Medicare Fraud

Medicare fraud is a problem that wastes a lot of money every year, and it can result in higher health care costs and taxes for everybody. Let’s look at a few examples of Medicare fraud, as well as some do’s and don’ts that you can use to help prevent fraud.

Some examples of Medicare Fraud can include:

  • A healthcare provider billing Medicare for services you never received.
  • A supplier billing Medicare for equipment you never received.
  • Someone else using your Medicare card to receive medical care, supplies, or equipment
  • A company using false information to get you to join a Medicare plan.

Now let’s take a look at some things that you should and should not do to help fight against Medicare fraud:


  • Do protect your Medicare number (on your Medicare card) and your Social Security Number (on your Social Security card). Treat your Medicare card like a credit card.
  • Do remember nothing is ever “free.” Don’t accept offers of money or gifts for free medical care.
  • Do ask questions. You have a right to know everything about your Medicare care including the costs billed to Medicare.
  • Do educate yourself about Medicare. Know your rights and know what a provider can and can’t bill to Medicare.
  • Use a calendar to record all doctor’s appointments and what tests or X-rays you get. Check Medicare statements carefully to make sure you got each service listed and that details are correct. If you spend time in a hospital, make sure date of admission, date of discharge, and diagnosis on your bill are correct.
  • Be wary of providers that tell you the item or service isn’t normally covered, but they “know how to bill Medicare” so Medicare will pay.
  • Do make sure you understand how a plan works before you decide to join it.
  • Always check pills before leaving the pharmacy to be sure you got the right medication, including whether it’s a brand or generic and the full amount. If you don’t get the full prescription, report the issue to the pharmacist.
  • Do report suspected instances of fraud.

Do Not’s

  • Don’t allow anyone other than your doctor or other Medicare providers to review medical records or recommend services.
  • Don’t call your doctor and request a service you don’t need.
  • Don’t let anyone sway you to see a doctor for either care or services you don’t need.
  • Don’t accept any medical supplies from a door-to-door salesman. If someone comes to the door and claims to be from Medicare or Medicaid, remember that those companies do not send representatives to homes to sell products or services.
  • Don’t let media advertising about your health influence you. A lot of T.V. and radio ads don’t have a person’s best interests at heart.
  • Don’t give out your Medicare card or number, Social Security card or number, to anyone other than your doctor or other authorized Medicare provider.

If you follow these simple tips, you’ll be well on your way to educating yourself about fraudulent practices, and better able to respond if the situation arises.