Fraud & health care

Health care fraud and abuse is a serious issue and it can affect everyone. Health care fraud may result in inaccurate medical records, lost benefits, increased premiums and medical expenses. Below you will find important information on how to protect yourself from fraud and abuse.

Suspect insurance fraud?

Use our form to report insurance fraud.

Beware of potential scams

Protecting yourself from identity theft during Open Enrollment

Identity theft occurs when someone obtains your personal information and uses it to bill for medical supplies and services. It is always important to protect your Medicare and health care member numbers, but be especially careful during any period of open enrollment.

Never give out your Social Security, Medicare or member numbers to someone you don’t know. And of course, carefully review your statement to ensure all the information is correct, including that you received the health care services indicated on the statement.

Besides those precautions, be wary if any of the following occur:

  • Someone says that you are eligible for a refund based on last year’s premium or because you have reached your prescription drug plan “donut hole” and they need your Medicare or health plan member number to issue the refund to you.
  • A company offers you free medical supplies, gift cards or other offers if you provide your Medicare or health care plan member number.
  • To report suspected identity theft or fraud, call 866-595-8495 or use our form.

Beware of 'free' services

Be wary of anyone calling you and offering “free” gift cards in exchange for your insurance or credit card information.

To protect yourself never give your personal information to someone you don’t know. If you receive a telephone call or voice message, hang up and do not press any keys or numbers when prompted even if it is to be removed from their list.

If you suspect services have been submitted to your account that you did not receive, call our Fraud Hotline at 866-595-8495 or use our form.

If you believe someone is using your identity

Use our online form to report suspected health care fraud or abuse. This form is completely confidential. You will need to provide:

  • The name and address of the complaint subject
  • An explanation of what you suspect is fraud or abuse
  • Your complete contact information, including your health insurance identification number, unless you wish to remain anonymous. 

For questions about fraud awareness or to discuss a potential case of abuse, call us at 866-595-8495.