Beware of Medicare Open Enrollment Scams

Published

October 29, 2021

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fraud, scams

The annual open enrollment period for Medicare began on October 15th and will continue until December 7th. This is the only time during the year that people enrolled in Medicare are able to change their Medicare health plans, Medigap plans and prescription drug plans. Those already enrolled in Medicare should have received an Annual Notice of Change from their health insurance providers describing any changes to their plans. If you are satisfied with your plans and coverage, you do not need to do anything.

Scammers and identity thieves are constantly inventing new ways to take advantage of people, especially older adults. Medicare Open Enrollment period offers the perfect opportunity to trick unsuspecting older adults into sharing their sensitive personal and financial information. Below are some common methods that scammers use on Medicare beneficiaries around the open enrollment period each year.

1. Fake Medicare Representatives

Seniors may be contacted by someone pretending to be from their insurance company asking them to verify information. This is a common tactic of identity thieves trying to trick their victims into providing information. They also may be contacted by people claiming to have supplemental insurance programs that will save them thousands of dollars. Here too, you cannot be sure that they are legitimate when they contact you by phone, text message, email or even regular mail. If you haven’t requested an agent to contact you, federal law prohibits an insurance agent from trying to sell to you, whether it’s via a phone call, an e-mail or a knock on your front door. If an “agent” tries to sell you something on behalf of Medicare, you should report that person to the authorities immediately.

2. Threatening a Loss of Coverage

This scam usually begins with a senior receiving a call that says they must have a prescription drug coverage plan (also known as Medicare Part D) or they will lose their other Medicare benefits. If the person doesn’t purchase a plan during enrollment time, then their Medicare benefits will be “terminated.” This caller will then claim to offer the perfect Rx plan for the person to increase their coverage and safeguard their benefits. If someone says you must join a plan or buy some sort of coverage to avoid losing your other Medicare benefits, it’s a scam. The Medicare prescription drug benefit is an entirely optional addition to your coverage under Original Medicare (Parts A and B). The same applies for Medicare Supplement Insurance, which is often referred to as “Medigap.”

3. Fake Rebate Notices

In this scam, the scammer calls a Medicare beneficiary to notify them that they are owed a substantial refund because they’ve reached the prescription drug coverage gap known as the “donut hole.” The Medicare “donut hole” is the gap in prescription drug benefits that occurs when Medicare Part D policyholders reach their yearly maximum coverage amount but still have not reached the point where the catastrophic part of their coverage kicks in. The catch is that the person must then provide their birth date, Social Security number, bank account and Medicare numbers so the refund can be automatically deposited into their checking account.

Medicare will NEVER call and ask for a beneficiary’s Medicare number or Social Security number. Protect your personal information. If someone claims to be with Medicare and asks for sensitive information like this over the phone, hang up and report it to 1-800-MEDICARE.

4. Counterfeit Sales Materials

Scammers may create and distribute very official-looking brochures and sales materials for new Medicare products that are available at a “discounted price” during the open enrollment period. They hope that seniors will contact them about enrolling and collect their personal information, payment information or both. Don’t be fooled by sales materials that look like they’re from a government agency. If you receive any mail or digital communication about Medicare products that you are interested in learning more about, do not use the contact information listed on the materials. Instead, call Medicare directly at 1-800-MEDICARE (1-800-633-4227) or look up and compare available plans in your area using Medicare’s Plan Compare Tool. Contacting CMS directly is the safest way to explore your options and make changes to your coverage.

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