Protect yourself from Medicare fraud

The Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) program is Washington state’s Senior Medicare Patrol (SMP). A federally funded and volunteer-based program, SHIBA/SMP volunteers provide education on how to prevent, detect and report Medicare fraud.

Medicare is the national health care plan for all U.S. citizens age 65 and older. It also covers people younger than age 65 who receive Social Security Disability Income and people who are diagnosed with certain medical conditions.

In Washington state, SHIBA/SMP volunteers help protect seniors and fight health care fraud, leaving more money in the system for everyone. Our state’s volunteers educate beneficiaries on how to avoid becoming victims of health care fraud, and how to report abuse or fraud, related to their Medicare benefits.

We all pay a price for Medicare fraud, waste and abuse, which contributes significantly to rising health care costs. There are three things you can do to help fight Medicare fraud:

1. Know your rights. As a person with Medicare, you have certain rights and protections designed to help protect you and make sure you get the health care services the law says you can get.
2. Protect your identity. Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes. Keep this personal information safe:
• Your name.
• Your Social Security Number (SSN).
• Your Medicare number (or your membership card if you’re in a Medicare Advantage or other Medicare health plan).
• Your credit card and bank account numbers.
3. Get involved with other seniors with the Senior Medicare Patrol (SMP). The SMP educates and empowers people with Medicare to take an active role in detecting and preventing health care fraud and abuse.

You can find more Medicare fraud tips on our website. If you suspect Medicare fraud or have questions about your bill:

• Call OIC’s Statewide Health Benefits Insurance Advisors (SHIBA) at 1-800-562-6900 or email us at shibahelpline@oic.wa.gov.
• Contact your local SHIBA office.