Reports of Medicare fraud targeting seniors are increasing. Scammers lure elderly individuals into home care and hospice services by offering illegal cash rebates. This scheme has spread within the Korean senior community. Recruiters promise cash incentives in exchange for signing up for medical services under Medicare and Medi-Cal.
How Medicare Fraud Targets Seniors
Kim Sung-Tae (81, pseudonym) was persuaded by a marketer from “H Health” to switch his Medicare and Medi-Cal plans. “They told me I would get $600 every three months for joining home care services,” he said. Kim and his spouse signed up and received $1,200. However, after consulting an insurance agent, he realized it was illegal. “Many people around me have signed up,” he added.
Similarly, Lee Eun-Ae (83, pseudonym) considered enrolling after hearing from friends at a senior care center. “A friend has been on hospice care for over five years and gets cash every three months,” she said. “I wonder if I can receive home care, caregiver services, and hospice care all at once.”
The Tactics Behind Senior Insurance Fraud
Recruiters target seniors at churches, senior apartments, and care centers. They promise cash payments of $500 to $600 every three months for signing up for home care or hospice services. A Medicare agent explained that Kim was frightened after realizing he had been part of a fraudulent scheme. “The home care provider billed the government for medical tests and procedures under his name. But he had no idea and only focused on getting cash payments,” the agent said.
The insurance industry warns that scammers use seniors’ personal information to file unnecessary medical claims. An insurance company spokesperson revealed, “Some organizations pay Korean seniors $600 every three months. Meanwhile, they bill the government up to $10,000 per month for medical expenses. Many seniors don’t even realize what’s happening.”
Dangers of Fraudulent Hospice Enrollment
Enrolling in hospice care should be based on a senior’s actual health condition. However, fraudsters exploit this system. Hospice care is meant for terminally ill patients. Once enrolled, individuals face restrictions on routine treatments, prescriptions, and doctor visits. Switching back to standard Medicare or Medi-Cal services is also difficult.
A hospice industry professional, who requested anonymity, warned about the legal risks. “Hospice services require a certification of terminal illness from a primary doctor,” they said. “If a senior who doesn’t qualify signs up, it becomes a criminal act. The patient, recruiter, and physician could all face charges.”
Government Crackdown on Medicare Fraud Targeting Seniors
Authorities are cracking down on Medicare fraud targeting seniors. An insurance industry representative urged seniors to be cautious. “Seniors must not falsify their health conditions to receive unnecessary Medicare or Medi-Cal services,” the representative said. “If caught committing fraud against the federal government, they could lose all healthcare benefits and welfare assistance.”
Investigators continue to monitor fraudulent Medicare schemes. Seniors should verify offers with trusted insurance agents and report suspicious activities.
BY HYOUNGJAE KIM [kim.ian@koreadaily.com]
