Just Another Day at HICAP (Medicare Counseling)

Over the past 6 months this Young at Heart article has covered Medicare Fraud, Medicare Enrollment Periods, Changes to Medicare due to the IRA and Benes Acts, and Medicare Preventive Services. Some may ask “How does HICAP (Health Insurance Counseling and Advocacy Program) keep up with all the changes in Medicare”?

All HICAP counselors are California State registered and go through extensive training to learn about the details of Medicare. Counselors must complete continuing education requirements each year to keep their state registration status up to date.

Every day at the HICAP offices we receive phone calls and emails from seniors and/or their families with questions regarding their Medicare. Below is a short list of FAQs that you can share with family and friends. Caller: “I have a bill for $700 from a medical company that does not appear on any of my Medicare Summary Notice’s. This company I never heard of is charging me for services I received while I was in the hospital last year. When I call them, they are very demanding and say I must pay right away”.

HICAP: HICAP called the number on the bill. HICAP asked the company if they submitted a bill to Medicare. They said they had. HICAP called Medicare and Medicare denied receiving a bill from the company from over a year ago. HICAP called the company back and told them that Medicare had not received billing from services that were provided a year earlier.

Caller:” I Received another bill from same company for $2000 for the same hospital stay”’

HICAP: This sounds like Medicare fraud. HICAP called Medicare again, and Medicare still had not received any bills from this company for this patient. HICAP then called Senior Medicare Patrol (SMP) to report this issue. SMP called HICAP back and informed HICAP to inform the client not to pay the bill. The company is currently under investigation for Medicare fraud. The Client was relieved for not having to pay $2700 but also frustrated that they were almost a victim of Medicare fraud.

Caller: “Medicare called me. They said Medicare is sending out new laminated Medicare cards. All I have to do is give them my Medicare number.” HICAP: No, this is a fraud