assistance Program: SHIP Locator or 1-877-839-2675
If you would like to . . .
- schedule a presentation
- receive SMP publications
- become a volunteer, or
- get help with potential Medicare fraud, abuse, or error,
call 800 856-4398, email firstname.lastname@example.org, or stop by one of our offices. Let's talk!