Insurance Scam Seeks Your Information

  • Medical fraud drugs

    Health insurance companies don’t prescribe or send medications and supplies to their members. That’s your doctor’s job.

    Nationwide, people are reporting they’ve received boxes of medications or devices such as back braces, without their doctor’s knowledge or prescription. Then their insurance company is billed and the member receives an explanation of benefits (EOB) for the supplies.

    Watch the KDKA2 news story

    How does the scam work?

    Our members are receiving telemarketing phone calls offering free pain medicine or medical supplies. In other cases, people are prompted to take a survey, either in a store in exchange for a gift card or in a social media feed, such as Facebook. The survey may ask about pain and other medical information. It also requests the name of the user’s auto and health insurance. That’s enough information for the scammers to move forward. They may ask for your member ID or primary physician name.

    Open quotation I have received an EOB for a brace for my back. I have never received (the brace) and I have not ordered (it) and this is the second time that this same firm has billed Medicare for this same brace. They were billed to Premera … I think this is so wrong. Close quotation

    Open quotation They have called my house every day, for months and months and I keep saying I don’t want them, I don’t want them—well they sent them. Close quotation

    Why should you be concerned?

    Scammers won’t send you quality medications. The medicine might be unsafe or interact with your other medicines. Medical devices should be carefully fitted to you, not sent in the mail in a random size. We want you to get all the care you need. If you need medical equipment or prescriptions, work with your own provider.

    When “free” stuff isn’t really free

    Scams like this can end up costing insurance companies enormous amounts of money, which raise premiums for everyone.

    Open quotation [I feel] exploited, very angry, taken advantage of. Insurance costs are high to begin with, but those indirect costs on pulling a scam like that only increases the cost of insurance for people, and people that can’t afford it. Close quotation

    How can you avoid scams like this?

    • Don’t fill out online surveys, such as those on Facebook.
    • Surveys for gift cards are usually too good to be true—they want something from you.
    • Never give the name of your insurance company or doctor to someone unfamiliar to you.
    • If you are called and offered free medicine or supplies, hang up.