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Consumer Protection Tips

Health care error, fraud, and abuse affect everyone. They contribute to the rising costs of health care and, in some instances, diminish the quality of care that is provided.

Most health care providers are honest and are providing the best care that they can, but the small number who aren’t find ways to steal billions of dollars from the health care system each year. Even more is lost to errors in billing that are never found.

It is in your best interest, and the best interest of all citizens, to be informed, aware, and involved in stopping and preventing error or fraud.

You should be suspicious if a health care provider tells you that:
  • The test is free; he only needs your Medicare number for his records.
  • Medicare wants you to have the item or service.
  • They know how to get Medicare to pay for it.
  • The more tests they provide the cheaper they are.
  • The equipment or service is free; it won't cost you anything.
Be suspicious of providers that:
  • Routinely waive co-payments without checking on your ability to pay.
  • Advertise "free" consultations to Medicare beneficiaries.
  • Claim they represent Medicare.
  • Use pressure or scare tactics to sell you high priced medical services or diagnostic tests.
  • Bill Medicare for services you do not recall receiving.
  • Use telemarketing and door-to-door selling as marketing tools.
NEVER give your Medicare/Medicaid or Social Security number over the telephone or to people you don’t know.

NEVER allow anyone to convince you to contact your physician requesting a service you don’t need.

NEVER give your Medicare or Medicaid number to anyone for a free service. They don’t need your Medicare or Medicaid number if the service is truly free.

NEVER accept medical supplies or equipment from a door-do-door salesperson. Neither the Federal Government nor Medicare sell supplies or equipment door-to-door.

NEVER believe anyone who says they are from Medicare or any Federal agency trying to sell you products or services. Neither the Federal Government nor Medicare endorses the products or services of any individual or company.

ALWAYS rely on your personal physician to recommend all medical services and equipment for you.

KEEP a record of your health care appointments and services.

READ your Medicare Summary Notice (MSN) carefully. Look for:
• Duplicate payments for the same service.
• Dates of service on the MSN that differs from the dates you actually received the service.
• Items or services you do not recall receiving.
• Billings for medical equipment or services that were not ordered by a physician.

CONTACT your health care provider, supplemental insurance company and/or carrier if you have questions about services listed on your MSN.

If you still have questions, CONTACT the Senior Medicare Patrol Project in your state.
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 Last Updated: 9/9/04 report issues regarding this pagereport icon 
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