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Protecting Yourself from Health Care Scams

Five ways to avoid being a victim of fraud

By Blake Amos and Cigna
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Credit: Photo by Kampus Production

Although most people are worthy of our trust, some, unfortunately, are not. There will always be those few who take advantage of others. This is true across industries, including in health care. According to the U.S. Senate Committee on Finance, fraud, waste and abuse in health care costs Americans more than $60 billion every year. 

Anybody of any age can be scammed, but older adults can be particularly susceptible. Scammers are especially creative in targeting people with a trusting and polite nature, and they are skilled at using personal tactics to deceive. 

With that in mind, it's important for older people and their caregivers to learn how to sniff out suspicious activity. Here are just a few tips I recommend taking to avoid being victimized. 

Know Who is Contacting You

Medicare and its affiliated plans are not permitted to call you or visit your home without your permission. Of course, your insurer might call you — with your permission — to conduct regular business activities. But even then, you should be on guard. If you think a call is suspicious, hang up and call your insurer back on the telephone number listed on the back of your customer identification card. 

Since many scams occur over the phone, don't feel compelled to release any personal information, particularly to an unknown caller. Remember that fraudsters are good at what they do. They might sound official and know some personal information like your name and address, and they may create a reason for you to act immediately. Don't be intimidated. No one can force you to divulge any private information. 

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Guard Your Card

Protect your Medicare ID as you would a credit card or Social Security card. If you get a call from someone promising you something in exchange for your Medicare card number, don't believe it. This is a common scam. Provide your Medicare ID only to trusted individuals, such as your own health care provider. Don't readily offer up your ID at public events like health fairs. If services are advertised as "free," then you shouldn't need to provide your insurance card. Also, don't ever let anyone use your card for services, as this is against the law. 

Get What You Pay For

You will receive statements in the mail or online from your insurer as you utilize health care services. Pay close attention to these statements to ensure they accurately reflect your visit. It helps to keep a calendar of your visits, including what occurred and when. If you see a service listed that you didn't receive, notify your provider immediately and/or call the number on the back of your insurance card. You can also call 1-800 MEDICARE. 

Be Alert Online

Many older adults are very adept at using the Internet and digital tools, but for others, the learning curve can be steep. No matter what your knowledge level is, it's important to approach the Internet with caution. Don't overshare on social media sites. Information like your birth date, birth city and names of your spouse, children or grandchildren can be used in breaking passwords or in identity theft. Additionally, be wary of unsolicited emails, even if they look official. Compare the email address with the supposed sender's name to see if they match. Never click on embedded links in an email unless you are absolutely sure the sender is legitimate. 

Don't Fall for Fake Savings

We all want to find savings when possible, including on our prescription drugs. This is particularly true of older adults, many of whom take multiple medications. However, be careful of offers that seem too good to be true. Be aware that there is a growing counterfeit drug industry online. These drugs may look real, but they could include the wrong ingredients, the incorrect quantities or no active ingredients at all. They could even be harmful to your health. To avoid this, always make sure you are working with a licensed pharmacy. If you're not sure, your insurer or your doctor's office should be able to connect you with a licensed pharmacy so you can safely maximize your benefits.  

The running theme throughout all these tips is to always remain alert and protect your personal information. 

We all want to assume the best intentions of others. We don't want to become jaded or be too cynical, but we don't want to be a victim either. It's perfectly acceptable to be a little skeptical of strangers to potentially avoid pain and aggravation down the road. 

If you think you have been the victim of Medicare fraud, report it immediately. By doing so, you can play an important role in helping to cut health care costs for everyone, and you might even be able to prevent others from becoming victims. 

To report Medicare or other health care fraud, contact your insurance company or state insurance fraud bureau. You can also contact the U.S. Department of Health and Human Services' tips hotline at 1.800.HHS.TIPS (1.800.447.8477) or [email protected]

The information contained in this article is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. To learn more, visit https://www.cigna.com/medicare.

Blake Amos oversees customer retention and experience with Cigna's Medicare Advantage business. He has been with the company for nearly a decade. Amos holds a bachelor's degree in business administration from the University of Tennessee and a master's degree in business administration from Belmont University. Read More
Cigna
By Cigna

Cigna Corporation (NYSE: CI) is a global health services company dedicated to improving the health, well-being and peace of mind of those we serve. Cigna delivers choice, predictability, affordability and access to quality care through integrated capabilities and connected, personalized solutions that advance whole person health. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Evernorth companies or their affiliates, and Express Scripts companies or their affiliates. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. 

Cigna maintains sales capability in over 30 countries and jurisdictions, and has over 190 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com. 

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Some content may be provided under license. © 2022 Cigna

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