Medicare Identity Theft – How to Protect Yourself

Identity theft has become a concern to countless Americans in recent years—and with one horror story after another having surfaced about possible breaches of personal privacy, Americans have every right to be concerned.

As far as Medicare goes, some Americans are worried that personal information they are required to provide Medicare, healthcare providers, private insurance companies, and medical suppliers may be compromised. While it is impossible to guarantee that personal information will never fall into the wrong hands, here are five easy tips that can help reduce your risk of being a victim of Medicare identity theft to an absolute minimum.

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1. Know your rights.

Many people are intimidated by a federal bureaucracy wielding enormous power, yet there are measures in place to protect individuals.

As spelled out at Medicare.gov, with regard to personal information related to your enrollment in Medicare, you have the right to:

• Receive and review a copy of your personal medical information held by Medicare;
• Have your personal medical information amended if you believe that it is wrong or if information is missing, and Medicare agrees (if Medicare disagrees with your assessment,  a statement of your disagreement may be added to your personal medical information);
• Receive a list of those getting your personal medical information from Medicare (this does not include personal medical information given out to pay for your healthcare or for Medicare operations, or given out for law enforcement purposes);
• Ask Medicare to communicate with you in a different manner or at a different place (for example, by sending correspondence to a post office box instead of your home address); and
• Ask Medicare to limit how your personal medical information is used and given out to pay your claims and run the Medicare program.

2. Understand when Medicare needs to share your information and why.

The Medicare administration may be required to share your personal information with the federal cabinet department it functions under—namely, the Dept. of Health and Human Services (HHS). It may also be obligated to release your information from time to time as the law may require. It must also make your personal information and records available to you or your legal representative upon request.

Your information may also be released to agencies and carriers involved with collecting premiums, processing claims, and otherwise facilitating your health coverage under Medicare. Check out Notice of Privacy Practices for the Original Medicare Plan to learn about other instances in which Medicare may have a legitimate right to share your personal information.

If you are enrolled in a private Medicare health plan, your plan will provide an explanation of how it will use your personal information. It is important to read this explanation carefully.

3. Be aware of the source of most Medicare-related identity theft.

The US Medicare administration is not the enemy when it comes to jeopardizing your security and putting your identity at risk. In fact, Medicare is squarely on your side in this battle.

Much concern about the potential for Medicare identity theft lies in the practices of unscrupulous “Medicare agents” who often target seniors and do everything they can to collect personal information that can help line the pockets of those “agents” while endangering the finances of the seniors they target. Sometimes such “agents”—better referred to as outright scammers—will telephone unsuspecting people, earn their trust, and proceed to “verify” or otherwise collect personal information including Social Security or Medicare numbers and even personal financial information. While such scammers often come out of the woodwork during open enrollment periods, it’s important to remember that there is no “off-season” for those who are eager to take advantage.

4. Exercise your very best judgment.

This cannot be overemphasized. You should not provide personal information of any sort to any individual or agency that strikes you as being suspicious. Be careful to give personal information only to Medicare-approved doctors, providers, plans, and suppliers; agents associated with government or community-based programs you can trust to work in your best interest; or insurers needing further information to pay benefits on your behalf. Where any other party is concerned, you should take every precaution to guard all personal information.

5.  Know what to do if you think your identity has been stolen or is at risk.

You can:

• Report any suspicious incident by calling 1-800-MEDICARE (TTY: 1-877-486-2048);
• File a Medicare fraud and abuse report; and/or
• Contact the Federal Trade Commission (FTC).

While it is important to do everything possible to prevent the theft of your personal information or identity, it is far from “game over” if such a breach or theft has already taken place. Reporting concerns to the Medicare administration and the FTC will make these agencies aware of your concern, and if there is any need to take further steps for your protection, these agencies will let you know. If you suspect your identity is at risk, you should contact Medicare and the FTC promptly.

There seems no end to all the scams targeting seniors in recent years. According to the Common Fraud Schemes page on the Federal Bureau of Investigation website, seniors are often targeted because they’ve accumulated assets, own their own homes, and have good credit. In other words, scam artists are likely to view seniors as a lucrative market for their twisted schemes.

Here are a few other suggestions to help keep you safe from Medicare identity thieves:

Never believe it if a “Medicare agent” comes knocking on your door.

An unexpected visit of this sort will never happen. Even if the “agent” claims to be delivering correspondence or a check from Medicare, don’t believe it.

Never give personal information to anyone claiming to represent Medicare unless you are the one who initiated contact.

Always think twice (or more) about offering information such as your birthdate, Medicare number, Social Security number, or bank account or credit card number over the phone or Internet. Scammers are looking for information that can lead to identity theft, but you’ll stop them cold if you protect your personal information.

Be suspicious of anyone claiming to be calling you on behalf of Medicare.

You will not receive a call from Medicare unless you have initiated contact. If you receive a call you didn’t request, do not offer personal information regardless of what the caller claims. Even if your caller ID shows the call is coming from a legitimate organization or a number associated with Medicare, don’t be fooled. If you think the call may be legitimate, call the organization yourself to confirm they made the call. But even if they did, keep in mind they shouldn’t have called you. Remember, you’ll never get a call from a Medicare representative unless you’ve requested it. Stay safe by hanging up the second you’re suspicious, and report the incident at once.

As far as Medicare supplement plans and Medicare Advantage plans are concerned, the same general principles apply. There are scammers in the supplement market, too, and you can never play it too safe. While purchasing a good supplement or Medicare Advantage plan will work to almost anyone’s benefit by offering health and financial protection second to none, it’s best to deal with an established broker or agent who will always be looking for ways to serve you better and not for ways to take advantage of you. A legitimate Medicare supplement agent will never contact you out of the blue, come knocking uninvited at your door, or try to pressure you into providing personal information he or she has no business asking for.

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StopMedicareFraud.gov offers some helpful tips

Scammers have been around for as long as we know, and Medicare scammers have been active in one form or another since the early days of Medicare. Identity theft, meanwhile, has existed in some form for many centuries. Think of the account in the Book of Genesis about Jacob putting on the goatskin to fool his sight-impaired father, Isaac, into believing he, Jacob, was really his hairier, older brother, Esau. Jacob, you may recall, stole his father’s blessing from Esau essentially by stealing Esau’s identity.

Identity theft has come a long way since then, and you have to be on guard now against a lot more than body hair. HHS and the Dept. of Justice have combined to offer valuable suggestions at StopMedicareFraud.gov, and the Better Business Bureau has further advice to offer as well to help protect you against the dangers of Medicare identity theft. But the best advice to keep you protected against Medicare identity thieves and other scammers can be boiled down to the five key tips offered above—and particularly to tip number four. Exercising your best judgment is your best possible protection against scammers or thieves of any sort. In fact, standing up to those who would take advantage often reveals just how cowardly scammers and identity thieves can be.

Can you suggest any other ways to protect personal information? Leave a comment below!

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