Alert: Medicare Members Being Targeted For Medicaid Recertification Scam

Please be aware of a fraud that is targeting Medicare/ Medicaid (dual-eligible) members who are due to renew their eligibility in their Medicaid health plan. This is also known as “recertification” or “redetermination”. Scammers will offer help with “recertification” for a fee and ask members to share credit card or other personal information.

Details

Members receive a renewal notice prior to the end of the renewal date of their Medicaid health plan. Members may receive a text, call, or direct mail that includes a reminder that it is time to update their personal information, including contact and income information. The notice will usually tell the member they need to provide this information directly to the state in order to renew their health care coverage. These notices will never ask members for money to renew their coverage. These notices will come either directly from the state or the state’s eligibility vendor.

Important Note: Carriers will never ask members for money to renew or apply for Medicaid.

The scammers then use the information they collect to commit fraud and identity theft.

• They offer to help members to recertify the member’s Medicaid eligibility.
• If the member is interested, the scammer will ask for the member’s personal information, such as their credit card number, Medicare number, member ID, SSN, or even driver’s license number.
• Scammers have contacted members
• Online, by phone, and face-to-face.
• At health fairs, places of worship, grocery stores, and senior centers.
• They have even knocked on doors and tried to bully people into signing up for genetic testing.

Tips to Prevent Fraud (*Not an all-inclusive list)

If you have any questions, call us today at 866-568-9649!