How to Protect Yourself Against Medicare Fraud

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Identity fraud. It's something you think won't happen to you. But the reality is, it can and does happen — and those 65 and older are at a higher risk of becoming victims of this crime.

Seniors are popular targets for identity fraud. They tend to have more money than younger people and may not check credit reports as often. Or be aware of the latest identity fraud schemes specifically targeting people on Medicare.

Of course, not all seniors are targets or victims of identity fraud schemes, but it's important to know what to watch out for in case you ever do get targeted. We talked to Herbert McCann, manager of clinical pharmacy at Aetna, to find out about some of the most common ways seniors are targeted for identity fraud through Medicare — and how you can protect yourself.


1. Don't answer phone calls from numbers you don't recognize

Phone calls are one of the most popular ways fraudsters can get a hold of your identity. That's why it's important to make sure any calls you receive are legitimate, especially when you don't recognize the number. You can do this by asking the caller to provide their title and the company they're working for. If you're still not sure the call is legitimate, you can always ask for a callback number to verify.

McCann says you should also look out for two phrases that are commonly used in identity theft schemes:

"If you get a call from someone and the first thing they say is, 'Is this your name?,' or, 'Are you experiencing pain?,' you should not answer those questions and hang up," he says. These types of calls could be coming from an illegal marketing company whose purpose is to get your personal information to gain access to your Medicare benefits.

"These schemes are incredibly deep-routed, and simply saying 'yes' to one of the questions they ask you can be dangerous," says McCann.

You should never give your Social Security number, Medicare number, credit card number, or bank account number to someone over the phone. The only time you should provide your personal information is if you have verified the caller's identity as someone from your Medicare plan. It's normal for your Medicare plan to ask you for your personal information in order to verify your identity.

McCann also warns against someone telling you they'll send you free products.

"Beware of anyone offering you free medical services or medications over the phone. In almost all cases your Medicare benefit is being billed," he says.

If a fraudster unlocks your Medicare benefits, they can use them to receive inappropriate payment from Medicare. This is called Medicare fraud — and its consequences are costly. Medicare fraud wastes a lot of money each year and can cost taxpayers billions of dollars. Medicare fraud can also cause false information to end up on your medical records. This could potentially lead to complications with receiving medical treatment in the future.

You can always call your Medicare plan to verify a phone call. If you suspect someone is attempting to steal your information to get to your Medicare benefits, call the Centers for Medicare & Medicaid Services (CMS). CMS works with individuals, entities, and law enforcement agencies to prevent and detect fraud and abuse.

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2. Beware of social media "quizzes" that prompt you for your information

As the rate of social media use among seniors rises, so does the frequency of online identity fraud schemes. These schemes are often presented as quizzes on popular social media sites.

"You may be on your social newsfeed and see something that says, 'Take this quiz to see if you're diabetic.' There may be a few normal questions, but then you'll be prompted to give more personal information. That's where you need to watch out," says McCann.

Make sure the quizzes you take on social media are built by a company you trust, and if they start to ask you for personal information, like the street you grew up on, your mother's maiden name, or the name of your high school, close out of them immediately. They're likely scams trying to access your identity and other personal information.

3. Be suspicious of emails you're not expecting

When it comes to email scams, phishing scams are by far the most popular. Phishing happens when a deceptive email message is sent to your inbox that aims to trick you into revealing personal or confidential information. These emails look like they're from organizations you do business with, like your bank or credit card company. They'll often ask you to click a link that leads to a fake site that's trying to steal your information.

If you have the official phone numbers and websites to the companies you think the email is from, you can call them to check and make sure the emails you're receiving are legitimate. If an email looks, well, "fishy," or an organization has confirmed it's fraudulent, delete the email. Never reply to a suspicious email, click on the links it provides, or open its attachments.

Identity theft happens but being aware of the schemes and methods scammers are using to try and steal your personal information can help you protect yourself. If you think you've been targeted for identity theft, contact law enforcement. And if you think the theft is targeting your Medicare benefits, call your Medicare plan and CMS right away.

Rachel Quetti is a health care writer at Aetna with experience in senior wellness, Medicare, commercial health care, and consumer engagement. When Rachel isn't trying out new fitness classes, she is cooking up fun, (mostly) healthy recipes in the kitchen. Rachel lives in Watertown, Massachusetts and has a degree in journalism from the University of Massachusetts, Amherst.

Speak to a licensed Aetna representative about Medicare
Monday-Friday 8am to 6pm CT
1-833-942-1968 (TTY: 711)

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