Many of you probably read my July article about Advocacy, related to health care and the importance of having a caring person, family member or professional advocate be there to support you in times of need, especially after hospitalization. Today’s subject is a little different, yet advocacy does play a part yet again. I am advocating that you STOP, PAY ATTENTION, KNOW THE WARNING SIGNS, and then resist – I mean, say “No” and walk away. This time, I am talking about Medicare scams.
You’ve heard me say it before and now it is fitting to say it again – “if it sounds too good to be true, it probably is.” Another saying that rings true --- “nothing worthwhile in life is FREE.” Well, a number of local seniors unwittingly got caught up in one of the newer scams (it’s not a new scam – just new here in Santa Barbara) right here in paradise city. It sounded good and … it was FREE (nope!).
The scammer was so slick, that she even convinced a senior property manager to allow her to have a booth at a senior fair. Now, how can that possibly happen … but it did! Now it does not mean that the managers were not paying attention or not careful. It is rather that the scammers are what I customarily refer to as ‘slick.’ This is how they (scammers) get into health fairs, homes and would you believe, the lawn bowling club right here in Santa Barbara?!
Our dear Jane Doe (I am not at liberty to tell you her name, even though she left her calling card – fake, of course – everywhere), did just that. She ‘sweet-talked’ managers, seniors and who knows how many others, that she had such a great service to provide and it was FREE! This is the story of the Genetic Testing Scam. Here’s how it works: Miss Scammer asks the senior “do you have cancer in your family – are you worried that you might be carrying a gene that might predispose you to Cancer or Dementia or … whatever?”
Next, of course, is followed by getting your name, telephone number and home address. Off we go … you are on your way to a FREE Genetic Testing and … being part of a Medicare scam. That is the ruse being perpetrated … Medicare will pay for this – and it is FREE to you. Well, let me set you straight on this --- Medicare pays for Genetic testing only when it is determined to be ‘medically necessary’ and is ordered directly by a physician. NOTE: this scam and other Medicare scams may happen to you in person, or via a telephone call or via the internet.
Next comes the visit, and of course, a request to do this simple test – swabbing your cheek for saliva. Wa-la! Easy, painless, FREE. Oops … the scammer needs to see your Medicare card to bill Medicare for this (non-covered) service. Hoorah – success! The scammer asks for your Medicare number and can now or in the future, send bogus claims to Medicare (lab tests you never received, equipment you do not need, procedures you never had, and the like). Dare I say – Medicare fraud is a multi-million, if not multi-billion dollar industry. This must STOP now, and it begins with you and me.
Here are some helpful tips to avoid Medicare scams:
Vigilance – This means, be skeptical. Any test, procedure, medication must be ordered by a physician in order to be covered by Medicare. It should be YOUR PHYSICIAN ordering any of these items, not someone unknown to you (there are most likely MD scammers in this business who sign the bogus claims). NEVER give out your Medicare number to anyone other than a known local medical provider and only AFTER your physician has given authorization.
Communication – If you have a concern about your health, impending signs/symptoms or questions about the latest and greatest in health investigation, technology, etc., talk to your physician. Find out about options through a known and respected legitimate source.
Education – If your curious about a subject, procedure, new drug, etc. and are looking for information or answers, go to a well-known source: your physician, the local hospital, or other experts known to you in the community.
Information – If you have questions about something (Medicare related) being offered to you, or believe you have fallen for a Medicare Scam, call HICAP (Health Insurance Counseling and Advocacy Program) of Santa Barbara County (located in Santa Maria) at either of these numbers: (805) 928-5663 or TOLL FREE (800) 434-0222.
Investigation – In the event this scam happened to you, be sure to carefully review/investigate every charge on your Medicate Explanation of Benefits (EOB) statement. If a procedure, test, item of equipment was not ordered for you, then Medicare is being fraudulently billed, probably by those scammers. Notify HICAP (information above).
Our county now has a slogan related to disasters, which has really caught on – AWARE AND PREPARE. That is the main intention of this article. I think that fits avoidance of falling for a scam – and there are so many out there!
If you are more aware, you will be prepared by the steps outlined above: be vigilant, talk with your own doctor or health care provider, get and stay educated on the latest topics of concern to you and seek advice – second opinions, more information. Most importantly, report any unsavory incidents or suspicions to HICAP, or even call the District Attorney’s office – see below.
Aware and Prepare – don’t fall for a scam – whether in person or on the phone. It may sound scary (your grandson is in jail in Mexico and needs money for an attorney – oh, and don’t tell anyone, just wire the money to bail him out) – SCAM☹
Or … why not get this FREE test to see if you have a genetic marker for Cancer, Dementia or whatever – SCAM☹ - just walk away. And, there are so many more! Just remember be aware, be prepared!
Jeanne M. West, RN, MHA