What Can Scammers Do with Your Medicare Number?

One of the many privileges afforded Americans is the right to healthcare. Medicare, begun in 1965, is a national health insurance program administrated by the Centers for Medicare and Medicaid Services or CMS. A significant aspect of the program is the Medicare ID number. 

In 2015, to stem the tide of rising identity theft, the CMS developed a new identity system. Instead of Medicare numbers containing the recipient’s social security number, it has been replaced with a Medicare Beneficiary Identifier (MBI). New numbers contain 11 characters and are unique to every person with Medicare.

Scammers and Medicare

Medicare fraud has dramatically risen in recent years due to pandemic-related claims. As usual, predators are finding new ways to scam hard-working Americans out of their money and benefits. Everyone has heard of hospitals and doctors overbilling or prescribing patients unneeded tests. No matter where you live, Medicare fraud is not far away.

Year after year, Medicare fraud increases dramatically around open enrollment dates, October 15 to December 7. It is important for Medicare recipients and beneficiaries to be aware of fraudulent activity and to protect themselves.

Open enrollment is a massive opportunity for predators. There are currently 60 million beneficiaries of Medicare; according to CNBC, 332,000 fraud and identity theft reports cite government imposters from Medicare or the Department of Health and Human Services as the impetus. 

Most Medicare fraud starts with a phone call and occasionally with email or a door-to-door visit. Fake Medicare callers always sound empathetic and knowledgeable, making calls credible. To legitimize the call, scammers gather basic information about the victim, like birthdates, relatives, and so on.

Medicare ID fraud tricks:

• Predators call recipients asking for their new number to activate the account, or during the rollout of the new MBI numbers; scammers call beneficiaries asking them to verify identities or pay a processing fee. 
• Another trick is telling the recipient that they have the wrong card, which will not work. A new card is on the way if the victim verifies personal information such as a social security number.
• Scammers may ask if the victim would like to stay with a paper card or switch to a new plastic card with a chip; a fee is attached, of course.
• Predators claim there has been suspicious activity on the account, and your social security number is needed to verify the account.
• Predators may call seniors and offer free medical supplies because Medicare will cover the cost. The catch is that scammers need your Medicare ID or social security number to move forward.

Identity Theft

Identity theft using a stolen Medicare ID has become more commonplace as American citizens get older. The CMS helped itself by replacing old social security-based numbers with new MBI characters. There are a few significant reasons why predators steal Medicare IDs. The most telling reason is filing a false claim to an insurance carrier for medical treatment or equipment. Other fraudulent reasons may include drugs or needed surgery. 

Medicare recipients must protect their ID numbers because falsehoods may affect beneficiaries. Every time a predator uses a stolen Medicare number, a record is created using fraudulent information. These falsehoods may limit coverage or benefits because of a medical condition you do not have. In addition, test results based on the predator’s health co-mingled with yours may cause a host of added problems. 

Free Medical Equipment

Recipients may receive phone calls from someone sounding very official, offering free medical supplies with Medicare covering the cost. The catch, scammers need your Medicare ID or social security number to move forward.

Callers may offer wheelchairs, knee or back braces, and services in exchange for that precious Medicare ID. If predators can get the number, they fraudulently bill Medicare for the equipment. The significant problem with this; is fraudulent billing uses up your benefits for something never received. 

Callers promise revolutionary braces for recipients but get off-the-shelf equipment for nothing. Invariably, Medicare gets billed thousands of dollars with your Medicare ID. Predators call offering free or heavily discounted genetic testing for cancer screening. 

Medicare rarely calls a recipient and never offers to pay for random genetic testing. 

Prescription and Pharmacy Fraud

One of the most lucrative schemes against Medicare is fraudulently billing the agency for drugs that are never used or prescribed. The scam does not work without a recipient’s Medicare ID. Always check your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) for the following errors:

• Drugs and refills are never picked up, delivered, or prescribed. Prescriptions from doctors you have never seen or an over-prescribed quantity—different prescription than your doctor’s.
• The pharmacy issues you expired drugs.
• Pharmacy delivers a more expensive drug than the less expensive drug prescribed.
• Companies offer prescription drugs without a doctor’s signature. 
• Gifts are promised if you switch drugs.
• Refills are given on expired prescriptions.
• Individuals or companies offer cash or rewards for using your Medicare ID.

Do Not Ignore the Signs

Medicare recipients must be aware of the fraud that occurs with stolen ID cards. With stolen ID numbers, predators scam the US Government out of billions of dollars yearly. Learn to spot a scammer before it happens to you or a family member.

• Medicare or Medicaid rarely calls one of its recipients. If you start receiving calls, hang up immediately and report the incident.
• Callers want to know more of your personal information than is necessary, such as a social security number or mailing address. 
• Predators may get aggressive and demand payment for services without you seeing the bill.
• Never sign any enrollment form or other document until you are ready or someone else has the chance to peruse the form. 
• Predators will push to get the names and phone numbers of family members. 

Final Word

Medicare and Medicaid are great benefits for Americans. Do not abuse the privilege by letting a predator steal your Medicare ID number and fraudulently bill the government for services never received. Use common sense or let a trusted family member handle your benefits.