Seniors urged to protect against Medicare scams

Oct. 23--TUPELO -- Seniors are favorite targets for all kinds of scams, but they may not realize how much their Medicare benefits are under assault.

Seniors worked hard to earn their Medicare benefits, and they need to protect them to protect their own pocketbooks and preserve the program for future generations, said Ken Patterson, a Tupelo volunteer with Senior Medicare Patrol.

"Once they have your information, they can sell it," said Patterson, who along with other trained volunteers, talks to civic, church and senior groups about how to protect their Medicare benefits. "It's like having a credit card with no cap."

Medicare fraud adds up to about $60 billion a year.

"Our mission is to empower seniors and prevent health care fraud," said Keith Havins, community outreach specialist with the Senior Medicare Patrol program. "There's always different scams going on."

The identifying number used by Medicare is no longer your Social Security number, but it still should be guarded carefully. Seniors who get calls asking for their Medicare number to verify who they are should just hang up.

"We see that constantly," Havins said. "Never give out the number over the phone to someone you haven't called. No one from the IRS, Social Security or Medicare is going to call you to verify who you are."

The best remedy is to just hang up; don't worry about being rude, Patterson said.

"If you get a call from an unfamiliar company that you didn't call first, just hang up," Patterson said. "If you stay on the line, they know they have a live fish."

Currently, genetic testing has become a hotbed of Medicare fraud. Marketers show up at grocery stores, community health fairs and senior fairs, offering free genetic testing for cancer, dementia, Parkinson's disease or medication metabolization without a doctor's order. The scammers use the information they collect for identity theft or fraudulent billing.

Medicare will pay for genetic testing under very specific guidelines, Havins said. It is not covered as a general screening test. It must be ordered by a physician.

"Talk to your doctor about if this is something you need," Havins said. "It should be your doctor, not some random marketing person, who makes that decision."

Seniors should review their quarterly Medicare statements, Patterson said. In some cases, an unfamiliar medical provider may have provided services behind the scenes, like a pathologist or a radiologist.

Some mistakes can happen honestly, like an ambulance ride that cancelled at the last minute, but ends up getting billed out to Medicare. Most providers will rectify those issues quickly when they are made aware of them.

Concerns can be reported to the Senior Medicare Patrol at (877) 272-8720 and resources are available at www.smpresource.org. Fraud can be reported directly to the Office of the Inspector General at (800) 447-8477.

Enrollment

Open enrollment for Medicare runs through Dec. 7. While predatory sales practices for Medicare Advantage and supplemental plans have greatly decreased, Mississippi Insurance Commissioner Mike Chaney said seniors should be aware that brokers are bound by strict professional rules about how and where they can make sales pitches.

Insurance agents went to jail for having nursing home residents sign up unknowingly for Medicare Advantage or going door-to-door without appointments, said Mississippi Insurance Department investigator John Hornback.

"We've had no significant cases come up in the last two years pertaining to Medicare scams," Hornback said.

The state insurance department doesn't regulate Medicare Advantage plans, but staff is available to answer questions and can be contacted at (800) 562-2957. The state insurance department produces an annual Medicare Supplement Shoppers guide, which is available at mid.ms.gov.

Individuals contacting consumers about any type of private Medicare coverage must be licensed by the state and are not allowed to make unsolicited contact. There are very specific rules about what they can present and where they can make presentations.

The state insurance department warns against giving out personal information, such as Social Security numbers, bank account numbers or credit card numbers to anyone you have not verified as a licensed agent. They are not allowed to request such personal information in their marketing activities and cannot ask for payment over the Internet. They must send a bill.

michaela.morris@journalinc.com

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