7 On Your Side: How to stop Medicare/medical ID scams

Nina Pineda Image
Friday, May 6, 2022
7 On Your Side: How to stop Medicare/medical ID scams
The FTC has labeled medical ID theft a growing menace, but 7 On Your Side has ways you can protect yourself.

The Federal Trade Commission labeled it a growing menace: medical ID theft, where a thief steals your Medicare or health insurance number to steal treatment, prescriptions or submit claims all under your name.

But how can you make yourself scam proof? Nina Pineda and 7 On Your Side have the answers.

"This is what happens to a senior citizen," fraud victim Gerald D'Ambrosio said. "It's a disgrace."

He hasn't seen his cardiologist since last August, but it's now that he feels like he's going to have a heart attack.

"I got a bill, I think two weeks ago, from an ambulance service for $750," he said.

More 7 On Your Side | Property tax nightmare for NJ homeowner

What happens when one of the country's largest mortgage companies simply doesn't pay and blows you off for months?

He hadn't been in an ambulance, but someone billed Medicare for transporting him to the ER, and then his stolen Medicare was abused over and over.

His explanation of benefits" showed he also had:

--A knee and chest X-ray

--An EKG

--A psychiatric evaluation

--A battery of blood work

--A slew of doctor visits

It all supposedly took place last November, while the couple spent a quiet Thanksgiving week at home, staying away from kids and grandkids because of COVID. But his medical records show him being taken to the hospital on November 23, and that was just the start of the bogus billing.

"When we got these bills, it was unbelievable," wife Roseanne D'Ambrosio said. "You know, we were devastated."

They wound up calling the New York Statewide Senior Action Council, a non-profit organization dedicated to advocating for the needs and wellbeing of New York's 2.5 million senior citizens.

"We are the federal grantee for the Senior Medicare Patrol Program, which helps prevent, detect and reort healthcare fraud in New York State," Executive Director Maria Alvarez said.

Medical ID theft is the fasted growing and most lucrative fraud out there, and a Medicare number will fetch $1,000 on the dark web compared to $1 for a Social Security number or $5 for a credit card.

"They resell it, and they keep reselling it," Alvarez said. "They won't sell it just once."

Alvarez warns the sophisticated rings don't just wreak havoc on families like the D'Ambrosios, and the theft could be deadly. The dangers of medical ID theft include the patient being denied services in the future, suffering a life-threatening medicine mix-up, or a medical history mistake.

"What if Gerry had to go for an X-ray of his knee," Roseanne D'Ambrosio said. "And they said, 'Well, you just had an X-ray of your knee. You can't have another.'"

More 7 On Your Side | Warning about sugar substitute that could be fatal to dogs

There is a consumer warning for pet owners about a sugar substitute called Xylitol that is harmless for humans but can be fatal to dogs.

The good news is they reported it, and the Senior Action Council ordered a new Medicare number for Gerald. It should arrive in about 14 days, so he won't be on the hook for any co-pays or patient responsibility.

"They know that this is not him and that this has something that has to be investigated," Alvarex said. "And they will take that off."

The big takeaway is to guard your card. Do not share your card with anyone who calls, and don't text or email it to anyone. Also, read your explanation of benefits, and if you see something that wasn't you, report it right away.

CLICK HERE for more on the NY Statewide Senior Action Council.



Do you have an issue with a company that you haven't been able to resolve? If so, 7 On Your Side wants to help you!

Fill out the form below or email your questions, issues, or story ideas by filling out the form below or by emailing 7OnYourSideNina@abc.com. All emails MUST INCLUDE YOUR NAME AND CELLPHONE NUMBER. Without a phone number, 7 On Your Side will not be able to respond.