Medicare Medicare is the federal government health insurance program that provides health care coverage if you are 65 or older, are under 65 and receive Social Security Disability Insurance (SSDI) for 24 months, begin receiving SSDI due to ALS/Lou Gehrig’s Disease, or have End-Stage Renal Disease (ESRD) no matter your age. You can receive health coverage directly through the federal government (see Original Medicare) or through a private company (see Medicare Advantage). abuse includes practices that result in unnecessary costs to the Medicare program. Any activity that does not meet professionally recognized standards or provide patients with medically necessary Medically necessary refers to procedures, services, or equipment that meet accepted medical standards and are necessary for the diagnosis and treatment of a medical condition. services is considered abuse. Committing abuse is illegal and should be reported.
Common types of abuse include:
- Billing for unnecessary services (services that are not medically necessary)
- Overcharging for services or supplies
- Misusing billing codes to increase reimbursement
To report abuse, contact 1-800-MEDICARE (1-800-633-4227), the Senior Medicare Patrol (SMP) Resource Center (877-808-2468), or the Inspector General’s fraud hotline at 1-800-HHS-TIPS (447-8477). Medicare will not use your name while investigating if you do not want it to.