Medicare scams are a significant problem. They cost billions of dollars each year. Scams may include identity theft, false claims, and durable medical equipment (DME) fraud.
Medicare scams occur when someone pretends to be from Medicare or connected to the program to obtain your personal information or money.
These scams tend to rise during Medicare’s open enrollment period (October 15 to December 7). This is the time of year when Medicare beneficiaries are encouraged to review their coverage and make any necessary changes.
It is important to know the signs of scams and understand how to protect yourself from them.
Do not give your personal information to anyone who contacts you unexpectedly and claims to be from or connected to Medicare.
It is important to protect yourself from Medicare scams. In 2024, Medicare fraud and scams resulted in a loss of $1.6 billion.
Medicare scams not only take money from the United States taxpayers, government, and Medicare, but they also cost Medicare beneficiaries in:
- time
- stress
- money
- health
However, there are various ways you can protect yourself from Medicare scams.
Avoid sharing your Medicare number
Only share your Medicare number or Social Security Number with your doctor, pharmacy, or people who work with Medicare.
If you receive an unexpected phone call from someone claiming to be connected with Medicare, do not share any personal information with them. Medicare will not usually call you unless it is in response to a request you have sent. If a Medicare representative does call you, they won’t need your personal information because they will already have it.
Don’t trust your caller ID
Scammers can spoof (fake) a phone number. This means that your caller ID may show Medicare’s name or number, even if Medicare isn’t calling you.
To be sure the call is legitimate, hang up and call Medicare directly at 800-633-4227.
Don’t click suspicious links
Not only can scammers fake phone numbers, but they can also fake emails. They can make it appear that an email is coming from Medicare.
These emails can even take you to a website that looks authentic. Do not respond to any unexpected emails or texts, and do not click on any links.
If you need to update your information or receive a text or email telling you to do so, go directly to Medicare.gov and log in to your account. You can also call Medicare at 800-633-4227.
Don’t be afraid of threats
Scammers may threaten that your Medicare benefits will be terminated if you don’t do what they’re asking. This often involves signing up for a specific plan.
If you are eligible for Medicare, your benefits cannot be terminated for these reasons.
Ignore persuasions to choose a certain plan
If someone tries to sell you a plan that is “preferred by Medicare,” do not speak with them. Medicare does not endorse any specific plans or policies.
Destroy your old Medicare card
Some scammers may claim you need to return your old card to Medicare. This is not true.
If you receive a new Medicare card, destroy the old one immediately by cutting it up or shredding it. Medicare does not need your old card back.
Protect your health records, and don’t accept unexpected genetic testing kits
Do not allow anyone but your doctor and other healthcare professionals to review your personal medical records.
If you receive a shipment of a genetic testing kit that your doctor did not order, refuse the shipment and return it to the sender.
Review your Medicare information
It is important that you review your Medicare summary notice carefully for any unexpected charges.
A summary notice is a letter Medicare will send you that lists all the healthcare services, supplies, and equipment you received.
Finding unbiased Medicare advice
If you’re looking for unbiased advice on Medicare coverage, plans, or scams, you can contact the State Health Insurance Assistance Program (SHIP).
You can contact SHIP by calling 877-839-2675 or locating your local SHIP office.
It helps to be aware of certain signs of Medicare scams so you can protect yourself against them.
Offers of free items or services
You should be suspicious of any offers that involve free medical services, supplies, or prescription medications. Scammers will often offer older adults valuable medical equipment. They then ask for your Medicare number and file high cost Medicare claims in your name.
You should also be wary of any genetic testing or screenings your doctor did not order. This is a known scam where scammers bill Medicare for unnecessary genetic testing.
Pressure to switch your Medicare plan
Scammers claiming to be associated with Medicare may claim that you are preapproved for a new healthcare plan or prescription drug plan that has lower payments and better benefits. They may also tell you there is a fee to enroll in this new plan.
Threats to cancel your coverage
Scammers may call you and state that there is an issue with your Medicare account, like fraudulent activity. They may then tell you that your benefits will be canceled if you don’t verify your personal information and enroll in a new plan.
Claims you are eligible for a refund
A common tactic for scammers is to tell older adults that, due to changes in their coverage, they are eligible for a Medicare refund.
The scammer may ask for your Medicare number and bank account information.
If you believe you have experienced any kind of Medicare scam or fraud, it’s important to report it.
You can do this in the following ways:
Reporting Medicare scams and fraud is important and may help prevent them from happening to others.
Medicare scams are on the rise. They tend to be more common during Medicare’s open enrollment period.
Medicare scams can happen to anyone. It is important to know the signs, how to protect yourself, and how to report scams and fraud.
To report scams and fraud directly to Medicare, call 800-633-4227.