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Medicare Enrollment Seasons Provide Opportunity for Fraud and Identity Theft

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Ways to Stay Secure During Medicare Election Periods

By Jeanne Skinner, manager of payment integrity and recovery at Network Health
Originally published on 1/22/2021 at 3:45 p.m.

Every year, individuals on Medicare are given the opportunity to re-evaluate their health care needs, research the Medicare health insurance market and choose a plan that best meets their unique health care wants and needs.

During this period, called the annual enrollment period (AEP), and the one following, called open enrollment period (OEP), those who qualify for Medicare are empowered to find the insurance plan that will best suit them in the year ahead.

During this time, there is a lot of Medicare-related media that occupy television, radio, internet, mail and telephone channels. Unfortunately, this can provide cover for criminals looking to use the guise of Medicare enrollment to commit identity theft or insurance fraud.

Every year, thousands of Medicare-aged people are targeted by people preying on the abundance of advertisements and noise. These bad actors will pretend to be from the federal Medicare agency, your insurance company or a new insurance company. They promise better rates, plan reviews and more with one simple catch – you have to provide private information to start.

How to Avoid Medicare Fraud in 2021 and 2022

Here are some tips to observe and stay safe during the annual enrollment and open enrollment periods for Medicare.

Never sign a blank form.

Insurance claim forms that are left blank can be gateways for fraudsters to access your private information and submit high claims on your behalf. Always make sure claim forms are filled out before signing.

If it sounds too good to be true, it might be.

Things that sound too good to be true, often are. While there are Medicare Advantage plans with $0 monthly premiums, a common tactic used by fraudsters is calling you or showing up at your door promising medical services or products for free.

Never give out personal information to cold callers.

Signing up for Medicare or a Medicare Advantage plan may be something you want to do as early and as quickly as possible. It’s important that you never give your personal information to somebody who has called you or come to your home, selling Medicare products at no cost.

Charge cards are a red flag.

Medicare plans cannot legally ask you for your credit card or banking information over the phone—unless you’re already a member of that plan. Fraudsters may pretend to get you signed up with a new Medicare plan and ask for a first payment to start your plan. If you are not already a member of a health plan, you can’t be enrolled from a cold call. As always, if you have doubts or questions or would like to report somebody doing this, call 1-800-MEDICARE.

Keep records of your health plan services.

Holding onto your receipts, records, discharge instructions and explanation of benefits paperwork helps ensure you are on top of your health history. It can also help you avoid falling victim to a fraudster who is calling and trying to confuse you about your appointments or medical visits.

Only give your private information to providers.

Medicare health plans will never call you and ask for your insurance/Medicare identification or social security number on the phone. Only give that information to those who have provided you with health services, like your existing Medicare plan or health providers.

Monitor bank statements, credit card files and credit reports.

Stay safe by keeping a close eye on the items which are likely to be affected in the event of identity theft. Your bank account balances and credit reports are a great place to start. Credit Karma, for instance, is a free credit reporting website that allows you to see the accounts opened under your social security number and make sure there are no surprises.

Know Your Health Options this Enrollment Period and Future Ones

Keep yourself safe by knowing your health insurance plan performance, documentation and the regulations certified health plans must follow. Doing this will keep you safe during future enrollment seasons and help you identify people who are trying to use this time for the wrong reasons.

Remember, Network Health will never change your plan without your request, consent and your confirmed understanding of the changed details.

If you ever have any questions about your health plan and the communication methods used by Network Health to ensure you know about your health care options, we’d love to help.



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