Medicare Minute

Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes. Personal information includes things like your name and your Social Security, Medicare, credit card, or bank account numbers, and your online Medicare account user name and password. Guard your cards and protect your Medicare and Social Security numbers. Keep this information safe.

Only give personal information, like your Medicare Number, to doctors, insurance companies (and their licensed agents or brokers), or plans acting on your behalf, or trusted people in the community who work with Medicare like your State Health Insurance Assistance Program (SHIP). Don’t share your Medicare Number or other personal information with any unsolicited person who contacts you by phone, email, or in person. Medicare, or your Medicare plan representative, will only call you in limited situations:

• A Medicare plan can call you if you’re already a member of the plan. The agent who helped you join can also call you.

• A customer service representative from 1-800-MEDICARE (1-800-6334227) can call you if you’ve left a message, or a representative said that someone would call you back. TTY users can call 1-877-486-2048.

If you suspect identity theft or feel like you gave your personal information to someone you shouldn’t have, visit oig.hhs.gov to submit a complaint or call the fraud hotline of the Department of Health and Human Services Office of the Inspector General at 1 800 HHS TIPS (1800-447-8477). TTY users can call 1-800-377-4950.

Medical identity theft is when someone steals or uses your personal information (like your name, Social Security Number, or Medicare Number) to submit fraudulent claims to Medicare and other health insurance companies without your permission. When you get health care services, record the dates on a calendar and save the receipts and statements you get from providers to check for mistakes. If you think you see an error or a provider bill you for services you didn’t get, take these steps to find out what was billed:

• Check your “Medicare Summary Notice” (MSN) if you have Original Medicare to see if the service was billed to Medicare. If you’re in a Medicare health plan, check the statements you get from your plan.

• If you know the health care provider or supplier, call and ask for an itemized statement. They should give this to you within 30 days.

• Log into (or create) your secure Medicare account at Medicare.gov to view your Medicare claims if you have Original Medicare. Your claims are generally available online within 24 hours after processing. You can also use Medicare’s Blue Button to download your claims information. Call 1-800-MEDICARE.

If you’ve contacted the provider and you suspect that Medicare is being charged for a service or supply that you didn’t get, or you don’t know the provider on the claim, call 1-800-MEDICARE.

For more information about Medicare fraud, visit Medicare. gov or contact your local Senior Medicare Patrol Program. For more information about the Senior Medicare Patrol or to find help in your state, visit smpresource.org or call 1-877808-2468.

You can also call your local police department and the Federal Trade Commission’s ID Theft Hotline at 1-877-438-4338. TTY users can call 1-866-653-4261. Visit ftc.gov/idtheft to learn more about identity theft.

Medicare plans and agents must follow certain rules when marketing their plans and getting your enrollment information. They can’t ask you for credit card or banking information over the phone or via email unless you’re already a member of that plan. Plans don’t need your personal information to provide a quote. Medicare plans can’t enroll you into a plan over the phone unless you call them and ask to enroll, or you’ve given them permission to contact you.

Call 1-800-MEDICARE to report any plans or agents that:

• Ask for your personal information over the phone or email

• Call to enroll you in a plan

• Use false information to mislead you

You can also call the Medicare Drug Integrity Contractor (MEDIC) at 1-877-7SAFERX (1-877-772-3379). The MEDIC fights fraud, waste, and abuse in Medicare Advantage and Medicare drug plans.

You may get a reward if you help us fight fraud and meet certain conditions. For more information, visit Medicare. gov or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

Every tip counts. Medicare takes all reports of suspected fraud seriously. When you report fraud, you may not hear of an outcome right away. It takes time to investigate your report and build a case, but rest assured that your information is helping us protect Medicare.

An “ombudsman” is a person who reviews questions, concerns, and challenges with how a program is administered, and helps to resolve them when possible.

There are several resources to get answers to your Medicare questions and get help with your Medicare coverage, like Medicare.gov, 1-800-MEDICARE, and State Health Insurance Assistance Programs (SHIPs). The Medicare Beneficiary Ombudsman works closely with those resources and Medicare to help make sure information and help are available for you and works to improve your experience with Medicare.

Visit Medicare.gov for information on how the Medicare Beneficiary Ombudsman can help you.

Source: Medicare & You Handbook 2022: Section 8, Pg. 105 - 106