The holidays bring a lot of joy and often a sense of security and trust in others — that is part of the Christmas spirit.

Unfortunately, the season can also bring increased vulnerability, loneliness, and, a longing for more security. And, sometimes people with less than good intentions attempt to take advantage of especially vulnerable populations, such as seniors.

The North Gwinnett Voice interviewed William Revuelta, Southeast General Manager for Connie Health for advice on how to manage these risks.

NGV: Can you give us a rundown on the most common — and on the most potentially dangerous — scams targeting seniors? Who is particularly at risk in this population?

Revuelta: “The number of Medicare scams and scam calls increases during the Annual Enrollment Period, which runs annually from Oct. 15 to Dec. 7 — but you could become a Medicare scam victim throughout the year. Being a victim means having your personal and financial information and savings at risk, not to mention the major headaches it can cause you or your loved ones.

Each year, Medicare scams become more sophisticated. It’s crucial to stay up-to-date on the latest scams and know what to look out for. This year, some of the common and potentially dangerous scams are based on the current news you see on TV or your cell phone:

• The Inflation Reduction Act brought Medicare savings to many who take insulin. The latest scams offer free diabetic supplies such as Continuous Glucose Monitors (GCM), glucose meters, diabetic test strips, or lancets in exchange for your Medicare or Social Security number, financial information, or confirmation of this information.
• Another common scam is the sale of fake at-home COVID-19 test kits in exchange for your personal or medical information, like your Medicare or Social Security number. If you’re purchasing a COVID test, ensure it’s from a legitimate FDA-approved source.
• One other important scam has targeted Medicare beneficiaries who were enrolled in Medicaid. During the COVID-19 Public Health Emergency, they didn’t need to recertify their eligibility based on their income. When the emergency ended in May 2023, states began recertification. The recertification process has become an entry point for fraudsters. Once connected, someone demands that you pay a fee — as much as $500 — or risk losing their health coverage.”

NGV: What are the best ways to avoid being victimized or to help a relative avoid it?

Revuelta: “The best way to combat scams is to be alert and ensure that your address is updated to receive all official Medicare notices. Reach out to a licensed insurance agent or platform like Connie Health with licensed agents available to help complete changes to your plan and never give away sensitive information, such as your Medicare number over the phone.

Other tips to avoid being victimized include:

• Don’t accept medical supplies from a door-to-door salesperson. It’s a scam.
• Medicare and Medicaid never send representatives to your home. So, if someone comes to your house claiming to be from these agencies — it’s a scam.
• If anyone, other than your doctor or hospital providers, asks for your Medicare card, Medicare number, or Social Security card or number — it’s a scam.
• If someone offers you money or gifts for free medical care — it’s a scam. Nothing is ‘free.’
• If a provider tells you that the item or service isn’t usually covered, but they ‘know how to bill Medicare,’ so Medicare will pay. It’s a scam. You’ll be the one who gets a bill.
• If you receive a bill in the mail for services or products you didn’t order, and there’s a demand for payment — it’s a scam. Do not pay the bill. You’re not liable for things you didn’t order and then demand payment. When you get a bill like this, report it at ReportFraud.ftc.gov.
• If you review your Medicare statement and see that there are services, products, or equipment you or your provider didn’t request or are double charged — it might be a scam. You can review your statements by mail or through your account at Medicare.gov.
• Are you getting a new Medicare card? If someone tells you that you need to return your old Medicare card, it’s likely a scam. Once you receive your new Medicare card, the old one is no longer needed. You should destroy the old Medicare card with scissors or a shredder and start using the new card immediately.
• Did you get an email from Medicare? Are you sure? Look closely at the email address it’s coming from. While many emails may look like they’re coming directly from Medicare, once you click these links, you’re taken to a website that looks authentic but is a scam. Do not reply to unexpected emails, text messages or click on links — even if they seem genuine. If you need to log into your Medicare account, go to Medicare.gov, call 1-800-633-4227, or speak with your local Connie Health agent.
• Do not be afraid of threats to terminate benefits. If you qualify for Medicare, your eligibility will not be taken away because you don’t sign up for a particular plan. Don’t be pressured to sign up.”

NGV: What are some of the overlooked benefits you think our readers would appreciate hearing about?

Revuelta: “Chronic Conditions Special Needs Plans (C-SNPs) are for people with diabetes and other chronic conditions. These plans provide tailored benefits, out-of-pocket savings, and a personalized care plan. If you have a chronic condition, you should contact your local licensed agent to see if you qualify for this type of plan.

The income qualifications for Extra Help will change in 2024. Now is the perfect time to meet with a local licensed agent to review your eligibility. Medicare Part D prescription drug Extra Help, also called the Medicare Part D Low-Income Subsidy (LIS) Program, helps Medicare beneficiaries afford their medications.

Full Extra Help covers the cost of premiums and deductibles, and you’ll have lower copayments for medications until you meet catastrophic coverage. After that, you won’t pay any costs. Partial Extra Help entitles Medicare beneficiaries to lower premiums and deductibles than the standard benefit but pays more premiums and cost-sharing than individuals eligible for full Extra Help.”

NGV: Are there any specific plans you recommend; and, why?

Revuelta: “Selecting a plan boils down to various factors, from financial savings to health needs to where you call home.

First, start with defining what is important to you. For example, I want to keep my doctor, I want to bring down my monthly out-of-pocket cost, or I want a certain hospital system in-network. Use this handy checklist to make sure your unique situation will be considered.

Once you have an initial understanding of what you want included in your Medicare plan, work with an agent with local expertise in your area. A common mistake people make is speaking to a call center agent who lives in another state. Some of these agents are contracted in 40+ states and cannot possibly know the preferred provider groups and nuances in the benefits each plan offers.

There are 165 Medicare Advantage plans offered in the state of Georgia alone. Having help reviewing healthcare options is a simple way to ensure you select a plan that fits your criteria. Connie Health helps seniors choose a Medicare plan. Our local advisors learn about each individual’s personal needs, such as budget, doctors, medications, and other benefits like dental or hearing aids. They’ll then comb through the Medicare plans available to pinpoint the plan tailored to each individual.

Best of all, Connie Health’s services are provided at no cost to the individual. Unbiased advice is assured as Connie’s team of local agents receive the same commission regardless of the insurance company or plan selected.”

NGV: Do you have any other tips for seniors this holiday season?

Revuelta: “The holidays are a great time to speak with your loved ones about their healthcare coverage in the new year. One in six Americans care for a family member 50 years or older, and one in four people care for two or more people. Remind family members or loved ones to review their plan options during the Annual Enrollment Period. Start by helping them understand their health and financial requirements using our Caregiver’s Checklist.

Once you’ve completed a Medicare plan review for you or your loved ones during the Annual Enrollment Period, you can use your plan in the new year. Before the new year, contact your insurance agent to walk through how to take advantage of the plan offerings, including any benefits.”

NGV: Where can people access more expanded information on these or related topics?

Revuelta: “To set up an appointment, Georgia residents can visit conniehealth.com or call 1-888-858-0922. For folks who prefer meeting in-person, we also offer Medicare plan consultations at a client’s home or other location of their choosing.”

NGV: Explain your background and how you got into this industry.

Revuelta: “I am a Health Insurance Licensed Agent. My expertise in insurance, healthcare, and the Medicare industry began in 2009. Being able to help Medicare recipients navigate through the turbulent landscape of benefits, provider networks, and enrollment periods brings me great satisfaction. Having parents who’ve had Medicare for years, I have first-hand knowledge of how difficult it could be to find the answers necessary to make the right choice regarding healthcare coverage. With well over a decade of experience in the Medicare insurance industry, it is an honor and a privilege to educate my clients on what is available to them in order to make the right decision based on their needs.”