Pennsylvania seniors are warned to watch out for Medicare scams

Because it’s administered through private insurance companies, fraudsters exploit this fact to prey on seniors and others who are shopping for new plans.

  • Sarah Boden/WESA

(Pittsburgh) — Seniors should be on the lookout for a couple of types of Medicare scams due to the ongoing open enrollment period, which ends Dec. 7.

Various types of grifts occur year-round in regards to Medicare, which is a federal health insurance program for people who are 65 and older or have certain qualifying disabilities. Because it’s administered through private insurance companies, fraudsters exploit this fact to prey on seniors and others who are shopping for new plans at this time.

One way they do this is identity theft, which commonly occurs when criminals posing as Medicare representatives or insurance brokers call enrolls to try to get personal information, such as their Medicare number. Sometimes the caller-ID might even say “Medicare.”

Ariel Rabinovic specializes in Medicare fraud prevention at the Center for Advocacy for the Rights and Interests of the Elderly, a nonprofit based in Philadelphia. He says legitimate entities don’t cold call, so anyone who phones claiming to be from Medicare or an insurance broker is probably lying.

“It’s shrewd to be rude,” said Rabinovic. “If somebody says they’re from Medicare, hang up immediately. They’re not. If they ask you for your Medicare number in exchange for a free service, hang up.”

Pablo Martinez Monsivais / Associated Press

FILE – This Nov. 8, 2018 file photo shows a page from the 2019 U.S. Medicare Handbook in Washington. The federal government is giving insurers who offer Medicare Advantage plans more leeway to pay for things they’d ordinarily never cover.

If the person on the phone is truly convincing, people can always disconnect and then dial the number on the back of their Medicare card to verify if the caller is legitimate.

The other hustle that enrollees need to be on the lookout for this time of year is false advertising.

“It’s usually a service that you don’t really need. Sometimes it’s actually a service that’s covered already by Medicare. And it just sounds like a great deal to get this extra supplemental insurance … but it’s really not necessary,” said Antoinette Kraus, director of the Pennsylvania Health Access Network.

It can be difficult to get out of these contracts which can lead to life-threatening situations, such as when a certain type of medication is not covered.

“I’ve had a few of those calls where [a Medicare enrollee] will call in a panic and like, ‘I’ve got three pills left, what do I do?’” said Rabinovic.

In those cases, seniors might be able to convince their old plan to take them back, but that’s not always the case.

If people need help understanding their benefits and options, they should contact their local area agency on aging. From there they’ll be directed to the free counseling provided by the Pennsylvania Medicare Education and Decision Insight program. These counselors don’t sell Medicare coverage and therefore have no financial incentive to direct enrollees to certain products.

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