Preventing Medicare Fraud

Physicians Health Choice-branded plans will not be offered for the 2014 plan year. This website covers 2013 plan information. Please refer to your plan information (e.g., Annual Notice of Changes, communications you’ve received by mail or e-mail, etc.) for more details. For information about 2014 plans that might meet your Medicare coverage needs, please visit .

Your Rights

Don't be a victim of identity theft.

  • No one should call you or come to your home uninvited to sell Medicare products.
  • Medicare plans cannot ask you for credit card or banking information over the telephone unless you are already a member of that plan.
  • In most cases, Medicare can't call you to enroll in a plan—you must call them.
  • Only give your information to doctors, other providers, and plans contracted by Medicare, and to people in the community who work with Medicare, such as your State Health Insurance Program (SHIP) or Social Security.

If you think you've been a victim of identity theft or fraud:
Call any of these numbers:

  • Call 1-800-MEDICARE (1-800-633-4227). TTY, call 1-877-486-2048. 24 hours a day, 7 days a week.
  • The Fraud Hotline of the HHS Office of Inspector General, at 1-800-HHS-TIPS (1-800-447-8477). TTY, call 1-800-377-4950. You can also email .
  • The Federal Trade Commission's ID Theft Hotline at 1-877-438-4338 to make a report. TTY users, call 1-866-653-4261.

Senior Medicare Patrol (SMP) Program can help.
The SMP Program educates people with Medicare to take an active role in detecting and preventing health care fraud and abuse. There is an SMP Program in every state, the District of Columbia, the U.S. Virgin Islands and Puerto Rico.

Find your local SMP Program

How you can fight healthcare fraud
UnitedHealthcare® is committed to preventing fraud, waste, and abuse in Medicare benefit programs and we're asking for your help. If you identify a potential case of fraud, please report it to us immediately.

Examples of potential Medicare fraud cases:

  • A health care provider – such as a physician, pharmacy, or medical device company – bills for services you never got.
  • A supplier bills for equipment different from what you got.
  • Someone uses another person's Medicare card to get medical care, prescriptions, supplies or equipment.
  • Someone bills for home medical equipment after it has been returned.
  • A company offers a Medicare drug or health plan that hasn't been contracted by Medicare.
  • A company uses false information to mislead you into joining a Medicare drug or health plan.

To report a potential case of fraud in a Medicare benefit program, call UnitedHealthcare®'s dedicated fraud hotline at 1-877-637-5595, 24 hours a day, 7 days a week. TTY users may call 711.

This hotline allows you to report cases anonymously and confidentially. UnitedHealthcare will make every effort to maintain your confidentiality. However, if law enforcement needs to get involved, UnitedHealthcare may not be able to guarantee your confidentiality. Please know that UnitedHealthcare will not take any action against you for reporting a potential fraud case in good faith.

You may also report potential prescription drug program fraud cases to the Medicare program directly at 1-877-7SafeRx (1-877-772-3379). For potential medical or non-prescription fraud cases, you may report to the Medicare program directly at 1-800-MEDICARE (1-800-633-4227; TTY: 711; 24 hours a day, 7 days a week). The Medicare fax number is 1-717-975-4442 and the website is .

For more information, request the guide titled “Protecting Medicare and You from Fraud” by calling 1-800-MEDICARE (1-800-633-4227; 24 hours a day, 7 days a week). TTY/TDD users should call 1-877-486-2048. A customer service representative can answer your questions 24 hours a day, 7 days a week.

How Medicare protects you
Medicare works with other government agencies to keep you safe from fraud.

You also have the right to control when and to whom your personal information is given.

You are protected from discrimination. You can't be treated differently because of your race, color, national origin, disability, age, religion, or sex. If you think you haven't been treated fairly for any of these reasons, call the Department of Health and Human Services, Office for Civil Rights for your state, or call toll-free 1-800-368-1019. TTY users, call 1-800-537-7697. For more information, visit the U.S. Department of Health and Human Services website.

Medicare Beneficiary Ombudsman
An ombudsman is a person who reviews issues and helps resolve them. The Medicare Beneficiary Ombudsman shares information with the Secretary of Health and Human Services, Congress, and other organizations about what works well with Medicare — and what doesn't.

The ombudsman helps improve the quality of services and care you get from Medicare by reporting problems and making recommendations.

The ombudsman makes sure this Medicare information is available to Medicare members:

  • Your Medicare coverage.
  • Information for you to make health care decisions.
  • Medicare rights and protections.
  • How you can resolve issues.

The ombudsman reviews concerns through 1-800-MEDICARE (TTY users, call 1-877-486-2048; 24 hours a day, 7 days a week) and through your State Health Insurance Assistance Program. For more information about the Medicare Beneficiary Ombudsman, go to Medicare's website and click on “ombudsman.”

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