Join the fight against Medicare fraud

Medicare fraud affects everyone. You can team up with Medicare to help.

Our Senior Medicare Patrol volunteers are teaching people like you how to spot, report, and stop fraud, and protect themselves from identity theft.

Here are some things you can do:

  • Guard your Medicare and Social Security numbers. Treat them like you would treat your credit cards.
  • Hang up the phone if someone calls and asks for your Medicare number, Social Security number, or bank or credit card information. We will NEVER call and ask for this information, and we will NEVER call you or come to your home uninvited to sell Medicare products.
  • Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. It’s illegal, and it’s not worth it!
  • Do not let anyone borrow or pay you to use your Medicare ID card or your identity.
  • Check your Medicare claims for errors. Look at your Medicare Summary Notice (MSN) or statements from your Medicare plan. You can also check www.MyMedicare.gov or call 1-800-MEDICARE (1-800-633-4227) as soon as your claims have been processed. The sooner you see and report errors, the sooner we can stop fraud. TTY users should call 1-877-486-2048.
  • Call 1-800-MEDICARE to report any suspected fraud.

Learn more about spotting and reporting fraud, and get tips on protecting yourself from identity theft.

Find out about Senior Medicare Patrol activities in your area.

Medicare Open Enrollment: Better Choices, Sooner

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

Every year, people with Medicare get to explore new choices and pick the plans that work best for them. This year, this Open Enrollment period is starting early – on October 15 – and ending sooner – December 7.

As health plans start their marketing and advertising activities in just a few weeks, we want people to know that the Medicare program is strong and, in 2012, they have a broad array of choices. And, there are lots of new benefits thanks to the Affordable Care Act.

Every person with Medicare will have to choose a “Part D” plan to help them pay for prescription drugs. And people who have chosen to enroll in a “Part C” Medicare Advantage plan for their basic health care services have the option of staying in that plan, choosing a different plan, or going back to the Original Medicare program. These are important choices that should be made with care.

The good news is we have strengthened consumer protections and improved plan choices. We’re making it simpler for people to choose a new health or drug plan by reducing the number of duplicate plans. We’ve also worked with plans to reduce cost sharing on important benefits like inpatient hospitalization and mental health services.

And, thanks to our enhanced bargaining power we can report that average premiums for a Part D plan will be the same in 2012 as in 2011. The average premium for Part C plans is going down by 4 percent. That’s great news for people on Medicare who have a fixed income.

As with last year, people with Medicare will continue to have a variety of Medicare Advantage plan choices. Consumers in every part of the country will have a wide variety of Part D plan choices in 2012, including many plans with zero deductibles and plans with some form of generic gap coverage.

People with Medicare are also enjoying important new benefits. Every person is entitled to an Annual Wellness Visit with their doctor so that they can discuss their health and their health care needs. Prevention services like mammograms and other cancer screenings are now available with no cost-sharing. And people who reach the donut hole in their drug costs will get a 50% discount on covered brand name drugs and a 14 percent discount on generics. That puts money back in your pockets.

More good news for consumers is the fact that we’ll be closely monitoring marketplace performance to protect people from misleading information or prohibited tactics by a small minority of unscrupulous plans. Medicare plans are on notice: we’ll move quickly to take action against plans found to be violating marketing rules.

In short, there’ll be a wide range of health and drug plan options available across the country, including Original Medicare. People can turn to www.medicare.gov, call the 1-800-MEDICARE hotline, or consult with a local State Health Insurance Assistance Program (SHIP) for help. We want to make sure people can identify and enroll in the coverage option that suits their needs in 2012.

More Americans Accessing Improved Medicare Coverage

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

Millions of Americans are enjoying improved Medicare coverage thanks to the Affordable Care Act. More people are getting preventive services to keep them healthy, and people with high prescription drug costs are seeing the coverage gap “donut hole” starting to close. Here are the latest numbers from the past few months:

  • July:
    • Through the end of July, 1.28 million Americans with Medicare have received discounts on brand name drugs in the Medicare Part D coverage gap — up from 899,000 through the end of June and 478,000 through the end of May.
    • These discounts have saved seniors and people with disabilities a total of$660 million, including $199 million in July alone!

For state-by-state information on the number of people who are benefiting from this discount in 2011, visit this page.

  • August:
    • Through the end of August, over 18.9 million people with Original Medicare, or 55.6 percent, have received one or more free preventive services.
    • During the same time period, over 1.2 million Americans with Original Medicare have taken advantage of Medicare’s new free Annual Wellness Visit, up from 1.06 million in July.

For state-by-state information on the numbers of people who are utilizing preventive services in 2011, visit this page.

Over the coming years, provisions of the Affordable Care Act will help close the coverage gap completely. Here is a sense of what people with Medicare can look forward to:

  • 2013: Paying less and less for your brand-name Part D prescription drugs in the coverage gap.
  • 2020: The coverage gap will be closed, meaning there will be no more “donut hole,” and people with Medicare will pay only 25% of the costs of their drugs until they reach the yearly out-of-pocket spending limit.

The chart below shows what people with Medicare prescription coverage will pay over time:

Medicare Prescription Drug Coverage Over Time

chart showing Medicare Prescription Drug Coverage Over Time

Strengthening Medicare: Halting Cuts to Medicare Payments

By Kathleen Sebelius, Secretary of Health and Human Services

It’s important to protect the high-quality health care currently available to people with Medicare. Unfortunately, the 23% cut in Medicare payments to doctors that is scheduled to go into effect at the end of November has the potential to disrupt the health care that millions of Medicare beneficiaries rely on.

Today, in a speech to the Association of American Medical Colleges, I spoke about why this Administration has made it a priority to ensure this extreme cut in payments to doctors is addressed during the upcoming Congressional session. Here’s an excerpt from my speech:

“…[We] know that health care providers also face significant barriers as you strive to deliver the best care possible. And we’re committed to working with you to reduce them.

That starts with preventing the 23% cut in Medicare payments to doctors that’s scheduled to take effect at the end of the month. These drastic cuts could force doctors out of the Medicare program and jeopardize the care of our seniors.

On Thursday, I attended a Cabinet meeting where the President stressed that preventing these potentially disastrous cuts must be one of our top priorities. The American Medical Association has proposed a 13 month extension. And I hope that Congress will act quickly to pass it, so that our doctors and seniors can have some peace of mind while we work on a long-term fix.

There’s been a lot of talk in the last few months about Medicare and its future. The single biggest step we can take to strengthen Medicare for seniors and disabled Americans is to make sure these disruptive cuts don’t take effect.

As the President has said many times, we will ultimately need a permanent fix, so that the livelihoods of the hard-working doctors who care for seniors and people with disabilities are no longer subject to politics. But in the meantime, we don’t want any doctor to be stuck in a limbo where they don’t know week to week how much they’ll be paid for the services they deliver.

That’s why we’re urging Congress to act now to make sure that you can continue to provide the high quality care our seniors depend on every day.”

Strengthening Medicare is a core value for this Administration. We will continue to act to ensure that the program and the people who receive care and provide care have the resources they need. To learn more about other ways we are working to strengthen Medicare, especially through the Affordable Care Act, click here.