Protect Yourself from Medicare Supplement Fraud: What Our Community Needs to Know

​At Gerard Insurance Services, we believe that protecting our community goes beyond helping you find the right coverage—it also means helping you stay informed and safe. Recently, we received important information regarding Medicare Supplement fraud, and we want to make sure you know what to watch for and how to protect yourself. 🛡️

What Is Medicare Supplement Fraud?

​Medicare Supplement fraud occurs when someone uses your personal information without permission to bill for services, supplies, or prescriptions you never received. Unfortunately, these scams are becoming more common and often target seniors through misleading or “free” offers.

Common Types of Medicare Fraud

Here are a few of the most common scams to be aware of:
🔹 Medical Identity Theft
Scammers use your Medicare number or personal information to bill for services, equipment, or prescriptions.
🔹 Unsolicited Offers
Be cautious of unexpected phone calls or door-to-door visits offering “free” medical equipment, screenings, or gifts in exchange for your Medicare number.
🔹 Billing for Services Not Received
Always review your statements carefully. Charges for appointments, tests, or supplies you never received can be a sign of fraud.
🔹 Plan Switching Scams
Some individuals may pressure you into switching from Original Medicare to a Medicare Advantage (Part C) plan without fully explaining the changes or consequences.

How Fraud Is Investigated

Insurance companies take fraud seriously. Special Investigations Units (SIU) and Claims departments work together to review suspicious claims. This includes:

• Verifying the provider and services billed
• Confirming whether the insured actually received the services
• Reviewing billing patterns, especially for frequent or high-cost claims

It’s important to note that some claims may be flagged simply due to missing documentation, not because they are fraudulent.
To properly review a claim, documentation from Medicare is often required, such as:

• A Remittance Advice with a CO-45 denial code, or
• A Remittance Advice showing the number of units billed

What to Do If You Suspect Fraud

If something doesn’t look right, don’t ignore it. Taking quick action can help prevent further issues.
You can report suspected fraud by:
📞 Calling Medicare: 1-800-MEDICARE (1-800-633-4227)
🖥️ Reporting online to the Office of the Inspector General

How You Can Protect Yourself

​A few simple habits can go a long way:
✔ Never share your Medicare number with unknown callers
✔ Be cautious of “free” offers that require personal information
✔ Review your Medicare Summary Notices regularly
✔ Ask questions if something doesn’t feel right

We’re Here to Help ❤️

​At Gerard Insurance Services, we know Medicare can feel overwhelming—and situations like this can make it even more confusing. If you ever receive a suspicious call, letter, or bill and aren’t sure what to do, reach out to us. We’re happy to walk through it with you and help you stay protected.
Your health, your identity, and your peace of mind matter.