Seniors beware. Fall is fast approaching and before you know it, it will be time for you to consider your Prescription Drug plan options. Since the Part D drug plan was put in place, scam artists having been posing as Medicare representatives with the pretense of assisting beneficiaries in selecting a Part D drug plan. Here are some common scams people have fallen victim to surrounding the Part D open enrollment period.
The callers identify themselves as representing a seemingly legitimate organization. Nonexistent groups go under such names as "Pharmabay, " "Pharma Corp" or "Pharma Express," "National Medicare Office," or "National Medical Office."
The caller addresses the beneficiary by name, identifies their bank and their doctor's name. In many cases, the caller already knows the beneficiary's Social Security number. This ruse helps reinforce the notion that the caller is legitimate.
Typically, the caller offers to "help" the individual by making the Medicare Part D process easier, simplifying choices or helping to access benefits or save money. Then the caller asks for more personal information from the individual, such as their banking information or credit card number.
In this scam, referred to as the "299 gang," the callers often identify themselves as Medicare employees. Seniors are asked for their checking account information in order to "sell them a Part D drug plan for $299."
It is usually explained that there is a one-time fee, ranging anywhere from $299 to $399, which will ensure that the premiums will be paid for several years, or for their lifetime. Callers can be very persuasive, even aggressive, in their attempts to convince individuals that they must provide the requested information.
In some cases callers contact a beneficiary noting that he or she must renew their Medicare Part D insurance cards or risk losing not only Part D coverage but also Medicare A and B coverage. Again, the caller then asks for personal information such as a Social Security number and their banking information.
Marketing tactics can also be of concern when it comes to Part D enrollment. A beneficiary may believe he is enrolling in a stand-alone Part D plan when, in fact, an unscrupulous sales person is enrolling the beneficiary in a Medicare Advantage Plan.
The incentive for the sales person is the receipt of a higher commission for such an enrollment since Medicare heavily subsidizes the Medicare Advantage plan. Unfortunately, the beneficiary will not notice the change until he is advised that his doctor is not in the network of the plan he was falsely enrolled in.
By this time, the beneficiary has now also lost his original Medicare coverage and must spend a great deal of time and effort to reverse this enrollment.
Beneficiaries must remember that legitimate Medicare drug plans will not ask for payment over the telephone or Internet. Medicare, Medicaid and the Social Security Administration will never call a beneficiary on the telephone. A beneficiary who receives such a call should never provide any information, but should instead hang up and file a complaint with Medicare (1-800-MEDICARE) or the ND SMP (1-800-233-1737).
We, at the N.D. SMP (Empowering Seniors to Prevent Healthcare Fraud), are working to provide education and assistance to consumers on identifying, reporting and preventing Medicare and Medicaid fraud, waste and abuse. But, we need your help.
If you suspect fraud, waste or abuse, first call the provider to see if it can be corrected. If the complaint is not settled to your satisfaction, make a complaint to Medicare or to the ND SMP (1-800-233-1737). All taxpayers have a stake in reducing the cost of fraud, waste and abuse in Medicare because as taxpayers we pay for these programs.
By reducing fraud, waste and abuse, we can keep Medicare premiums from increasing beyond the ability of many older adults to pay for them.
Linda Madsen is project director for N.D. Center for Persons with Disabilities in Minot.