The red wheelchair Francisca Martinez neither needs nor wants stays covered in plastic in her tiny home. She won't run the electric motor, sound the high-pitched horn or even sit in the chair for fear she'll have to pay.

The 83-year-old Santa Paula woman who once worked in strawberry fields and now lives on Social Security says she was duped into the kind of Medicare scam social workers and watchdogs contend happens all the time. After being persuaded by another senior, she was taken in August by a minivan to a Los Angeles doctor's office where a roomful of seniors were asked to sign a stack of documents.

All the paperwork was in English. Martinez can read only Spanish. She signed everything and discovered later Medicare was billed at least $988.29 for the wheelchair and more than $500 worth of medical tests Martinez said she never received.

Now she wants to return the chair, along with the Springstep shoes, knee brace and geriatric girdle also charged to Medicare and worries somehow she'll be asked to shoulder at least part of the cost.

"Why does it upset me? Because it's taking advantage of our seniors," said Isa Ramos, the social worker who fears that if Martinez really needs a wheelchair in five or 10 years, Medicare won't fund it. "What burns me is that nothing happens. Nothing changes."

Hundreds of fraud cases

So far this year, Medicare has received more than 700 complaints in California alleging fraud. The complaints range from wheelchair giveaways to medical tests for incontinence that are needed once a lifetime but are ordered several times a week so the government can be billed.

Medicare officials say they aggressively pursue complaints and project their efforts saved $288 million in fraudulent payments in California over the first five months of this year.

"We're always looking for ways to stop crooks from looting money from this program," said spokesman Jack Cheevers. "Are the crooks clever? Do they come up with new ways to get money? Yes. Are we looking for ways to stop the crooks? Absolutely."

The most alarming allegations include seniors being manipulated into privatized fee-for-service insurance policies that may leave them without adequate coverage and liable for huge medical bills. Audits of the private insurance plans in Medicare's Part D drug benefits program show tens of thousands of people have been deceived or have had claims denied, according to an investigation by The New York Times published in October.

Senior advocates worry strong-arm tactics could rise this month with the beginning of a new enrollment season. Medicare recipients who sort through the maze of different insurance options can enroll in coverage or change their current plan from Nov. 15 to Dec. 31.

"It's kind of hang on to your hat," said Julie Schoen, director of the California Senior Medicare Patrol Project. "Everyone is looking for their market share. They're going to be aggressive."

Schoen and other advocates warn seniors about agents who may show up at an adult day care center, at their homes or call on the phone, offering policies they promise are much better than Medicare's traditional programs.

That's what happened to Clarice Swallows of Oxnard, who is 58, disabled with a form of lupus and covered by Medicare. Her husband, Earle, who has Alzheimer's, receives his prescription drug benefits through Florida-based WellCare Health Plans. An agent convinced her she should switch to WellCare, too.

"He conned us," said the Swallows' daughter and caregiver, Clarissa. "He never explained that this was going to opt us out of Medicare. Never once did he explain I had an option not to do it."

After changing plans, the family started getting $350 monthly bills for the breathing medications Clarice Swallows needs. They discovered the new insurance policy encompassed all medical care and replaced their traditional Medicare coverage. Doctors were getting their bills returned unpaid from the government.

The problems continued through October as the Swallows fought first to get out of the WellCare plan and then to get past bills paid. After a newspaper reporter asked a WellCare official about the case, the family was contacted and told at least some of the bills would be paid.

John Aberg, a WellCare spokesman, said he couldn't comment on the case because of patient privacy laws, but people with similar problems should make sure the company is aware of their situation.

The answer frustrates Clarice Swallows.

"We have called them so many times and my doctor's office has called them, and every time we get a different person and a different answer," she said.

WellCare is one of seven insurance companies that was asked by Medicare to stop marketing its private fee-for-service Medicare programs because of complaints. Late in October, the company's Florida headquarters were raided by federal and state agents.

Aberg won't comment on the raids beyond press releases that say the company is cooperating with officials and remains committed to its customers.

Restrictions lifted

As far as the private Medicare insurance, restrictions on the fee-for-service plans have been lifted on all the companies. Safety precautions have been added, including new training for agents and follow-up phone calls with clients who enroll in a plan to make sure they understand all terms and conditions.

United Healthcare, which operates an insurance branch called SecureHorizons, also suspended and then restarted its marketing of fee-for-service plans. Spokesman Peter Ashkenaz promised immediate action on any agents who mislead clients.

"You do have those guys who are out there who are trying to take advantage of people," he said, suggesting agents of a bygone era were family friends who earned trust. "We want to make sure the agents who are working with our plans are the agents you remember growing up with."

Senior advocates are already getting reports of insurance agents trying to enroll people in programs, though they are required to wait until Nov. 15. They urge beneficiaries to research plans before signing up and contact their doctors to make sure they're participating. People should be wary of anyone pushing them toward immediate decisions.

"If it sounds too good, it probably is," said Katharine Raley of the Ventura County Health Insurance Counseling and Advocacy Program, encouraging people with questions to contact her office.

Often, the people targeted in scams speak or read little, if any, English. The wheelchair gambit is spreading out from metropolitan areas like Los Angeles and San Diego to more rural areas. People may be approached by strangers or other seniors at adult day care centers, doctors' offices and, according to Maria Meva, as they cross the street to a grocery store.

"Someone comes up and asks them if they have a wheelchair," said Meva of the Oxnard Family Circle day care program, noting it happens at least once a month.

The seniors are told that if they go to a particular doctor's office, they can get the chair for free. Meva tells her seniors not to do it, but often they don't listen.

"They're being told it's the hottest thing," she said.

Red flags

A salesperson appears at your door uninvited.

Home visits from insurance agents are not allowed unless you have given the company permission before the visit.

A salesperson visits your home or calls on the phone and says he or she is with Medicare.

Medicare does not make home visits or unsolicited phone calls. The agent is probably from a private company and is selling an alternative plan.

A salesperson tells you a Medicare Advantage plan supplements Medicare and will not affect your existing Medicare plan.

Advantage plans don't supplement Medicare plans, but rather replace them.

A salesperson tells you your doctor accepts the new plan.

Don't believe it. Talk to your doctor before enrolling.

A salesperson wants to see your Medicare card and have you sign something.

Do not show the sales person your Medicare card. Do not sign anything you have not read. Do not sign anything you do not understand.

A salesperson wants you to make a decision today.

Take your time and do the necessary research.

Source: California Senior Medicare Patrol

Where to find help

If you're confused about Medicare insurance options or want to report fraud, the following agencies can help:

- Ventura County Health Insurance Counseling and Advocacy Program: 477-7310 or 800-434-0222.

- Medicare: 800-633-4227.

- Bureau of Medi-Cal Fraud and Abuse: 800-722-0432.

- For more advice and suggestions, go to the online version of this story and check out the links.