Don't let scammer get Medicare, health insurance information

Medicare AEP - open enrollment for drug plans - is going on now. It's a perfect time for scammers.

It's important to remember that Medicare will not call you at home. Don't give your information to someone you don't know personally. If the caller is persistent, tell them you'll be recording the phone call and see how they react.

Be aware fraudsters use multiple techniques to trick the unsuspecting into surrendering valuable personal information that can be used to defraud Medicare and the individual.

I recently spoke with a North State physician and her mother who was victimized by a scammer.

According to the doctor, she stopped by her mother's house and overheard her mother speaking on the phone - supposedly with Medicare. Her mother was getting frustrated because she couldn't hear the speaker very well, so she handed the phone to her daughter. The caller said he was from the pharmacy trying to coordinate with her doctor's office for an oral swab test kit used for cardio genetic testing.

* The daughter asked which pharmacy he was with and the caller said Health Solutions.

* She asked where they were based, and he said in her doctor's office.

* She asked who had ordered the test and he said the doctor's name and address.

* She asked again what kind of test it was, and he said it's a very simple oral swab that allows them to diagnose any heart disease.

* She asked who was the office manager, just for verification, and he said, "I'm not actually in the doctor's office but rather her mail-in pharmacy."

Meanwhile the daughter texted her mother's physician, who hadn't ordered any oral swab cardiogenetic testing.

Her mother had already given the caller her personal information including date of birth, Medicare information, insurance number, home address and doctor's name.

"I have a high index of suspicion, an internal fraud/scam alert," the daughter said. "There was a lot of background noise - and the caller spoke fast, using words like physician and pharmacy and cardiogenetic testing which I'm sure confused my mom."

One of the mother's greatest concerns about telling this story was protecting her identity. She didn't want to be further victimized, but was also embarrassed she might have fallen for a scam. When I asked how she might describe the call to a friend, she said, "Oh, I would not tell my friends about this."

Later her daughter pressed her on the issue. "Well, Mom, you wouldn't want (friend's name) to be a victim, so what would you tell her?"

"I guess I would tell her not to give her Medicare information to anyone on the phone," her mother replied.

Although the mother's testing was declined, she received a package from DIAX genetic testing addressed to Jane Doe Cardio, marked "TIME SENSITIVE" in big red letters with a return label to Health and Life Networking in Palm Harbor, Florida.

Now the two women face the daunting task of protecting the mother's identity and finances from further abuse.

This particular scam type was announced in a July 2019 Fraud Alert from the Office of the Inspector General. By Sept 2019, charges were filed against 35 individuals for over $2.1 billion in fraud: https://bit.ly/3ndmjTz.

Understand that in some of these cases, if Medicare doesn't pay for the testing, the senior can be billed for the charges: As much as $25,000.

How to know if your oak tree survived a fire

How to protect tomatoes from fall frost

If you suspect a case of Medicare fraud, contact the OIG Hotline online or at 1-800-HHS-TIPS or Medicare 1-800-633-4227.

The good news is that the Center for Medicare Services announced the 2020 improper payment rate was down to 6.7%, or $25.74 billion. That's down from 7.25%, $28.91 billion in 2019. Of course, not all of that is fraud. It included waste and abuse. But the numbers are mind boggling.

Margaret Beck has been a licensed insurance broker since 1978. She can be reached at 530-225-8583.