Published: August 28, 2008 11:09 am      

Medicare scams target lonely seniors

A group fighting Medicare scams is warning older residents to beware of a new scheme.

Fraudulent dealers try to sell free “Medicare-Approved Arthritis Kits” to those who qualify for Medicare Parts A and B.

The kits are touted as a cure for arthritis, diabetes, poor circulation, backaches, swelling, muscle pain and inflammation.

Once the senior agrees to obtain the free kit, Medicare is billed more than $1,000 for items such as a back brace, two knee braces, two wrist braces, two elbow braces, two ankle brace and a heating pad, according to a news release from the Better Business Bureau Education Foundation of Houston.

Selling the kits is apparently a burgeoning business.

A quick search of the Internet netted dozens of “sales opportunities” at job list Web sites for agents willing to sign up seniors for the kits.

One offer, listed on the site, Craig’s List, promised $250 for each completed application approved by a physician.

“Eighty percent of doctors sign off on the whole kit,” the ad claimed.

Often, the recipient never receives the medical supplies.

The scheme is similar to a motorized scooter scam which is thought to have defrauded Medicare of more than $31 million, the release stated.

“I know there are all kinds of scams out there that effect seniors,” said Benelle Fitts, elder rights coordinator for the Area Agency on Aging of Texoma.

Fitts said she isn’t aware of the arthritis kit scam but that she is concerned about another scheme in which insurance representatives talk seniors into signing up for “Medicare Advantage Plans.”

“Most of our seniors are on original Medicare and some have supplements. What I’ve seen is insurance representative who come here and go the senior’s home and sell them a Medicare Advantage Plan that really seems too good to be true. They tell them it covers so much more than Medicare does,” she said.

The plan actually removes the client from his or her original Medicare coverage.

“They may loose medical services such as home health care,” Fitts said.

Once the new plan goes into effect, the recipient also begins to receive notices that his or her Medicare claims are being denied.

The good news, according to Fitts, is that if the change is caught in time, “we can usually get them back on Medicare.”

But the window for switching back to Medicare is only about 30 days, she added.

Fitts said she is particularly troubled by the sales tactics of some of the insurance representatives who call or drop by recipients’ homes.

Some imply that they are with Medicare.

“Medicare does not send representatives out to sell insurance plans in peoples’ homes,” Fitts said.

Others pressure seniors to sign on with the new coverage without telling them how the change will affect their Medicare coverage.

“They don’t tell them this is going to take them off their original Medicare,” she said. “So many of our seniors are just from a trusting age when someone’s word was accepted on a handshake. These agents know that,” she said.

Fitts said another factor is often at work in seniors’ lives.

“I think many of our seniors are very lonely. They see these people coming and they think, ‘This is someone I can talk to,’” she said.

Her advice to anyone who is thinking of buying any kind of health care coverage is to let the representative know they’d like to check out the plan first.

“I try to alert these people to be really careful who they talk to on the phone. Don’t let anyone pressure them into signing anything,” she said.

Fitts said sometimes her clients let her know when an insurance representative plans to visit.

“If I don’t have an appointment and I can be there, I’m glad to do it,” Fitts said.

Fitts said her prescience helps keep the agent from pressuring the senior to sign anything.

The agents selling the plan are almost always paid a commission for every senior they ensnare.

Fitts said if she can obtain the seller’s name, she reports the person to Medicare. After two or more complaints the agent may lose his or her license.

She said she isn’t certain how shady insurance dealers find their victims, but that she suspects companies share lists of Medicare recipient names.

After last summer’s floods, the Area Agency on Aging office was forced to more to a temporary location.

With the agency out of its location in the Pecan Creek Village apartment community, Fitts said it seemed as if insurance representatives targeted both Pecan Creek Village and Summit Senior Village — another senior apartment community across the street.

“When we got back two months later, we discovered so many people had been hit by this (insurance scheme),” she said.

Fitts said she tries to spread the word about potential scams whenever she meets with a group of seniors.

“I warn them about things such as identity theft and other dangers. I just tell them to be very, very careful,” she said.

For information on consumer health care fraud or to report suspected fraud call the Texas SMP at (713)341-6184 or 1-888-341-6187.

For assistance and information from the Area Agency on Aging of Texoma contact Benelle Fitts at (940)668-1858.

The Area Agency on Aging of Texoma is a United Way agency.