Let’s look alive out there!”

by Joe Lykins, Senior Services Specialist, Senior Medicare Patrol, Area Agency on Aging of North Idaho

During my (very) short Little League experience I remember the coach saying this to us outfielders when the other team came to bat, “Wake up!” “Pay attention!” He knew how easy it was for us youngsters to let our minds wander, to stare at the sky, look for birds, anything except keeping our eye on the ball.

It can still happen. For those of us aged 65 or older, the term “Medicare” has become so common that we tend to stifle a yawn when it is brought up in conversation. When we get our Medicare Summary Notices or Explanations of Benefits we tend to just scan to the bottom right corner to see if we owe anything. And if we don’t, then we just toss it in the trash. We think, “Good! That visit to my doctor didn’t cost me anything!” Worse yet, we can tend to just throw the bills in a pile thinking we will get around to checking them later. It’s so easy to get complacent.

Wait a minute, though. Have you checked your Medicare statement over carefully? Does the service reflect what the physician actually performed? Does the billed amount match the bill his/her office sent to you? Is the physician’s name actually your physician? Or someone else you may not know?

Now, before you start accusing your doctor of malfeasance, start with assuming that any mistake is nothing more than a typing error on the part of a medical clerk. A simple call to the doctor’s billing office should clear this up. If the office personnel sounds confused or hesitant, the next step is to call the insurance company (if you have a Medicare supplemental or Medicare Advantage policy), or 1-800-MEDICARE. If you still are not satisfied with the result, then give your Senior Medicare Patrol a call at 800-786-5546 ext 4071.

As recently as February, 2023:

• A medical supply company was convicted of defrauding Medicare Advantage and Medicaid plans of over 3.8 million dollars.

• Two doctors were convicted of submitting over 31 million dollars in unneeded durable medical equipment claims.

• A marketer pled guilty to buying and selling 2.6 million Medicare ID numbers.

Also, if your organization would like a 10- to 30-minute presentation on dealing with Medicare fraud, please contact us at the Area Agency on Aging of North Idaho, Senior Medicare Patrol: 800-786-5546 ext. 4071 and we’d be happy to help.

We tend to think that since we don’t owe anything to the doctor that the service didn’t cost us anything. But an overlooked statement here and there can add up.

Bio: Joe Lykins has been a Senior Services Specialist with the Area Agency on Aging of North Idaho for over five years. Shortly after he started, he was asked to take on the task of Senior Medicare Patrol volunteer coordinator as well, and now divides his time between the two responsibilities. His motto is “Life is too short to spend any of it in retirement.”

How did these fraudsters get caught? Well, it probably started with us individual Medicare beneficiaries being diligent in checking our paperwork. It started with us.

Looking alive out there!

Joe Lykins has been a Senior Services Specialist with the Area Agency on Aging of North Idaho for over five years. Shortly after he started, he was asked to take on the task of Senior Medicare Patrol volunteer coordinator as well, and he now divides his time between the two responsibilities. His motto is “Life is too short to spend any of it in retirement.”

We at Senior Medicare Patrol have a “My Health Care Tracker” tool, a 5” x 8” booklet that can help you keep a record of the health care services you receive. Contact us at 800-786-5546 ext 4071, or smp@nic.edu and we can mail you one.

Also, if your organization would like a 10- to 30-minute presentation on dealing with Medicare fraud, please contact us at the Area Agency on Aging of North Idaho, Senior Medicare Patrol: 800-786-5546 ext. 4071 and we’d be happy to help.

• A ‘Hub’ for available resources in the community

• Senior Center meals and information

• Home Delivered Meal information

• Support and referrals for suspected Elder Abuse

• Long-Term Care Elder Advocate

• Help with navigating Advance Directives

• Connection to Alzheimer & Dementia resources

• Medicare Fraud education

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• Referrals for Housing, Legal, Transportation & much more

• Help with Wheelchair ramps, Grab-bar installation & other minor home repairs