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What if I suspect Medicare fraud?

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suspect Medicare fraud

If you think you’ve experienced or seen health care fraud, this explains how to tell us about it.  

Notice something fishy on your Medicare billing statement or Explanation of Benefits? Did you get charged for something you didn’t get? Or billed for the same thing twice? These common red flags are signs of fraud. If your instinct is to investigate further, we encourage you to do so.

First, ask the doctor, hospital or medical facility about the particular service or claim in question.

Still suspicious? Call our confidential Medicare Anti-Fraud hotline. 

    1-888-650-8136
    8:30 a.m. to 4:30 p.m.
    TTY: 1-800-588-2711


Why report fraud?

Medicare loses billions of dollars every year to fraudulent claims.  But health care fraud ultimately results in higher costs for you, too. It equals higher premiums and out-of-pocket costs, and reduced benefits and coverage. 

Eliminating fraud cuts costs and increases the quality of health care services. Protect your health care benefits by reporting suspicious activity.

How to spot fraud

Unfortunately, people have found many illegal ways to take advantage of Medicare. Visit the Fraud and Abuse page of the Official U.S. Government Site for Medicare to learn more about the different faces of fraud.

Here are some tips. 

  • Keep a personal record of dates you visited the doctor and the services you received. Comparing these details to your Explanation of Benefits statement will help you spot red flags.
  • Protect yourself from scam artists. Hang up on telemarketers who ask for personal information like your bank account, credit card and Social Security number.

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Page Last Updated Mon Aug 04 16:12:04 EDT 2014