One area where fraud is growing is in home health care — services that should help our seniors live comfortably and safely at home, not open the door to scams.
Here’s what you need to know to stay safe and protect yourself and your loved ones.
Medicare Parts A and B cover short-term, medically necessary home health services when provided by a Medicare-approved agency. These services are coordinated with your doctor and may include:
Intermittent skilled nursing care
Physical, occupational, or speech therapy
Nurse aide care for personal health needs
To qualify for Medicare home health care:
✅ Your doctor must certify that skilled services are medically necessary.
✅ Your condition should improve with therapy or need maintenance therapy.
✅ You must be considered homebound — meaning you need assistance to leave home or leaving home poses a health risk.
Scammers exploit Medicare by billing for services that aren’t medically necessary — or not provided at all. Watch out for these warning signs:
Billing Medicare when you are not homebound
Charging for services not ordered by your doctor
Billing for services you never received
Signing you up through a doctor you don’t know
Offering “free” groceries, rides, or gifts in exchange for your Medicare number
Asking you to sign incomplete or blank forms
Billing for skilled nursing when only housekeeping was done
Review Your Medicare Summary Notice (MSN) and Explanation of Benefits (EOB):
Verify that services listed match what you received.
Work Only with Your Doctor:
Don’t accept home health services arranged by strangers who call or visit uninvited.
Say No to Gifts:
Never accept money, groceries, or incentives in exchange for signing up for services.
Don’t Sign What You Don’t Understand:
Always review forms carefully before signing.
Report Suspicious Activity Immediately:
Early reporting can prevent bigger problems and protect others.
If you believe you’ve been targeted:
📞 Call SMP Hawaii: 1-800-296-9422
📧 Email: info@smphawaii.org
🌐 Visit: www.smphawaii.org
We offer free, confidential support to help you navigate Medicare safely.
Stay alert. Stay informed. Stay protected.
Together, we can keep Hawaii’s kūpuna safe and strong!
