To prevent healthcare fraud, you first need to know what it looks like. Healthcare fraud happens when someone bills your health insurance, including Medicare, for:

• Something you did not receive
• Something different than what you received
• Something that was not medically necessary

In short, someone is trying to bill your Medicare or insurance fraudulently.

Healthcare fraud is very common and occurs in every city, in every state, every day. If fraud happens to you, it is not your fault. Scam artists will do anything to gain our trust, and even the most sensible consumers can get “scammed.” But as the video points out, there’s something you can do and the Illinois SMP at AgeOptions can help!

The best way to detect healthcare fraud is to read your Medicare Summary Notice (MSN) or your insurance’s Explanation of Benefits (EOB). These documents show every claim billed to your insurance.

If you find a claim or charge for something that fits in the categories above, this may be a sign of errors, billing abuse or potential fraud. You can:

• Call the provider to ask about the claim of charge (if you know and trust the provider)
• Call the Illinois SMP at AgeOptions 800-699-9043 (ask for “SMP”).