Where to report
| If it involves | Report to |
|---|---|
| Original Medicare charges, doctors, equipment or suppliers | 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, or the HHS Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477) or oig.hhs.gov |
| A Medicare Advantage or Part D plan | The I-MEDIC at 1-877-7SAFERX (1-877-772-3379), or 1-800-MEDICARE |
| Texas Medicaid, STAR+PLUS or other Texas HHS programs | Texas HHS Office of Inspector General fraud hotline, 1-800-436-6184 |
| An insurance agent's sales conduct or a Medigap company | Texas Department of Insurance, 1-800-252-3439 |
| Not sure, or want help | Texas Senior Medicare Patrol, 1-888-341-6187 |
What to have ready
- Your Medicare number and the claim or statement in question.
- The provider's or company's name, and the date of service.
- What happened, in your own words, and any letters, envelopes or caller ID details.
The Texas Senior Medicare Patrol
The Senior Medicare Patrol (SMP) is a federally funded program, with one in every state, that helps people with Medicare prevent, spot and report fraud, errors and abuse. Texas's SMP, at 1-888-341-6187 and texassmp.org, can look at a confusing statement with you and help you decide where to report it.
What Medicare fraud can look like
Fraud isn't always a stranger on the phone. It can be a bill for a test you never had, equipment delivered that your doctor didn't order, or a plan change you didn't agree to. Errors happen too, such as a service billed twice. Either way, the first step is the same: compare your Medicare Summary Notice or plan statement with your own records, and ask the provider about anything you don't recognize. If the answer doesn't make sense, report it.
How to protect yourself
- Read every Medicare Summary Notice or plan statement, and check it against your calendar.
- Treat your Medicare number like a credit card number.
- Hang up on callers who offer tests, braces or equipment and ask for your Medicare number, and don't answer unknown texts asking for personal information.
- Remember that the only phone number that belongs to Medicare is 1-800-MEDICARE.
Get help
If you think you were enrolled in a plan without your permission, call 1-800-MEDICARE. For questions about your coverage, a licensed insurance agent with Benefits Life can help, at no cost to you, at (512) 265-6565, TTY 711. See Medicare fraud in Texas.
Related questions
Medicare phone numbers in Texas
Official numbers in one place.
Can I change Medigap plans in Texas?
Switching safely, and twisting.
Can I switch Medicare Advantage plans after open enrollment?
If you were switched without your consent.
Sources
- Medicare.gov — Reporting Medicare fraud and abuse
- HHS Office of Inspector General — Report fraud
- SMP Resource Center — Texas Senior Medicare Patrol
- Texas HHS Office of Inspector General — Contact and fraud hotline
- Texas Department of Insurance — Medicare supplement guide (twisting)
Frequently asked questions
What are signs of Medicare fraud?
Charges on your Medicare Summary Notice or plan statement for care, equipment or tests you didn't get; calls offering equipment or genetic tests if you give your Medicare number; and anyone pressuring you to switch plans with promises that sound too good to be true. Compare your appointment calendar with your statements.
Will Medicare call me?
Medicare doesn't call to sell you anything or come to your home. It contacts you only in limited cases, such as after you've left it a message or reported fraud. Never give your Medicare number to an unexpected caller.
Where do I complain about an insurance agent in Texas?
Contact the Texas Department of Insurance at 1-800-252-3439. TDI licenses insurance agents and investigates complaints about sales practices, such as misleading statements to get you to drop a policy.
Can I report anonymously?
The Texas HHS Office of Inspector General says you can choose to stay anonymous when you report Medicaid fraud, though a first-hand account can help. Ask the agency you're reporting to about its own policy.
Medicare in your Texas county
Plans, local agents and help, county by county: Harris · Dallas · Tarrant · Bexar · Travis · Collin · Denton · Fort Bend · Hidalgo · El Paso · Montgomery · Williamson · Cameron · Brazoria · Bell · Galveston · Nueces · Lubbock · Hays · Webb · McLennan · Jefferson · Brazos · Smith · Ellis · Johnson · Comal · Kaufman · Guadalupe · Midland · All 254 counties →
