Know a health care scammer when you hear one

Know a health care scammer when you hear one

When you hear about the risk of identity theft today, most of the time it’s in the context of cybersecurity – scammers hacking into people’s email or online bank accounts to steal private information such as credit card numbers and passwords. 

While the biggest risks may have moved online, scamming over the phone is still alive and well, and it did not take long for scammers and fraudsters to adapt their schemes to take advantage of confusion and fear during the COVID-19 pandemic.

One of their most popular targets? Seniors.Older adults may be at home more often to answer telephone calls and many have saved up a “nest egg,” both of which make them more attractive to con-artists.

These fraudsters are after more than just credit card or bank information. The Washington, D.C.-based Coalition Against Insurance Fraud says health care-related scams are by far the most common type of insurance fraud in the United States, with tens of billions of dollars lost each year to a variety of false reimbursement and billing practices. 

“It is bad enough that fraud is on the rise generally but to prey on people’s fears and hopes during this pandemic is unconscionable,” said Ben Kehl, vice president of member experience, UnitedHealthcare Medicare & Retirement. “Thankfully, new scams are consistently being uncovered. The first step in protecting yourself and your family is to stay informed.”

According to U.S. Department of Health and Human Services and state consumer protection offices, these are the common COVID-19 scam methods to look out for:

Text scams
Many people are receiving messages from people posing as government agencies falsely advertising a COVID-19 vaccine or cure. Do not click on links in texts related to the virus. Instead, check for current information.

Another government imposter text is asking people to register and update their personal information to receive an economic stimulus check, “regardless of your status.” The link asks for personal information and a debit or credit card number.  

Robocall scams
These automated calls are “phishing” not just for bank or credit card information, but also Social Security numbers and health plan ID numbers to use in other types of fraud. Some common scam examples seen lately include:

  • Offering a free COVID-19 testing kit along with a free diabetic monitor
  • Warning of a virus outbreak “in your area" and connecting you with a health advisor to get a vaccine

Phone scammers often prey on older adults through various guises. Some of the most common ones are the following: 

The “health care representative:” The caller will claim to be a representative of your health plan, such as your Medicare Advantage or Medicare supplement plan. If you’re enrolled with a national insurance company that serves a large number of members, you could be at even greater risk. Why? Phone fraud is a numbers game. Fraudsters will call hundreds or even thousands of people, pretending to represent an insurance company. If they say they’re calling from a national company, they’re more likely to reach people actually enrolled with that company.

The “government representative:” A caller might claim to be working for the government, saying he or she is calling from Medicare, for example, and is authorized to collect fees or penalties over the phone to set right some supposed problem with the person’s Medicare account.

Medical discount plans masquerading as health insurance: Sometimes the caller will offer medical discount plans that are said to be the equivalent of insurance. In reality, most are memberships in a “club” that claims to offer reduced prices from certain doctors and pharmacies, as well as on some procedures.

The “health insurance counselor:” This fraudster will offer help navigating the health insurance marketplace for a fee, capitalizing on people’s confusion about the state-based health exchanges created through the Affordable Care Act.This sort of assistance is indeed available and is legitimate, but the people who offer it – also known as “navigators” – aren’t allowed to charge for their services. Also, remember that people with Medicare coverage don’t need to use the state health exchanges. The exchanges are for people under the age of 65, who are looking to enroll in an individual health plan.

In addition to knowing some of the tell-tale signs the person on the other end of the line is a fraudster, other ways to help avoid health care phone scams, include:

  • Protect your personal information – including details about your Medicare coverage. Guard your Medicare card number just like you would your credit card number, providing it only to health care providers at the time you are seeking services.
  • Don’t answer a caller too quickly. If someone asks for your Social Security or Medicare number, for example, you should ask why they need it, how it will be used and what will happen if you refuse to provide it.Remember that your health care plan already has this information, so they have no need to call you to ask for it.
  • Any form of recorded sales call is illegal without your prior written permission to receive calls from the company. If you receive one of these calls that prompts you to press “1” to speak to the operator or to have your name taken off a list, it’s likely a scam. Simply hang up.
  • One of the leading Medicare health scams involves fraudsters filing false claims for durable medical equipment such as wheelchairs, scooters, walkers and nebulizers. It’s illegal for a medical supplier to make an unsolicited phone call to people with Medicare. So, if you receive a call to buy medical equipment that your doctor hasn’t ordered, hang up.
  • Another health scam that’s becoming increasingly common is designed to take advantage of people who accidentally mis-dial a toll-free number (a number starting with 1-800, 1-866 or 1-877). In these scenarios, scammers purchase a toll-free number that is just one digit off from a legitimate number. When people mistakenly dial that number, they think they’re speaking with a call center agent from the company they were attempting to reach. Instead they’re on the line with a scammer. For this reason, you should be vigilant about slowly and carefully dialing toll-free numbers.
  • Carefully monitor your statements from Medicare or your health plan for any claims for services or supplies that you did not receive.
  • Trust your gut. If something sounds too good to be true – such as free medical services or equipment in exchange for your Medicare ID number – it probably is. If any part of a phone conversation makes you uneasy, ask the caller for his or her first name and a call-back number where he or she can be reached. Better yet: Hang up and call the company or organization the person claims to be representing, using either the phone number on your health plan ID card, if the person claimed to be calling from your health insurance company, or the toll-free number on the organization’s website.
  • Report suspicious activity to local police, the state attorney general, the Centers for Medicare and Medicaid Services or the Federal Trade Commission. Doing so can help protect others from falling prey to the fraudster’s schemes.

UnitedHealthcare is committed to preventing fraud, waste and abuse in Medicare benefit programs. If you think you have been a victim of fraud or identity theft related to your health information or Medicare coverage, please call UnitedHealthcare customer service at 1-877-596-3258 (TTY 711), 8 a.m. – 8 p.m., 7 days a week, or access other resources online.