How To Recognize A Health Care Scammer When You Hear One

Updated on January 3, 2023

Image by 123RF

By Dr. David Britchkow, chief medical officer for UnitedHealthcare of NJ and PA

When you hear about the risk of identity theft today, most of the time it’s in the context of cybersecurity – scammers hacking into people’s email or online bank accounts to steal private information such as credit card numbers and passwords.

While the biggest risks may have moved online, identity theft over the phone is still alive and well in Pennsylvania and across the country.

These fraudsters are after more than just credit card or bank information. The Washington, D.C.-based Coalition Against Insurance Fraud says health care-related scams are by far the most common type of insurance fraud in the United States, with billions lost each year to a variety of false reimbursement and billing schemes. Medicare fraud alone is estimated to cost $60 billion every year.

According to U.S. Department of Health and Human Services and state consumer protection offices, these are the common COVID-19 scams to look out for:

Text scams

Many people are receiving messages from people posing as government agencies falsely advertising new COVID-19 vaccines, cures or tests. Do not click on links in texts related to the virus. Instead, check for current information. 

Robocall scams

These automated calls are “phishing” not just for bank or credit card information, but also Social Security numbers and health plan ID numbers to use in other types of fraud.

Phone scammers often prey on people through various guises, including:

  • The “health care representative”: The caller will claim to be a representative of your health plan, such as your Medicare Advantage or Medicare supplement plan. 
  • The “government representative”: A caller might claim to be working for the government, saying he or she is calling from Medicare, for example, and is authorized to collect fees or penalties over the phone to set right some supposed problem with the person’s Medicare account. Medicare does not make unsolicited phone calls.
  • Medical discount plans masquerading as health insurance: Sometimes the caller will offer medical discount plans that are said to be the equivalent of insurance. In reality, most are memberships in a “club” that claims to offer reduced prices from certain doctors and pharmacies, as well as on some procedures.
  • The “health insurance counselor”: This fraudster will offer help navigating the health insurance marketplace for a fee, capitalizing on people’s confusion about the state-based health exchanges created through the Affordable Care Act. This sort of assistance is indeed available and is legitimate, but the people who offer it – also known as “navigators” – aren’t allowed to charge for their services.

In addition to knowing some of the tell-tale signs the person on the other end of the line is a fraudster, other ways to help avoid health care phone scams, include:

  • Protect your personal information – including details about your Medicare coverage. Guard your health care insurance card number just like you would your credit card number, providing it only to health care providers at the time you are seeking services.
  • One of the leading Medicare health scams involves fraudsters filing false claims for durable medical equipment such as wheelchairs, scooters, walkers and nebulizers. It’s illegal for a medical supplier to make an unsolicited phone call to people with Medicare. So, if you receive a call to buy medical equipment that your doctor hasn’t ordered, hang up.
  • Another health scam that’s becoming increasingly common is designed to take advantage of people who accidentally misdial a toll-free number (a number starting with 1-800, 1-866 or 1-877). In these scenarios, scammers purchase a toll-free number that is just one digit off from a legitimate number. When people mistakenly dial that number, they think they’re speaking with a call center agent from the company they were attempting to reach. Instead, they’re on the line with a scammer. 
  • Carefully monitor your statements from Medicare or your health plan for any claims for services or supplies that you did not receive.
  • If any part of a phone conversation makes you uneasy, hang up and call the company or organization the person claims to be representing, using either the phone number on your health plan ID card, if the person claimed to be calling from your health insurance company, or the toll-free number on the organization’s website.
  • Report suspicious activity to local police, the state attorney general, the Centers for Medicare and Medicaid Services or the Federal Trade Commission. Doing so can help protect others from falling prey to the fraudster’s schemes.

UnitedHealthcare is committed to preventing fraud, waste and abuse in Medicare benefit programs. If you think you have been a victim of fraud or identity theft related to your health information or Medicare coverage, please call UnitedHealthcare customer service at 1-877-596-3258 (TTY 711), 8 a.m. – 8 p.m., 7 days a week, or access other resources online.

+ posts

Throughout the year, our writers feature fresh, in-depth, and relevant information for our audience of 40,000+ healthcare leaders and professionals. As a healthcare business publication, we cover and cherish our relationship with the entire health care industry including administrators, nurses, physicians, physical therapists, pharmacists, and more. We cover a broad spectrum from hospitals to medical offices to outpatient services to eye surgery centers to university settings. We focus on rehabilitation, nursing homes, home care, hospice as well as men’s health, women’s heath, and pediatrics.