Medicare Fraud and Ways to Protect Yourself

There are people out there who try to take advantage of others by attempting to obtain your Medicare number or personal information in order to steal your identity.It’s important to know what to watch out for and how to protect yourself from these violations.


Here are some ways that you can protect yourself from Medicare Fraud:

  • Use a calendar to document your appointments and save documents pertaining to your visits, such as the summary of your visit and any receipts.
  • When you receive statements from your visits be sure to verify that they are accurate and that the services on the statement reflect the services that you received. Also, verify the accuracy of the dates and other details. Check for services listed that you did not receive.
  • Check your statements and receipts for errors. If you find an error, call the provider’s office to ask about the mistake. If there was no mistake, they can help you understand the billing for the services you received.
  • If you feel that you need to report Medicare fraud, you can call 1-800-MEDICARE. Have your Medicare card on hand when you call.
  • Only give your Medicare number to people that you know should have it like your health care provider, doctor, etc.
  • Never give your Medicare number out in exchange for free medical equipment, a special offer or gifts.
  • Do not let anyone use your card.
  • Only carry your card when you need it for things like doctor’s appointments or insurance enrollment.
  • Legitimate sources will not use scare tactics or use pressure to sell you a product or service.
  • Educate yourself on Medicare and your type of policy.
  • Ask questions! Call your plan or call your agent.
  • Before joining a plan, understand how it works.
  • Know your medications and check the labels at the pharmacy.
  • Check your claim statements and Medicare Summary Notices.
  • Hang up the phone if someone asks you to give your personal information or makes you feel pressured or uncomfortable.
  • Do not be influenced by advertising in the media! They typically do not have your best interests in mind.

If you have Original Medicare, you will have available to you either by mail or by creating an account on MyMedicare.gov, a Medicare Summary Notice (MSN). The MSN will show your Medicare claims and you can check the services for errors.

If you have a Medicare Advantage Plan, check the billing statements that are sent to you.


How to Report Medicare Fraud

You can report suspected Medicare fraud by contacting:

  • Senior Medicare Patrol (SMP) (NY Statewide Senior Action Council, Inc.) 1-800-333-4374.
  • Medicare.gov How to report Medicare fraud page.
  • Calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

If you’re in a Medicare Advantage Plan, call the Medicare Drug Integrity Contractor (MEDIC) at 1-877-7SAFERX (1-877-772-3379).


Have this information before you report fraud:

  • Your name and Medicare number.
  • The provider's name and any identifying information you may have.
  • The service or item you are questioning and when it was supposedly given or delivered.
  • The payment amount approved and paid by Medicare.
  • The date on your Medicare Summary Notice or claim.