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Medicare Fraud Prevention: Avoiding Health Care Scams

Older couple worrying over their bills

Seniors – as well as their caregivers – should be aware of the risks posed by Medicare scams and how to avoid falling victim to this type of fraud.

Each year, Medicare loses tens of billions of dollars to abuse and errors. Older adults who receive Medicare may be subject to this type of fraud perpetrated by identity thieves, scammers, and deceitful health care providers.

Safeguard Yourself From Medicare Scams

To start, there are several easy ways for you to lower your risk of being scammed in the first place.

  • Don’t share your Medicare number over the phone.

  • Have your Medicare card with you only when necessary. Otherwise, leave it at home. (Think of it like a Social Security card or credit card and protect it in the same way.)

  • Be aware that Medicare representatives will never come to your residence uninvited. They also will not call you out of the blue to verify your information or to offer free or low-cost equipment, such as a back or knee brace.

  • Hold onto your receipts and bills from past medical appointments so that you can compare them to your Medicare statements.

  • Always look through your Medicare Summary Notices when you receive them. Keep an eye out for any errors or discrepancies regarding services, tests, or medical supplies that you did not receive, or that you were charged for more than once. You can call your health care provider and ask them to explain a charge and, if necessary, you have the right to dispute charges that are wrong.

Why Do I Need to Report Medicare Fraud?

Medicare abuse is far from being victimless. Reporting fraud to the proper authorities is crucial to help stop it.

If someone steals your Medicare card or number, you could receive bills for health services you did not receive or become a victim of identity theft.

A health care provider who may be fraudulently charging you for services can spell trouble for more than your wallet. A dishonest provider could be misdiagnosing you or even subjecting you to treatments or services you do not need or that could potentially negatively impact your health. Sometimes, billing errors are made by accident, but if you find that your provider makes these types of mistakes frequently, it may signal a potential case of fraud.

Ultimately, fraud that goes unchecked can lead to higher Medicare costs for you as the consumer.

What to Do If You Suspect Medicare Abuse

There are a number of options for reporting incidents that you suspect may constitute Medicare fraud:

  • Call the Office of Inspector General hotline at 1-800-HHS-TIPS or file your complaint online.

  • Call 1-800-MEDICARE to report suspected abuse by a Medicare provider.

  • In addition, each state (and the District of Columbia) has a dedicated Senior Medicare Patrol, or SMP. This service can monitor your Medicare account for fraud and TBD. Search online for your local SMP.

Experienced elder law attorneys are also equipped to help protect you from abuse.

Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to learn how we can help.


This article is a service of Sharek Law Office, LLC. We don’t just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than you’ve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

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