WEBVTT
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This program is designed to provide general information with regards
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to the subject matters covered. This information is given with
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the understanding that neither the hosts, guests, sponsors, or station
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are engaged in rendering any specific and personal medical, financial, legal, counseling,
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professional service, or any advice.
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You should seek the services.
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Of competent professionals before applying or trying any suggested ideas.
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The information contained in this podcast is intended for informational
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purposes only and is not a substitute for individual professional
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legal advice. The podcast information was carefully compiled from debted
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sources and references. However, Rose Resources outreach to safeguard the
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elderly cannot guarantee that you will not fall victim to
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a scam. Let's talk about scams. It's the must listen
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show for anyone who wants to protect themselves and their
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loved ones from scams. Every Tuesday am Pacific time on
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K four HD Radio, Joyce Petrowski, founder of Rose, and
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her guests will provide valuable insights and practical tips on
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how to recognize and protect yourself from scams. And now
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here is your host, Joyce Petrowski. Hi, I'm David staying
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active mentally, thing chess.
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Those are all the very important things. I'm seventy two,
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but I'm going to keep on learning. I'm going to
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keep on moving. I'm gonna keep on living my life.
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Healthcare for David's next move.
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Learn more at archwell health dot com.
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Welcome back, everybody. I'm Joyce Petrowski, founder and board president
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of Rose Resources Outreach to Safeguard the Elderly. Just coming
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off a long weekend from July fourth. I hope everyone
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had a great celebration and happy birthday to the United
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States two hundred and fifty years. You can find more
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information on our website at Rosadvocacy dot org. Scroll down
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to the bottom of the homepage you'll find where you
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can sign up for our newsletters. We do one in
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the mail each month, and we do one via email.
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The one via email every Tuesday morning at nine point
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fifteen am, Arizona time. You're going to get a Tuesday
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tip and it's going to have great information in it,
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some of which you might not know, some of which
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you might already know for the But no matter if
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you know it or you don't, the just as important
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reason to get it is it's helping you build your
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scam prevention habits and your healthy skepticism. You'll also find
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all of our social media channels on the top of
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the homepage and click on that YouTube and click subscribe
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because you'll get notified every week of what's coming up
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on our radio show. You can find all the past
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episodes on there as well. And really quick, I want
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to say thank our sponsor, Archwell Health, and I highly
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suggest if you have not gone in to take a
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tour of the arch Well Health location where you live,
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and you don't have to be in Arizona. They have
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them all over the United States. You can just get
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on archwellhealth dot com and check out their locations. They
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are an awesome primary care provider for Medicare patients and
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they have really thought about the smallest details to help
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reduce the anxiety of going to the doctors. And they
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have the capability of bringing in your family members as
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well that maybe cannot make it to the appointment but
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are part of your health journey, or maybe they live
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out of state and are part of your health journey
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as well. So today we have a guest with us
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and I want to welcome Joan to the show.
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Thank you, You're.
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Welcome, thanks for being on JOAN. And so you were
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at one of our presentations a few weeks back, and
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we had a conversation afterwards, and you told me about
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some scam experiences you had, and thank you for being
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willing to come on and talk about these so we
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can help other people. The first one I want to
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get to is, actually it was just this year. You said,
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in May of twenty twenty six you had some fraudulent
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charges on your Medicare summary notice for part B. Do
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you want to tell us a little bit more about
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about those.
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Yes, And by the way, thank you for using the
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words healthy skepticism, because I'm a pretty trusting person and
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it takes a lot too much sometimes for me to
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be suspicious. I received the Medicare summary notice, and as
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many of us, well my age, no, when it says
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this is not a bill, we either ignore it completely
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or then our eyes go down to total you may
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be billed, And as long as that says zero or
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a very small amount, we don't turn the page, we
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don't look. And that's what this one says. This that's true,
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not a bill totally. You may be billed zero. And
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then I turned the page and there were five separate
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monthly August, September, October, November, December of twenty twenty five bills,
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four each one read as follows, three hundred intermittent or
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andary catheter. The amount the supplier charged this is per
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month two thousand and fifty dollars.
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Wow.
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And then it goes down. If you follow the table
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and it says Medicare approved amount zero, amount Medicare paid
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zero maximum you may be billed zero. And the final
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column is c notes below footnotes A and B are listed.
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So then and whoever looks at these, A says the
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information we requested was not received, and B is you
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should not be billed for this service. You do not
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have to pay this amount.
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Okay.
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Now again there were five of these, so the total was,
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if my math is right, ten thousand, two high hundred
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and fifty dollars.
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Wow.
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I this was a Medicare notice. I called Medicare and
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I talked with two very nice people. I got a
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human right away, which was good, and they told me
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a few things. The first one was just the normal
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representative you get. And I told them the situation. I said,
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have you heard of this before? Has this ever happened,
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and he said, oh yes, he said, unfortunately, this is
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pretty common. And by the way, since this has happened,
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I've talked with a number of friends of mine my
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age and I'm in my upper seventies, and one had
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exactly the same thing happened to her. Oh wow. Anyhow,
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I'm talking with the gentleman at Medicare and he says,
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do you want to file a fraudulent acclaim report? And
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I said, yes, how do I do that? And he said, well,
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I'm going to take some information first, and he never
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asked me for my number because the phone number on
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the notice did work. It said how to get help
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with your questions, and it gives you the phone number
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to call, and he's after he asked me some questions,
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he said, I'm going to transfer you now to a
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fraud specialist. I talked with the fraud specialist for another
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five or ten minutes, and here's what it sort of
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surprised me, but didn't surprise me. I asked the question,
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will this be removed from my Medicare records since it's
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obviously fraudulent, and she said, the investigators will attempt to
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determine who is committing this fraud. However, these claims, though
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unapproved and unpaid, may never be expunged from my Medicare files,
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and I may never learn about the results of any investigation. Okay,
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she said, if I choose, I can request a new
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Medicare number, but then it would be my responsibility to
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give that new number to all of my medical providers.
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That made sense, but I've decided not to do that yet,
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especially when I learned that other people had this exact
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same charges for catheters. And I then googled the company
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name that's shown and I learned a lot because I said, yes,
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this is a fraud that's been going on for some time.
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So what did I learned from this? If anything, I've
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learned not to ignore, not to go beyond page one,
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look at every entry. And I know sometimes it's really
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hard to tell if you may not recognize the name
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of the doctor or the nurse practitioner who actually whom
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you saw. But if you keep dates, if you keep
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a calendar, which I do, you should be able to
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check back. Was I at any doctor? Oh yes, this
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corresponds all right. So sad to say, it's a little
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late in my life to go to that trouble if
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you will. But yes, I'm going to check all the
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entries from now on. Yeah.
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Absolutely. So a couple things talking to the fraud specialist
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at Medicare, I understand that they said, you know that
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you're not going to get any more information about the
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investigation and all that I was a victim of a
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tax related identity theft and I wanted to know, like
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what address this fraudulent return that was sent in my
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name and social Security number, and they wouldn't give me
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any information you know about it. But the one thing
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that he told you was that these charges may never
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come off of your account.
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He said, they may, but okay, he said, he's basically
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he said, don't worry because it's always going to show
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with zeros and it's always going to show that you
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own nothing. And what he did explain something else to me.
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He said, we get so many of these fraudulent claims.
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We try to track down every single one and sometimes
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sometimes if we wanted more information from the victim from me,
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someone may call you, but they will identify themselves as
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being from Medicare Fraud Division. Okay, but because there are
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so many, they can't guarantee and this apparently this particular company,
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And should I give you the name of the company.
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That is no asking for this now, because I mean,
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it could be a totally fake company, but it could
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be somebody impersonating a real exactly. Yeah, And I wouldn't
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want to. I wouldn't want people to think if it
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is a legitimate company and somebody is just impersonating them,
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I wouldn't want people to think it was a bad company.
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Yeah, but they said, you baby contacted by someone again
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from Medicare. But because there are so many and this
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particular scam is well known to them, sad they.
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Yeah, it was. I want to say, maybe a year
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year and a half ago, I talked to a lady
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who told me she had started looking at her Medicare
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statements and found out she was being charged for tens
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of thousands of dollars with catheters, which she's never used. Yeah,
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So it's you know, and the presentation that you that
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you saw from us, that was just a portion of
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our full presentation. And one of the things we do
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talk about is Medicare and how it is always good
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to look at your statements and look at what you're
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being charged for and always if you find charges that
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are not yours, that are fraudulent, to always report them
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to Medicare because you don't want those charges affecting any
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future benefits you might be entitled to. Yeah, and then
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always using a Medicare agent because you know, you don't
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have to pay the Medicare agent. It doesn't come out
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of your Medicare benefits, your Social Security benefits. But they're
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trained and they're required, you know, by law, to go
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through training so they know all the new things that
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are happening, any changes that are happening, and then they
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can look at their clients and say, Okay, this new
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plan or this plan because it changed, is going to
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be the best for you. Because I think a lot
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of people they talk to their friends and family, and
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you know, somebody might say, oh wow, I've got on
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this new Medicare plan and I'm really saving a lot
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of out of pocket costs, and so then by default
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a lot of people think that, well, then if they
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get on that plan, it's going to save them a
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lot ab out of pocket, and it might not, because
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your health situation is different from your friend or family
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member's health situation. And exactly I mean, but you could
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if you got on Medicare's website. You could go and
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review all the new things happening, all the changes that
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are happening. There's going to be a lot of technical
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terms in there that you're going to have to understand.
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And I haven't done that yet. I've got I am.
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I've transferred from another state when I retired and moved
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here to Arizona. And you're calling him Medicare agent. This
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is the gentleman from my original state. I still communicate
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with several times a year, and he handles my supplemental insurance.
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So that's what you're referring to, right, Yes.
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Yes, that you can when annual enrollment comes up October fifteenth,
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you know that you can go directly to him and say, Okay,
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what's new, anything changed? Do we need to review my policy?
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Is there anything or maybe something changed with your health
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that you can then talk to him and say, well,
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this is new in my in my what's going on
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with my health? And then you know, or maybe prescriptions
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or whatever. Yeah, so then they can help you navigate
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which plan works best for you.
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Yes, and I hope everyone has someone like this. I've
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dealt with him now for a number of years and
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one of the things that I'm happy about is that
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he's so much younger than I am that I know
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he's going to be around and I can continue to
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count on him. Yes.
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Yes, so you when you're you know, ten years down
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the road, you might not have to, you know, worry
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about trying to find a new a new agent. Yes.
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So let's look at the next one here. This is