Member Resources
Protect Yourself from Medicare Fraud
Learn how to prevent Medicare fraud, and what to do if you think you’re a victim.
About Medicare Fraud
Medicare fraud occurs in several ways, most frequently when Medicare is billed for services or supplies that the member doesn’t receive. There are regulations to protect you against Medicare fraud, but it can still happen.
Tips to Protect Yourself from Medicare Fraud
1
Report Lost or Stolen Card
Immediately report a lost or stolen card.
2
Do Not Share Card Information
Do not allow friends or relatives to use your member card. Do not give your card to someone who is offering you free medical services; if a service is free, your insurance information is not needed.
3
Keep a Journal
Keep a journal of doctor visits and other medical services you receive to compare with your statements.
4
Review Statements Regularly
Carefully examine all your statements, including Medicare Part D; be on the lookout for doctor visits you did not have, medical provider names that are unfamiliar, and supplies/equipment you did not order or never received.
Next Steps for Victims of Medicare Fraud
If you find something unusual on a claim or statement, call your doctor or medical provider first. It may be a simple error – but if it’s not, report it immediately.
If you think you have encountered possible fraud, you can contact any of the agencies listed below for assistance.
- Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048 24 hours a day, seven days a week.
- Fraud Hotline of the Office of Inspector General, U.S. Department of Health & Human Services at 1-800-447-8477. TTY users call 1-800-377-4950.
- Jefferson Health Plans’ Special Investigations Unit 1-866-477-4848. TTY users call 1-877-454-8477.
- Federal Trade Commission's ID Theft Hotline at 1-877-438-4338. TTY users call 1-866-653-4261.