Medicare Scams – What They Are and How to Avoid Them

Last Updated on April 30, 2024

When scammers are seeking personal information from seniors, they may attempt a number of different scams. 

Around the time of Medicare open enrollment, though, scammers may ramp up the frequency of trying scams focusing on Medicare.

Scammers may try to steal your Medicare card number through a Medicare scam. They may even try to gain access to some of your personal medical information.

The problem with these scams is they start with just your medical information. With that in hand, though, scammers may be able to gain access to other aspects of your personal information.

Before you know it, you’re a victim of identity theft

You need to take steps to protect yourself from Medicare scams. We’ll explain the different types of Medicare scams, helping you recognize them. We’ll also give you some tips for avoiding becoming a victim of Medicare scams.

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reporting medicare fraud & abuse

Source: Medicare.gov

What Is a Medicare Scam?

A Medicare scam typically involves a phishing attack. Someone reaches out to you, pretending to be a Medicare official or to be with an insurance company that provides Medicare coverage.

This may occur via a telephone call, text message, or email message. Someone may even visit your home in person. Because Medicare scammers are targeting seniors, a phone call is the most common means of communication.

Scammers follow specific steps when operating a Medicare scam, including the following.

1. Scammers prepare for these calls to make them more realistic

The scammer typically targets the senior directly before making the call. The scammer may research information about the target through social media and other online sources. 

They then can pretend like they understand your medical needs and what you are experiencing health-wise. 

Because scammers are spending time researching potential victims, they are not likely to give up easily. 

They do their homework regarding legitimate phone calls from Medicare, and they try to simulate them. This makes the scam seem more realistic.

2. Gaining your trust

For this type of scam, the criminals want to establish trust with the victim as quickly as possible. They will act friendly and helpful from the beginning of the call.

To prove they have your trust, they may convince you to tell them some harmless personal information, like your age, by pretending they can’t find it. This then sets them up to seek more important personal information later.

3. Creating a fake problem or benefit

Once they feel like you trust them, scammers may then explain that you are having a problem with your Medicare plan, which, of course, is fake. 

The scammers may claim that your coverage is going to expire unexpectedly, but they can help you work through it fast. They also may offer you an unexpected benefit that goes with your Medicare coverage.

4. Verifying your information

To help you with the problem, the scammers may claim that they need some personal information to verify your identity, including your Medicare number. 

Instead, though, they are tricking you into revealing your personal information, which allows them to complete the scam. If you provide it, the scammer ends the call. 

You may not know what really happened until the scammer commits Medicare fraud using your number or steals your identity later.

5. Creating a sense of urgency

If you hesitate to reveal your information, the friendly scammer’s tone may change

The scammer may begin making threats or may become angry. The scammer may claim that you will lose your Medicare benefits if you don’t provide the information or that you will have to pay thousands of dollars to restore coverage.

Of course, this isn’t true.

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Take steps to protect yourself

Hold tight against these types of scams. It’s important to remember that Medicare does not call you out of the blue to ask for this type of information. You would have to call Medicare to initiate the conversation or request a callback. 

Only scammers would call you without warning and ask you to provide this type of information.

person using laptop computers

Source: Jefferson Santos on Unsplash

When Do Medicare Scams Most Often Occur?

Most Medicare scams occur during the open enrollment period, usually between mid-October and early December. During this time, Medicare participants can decide whether they want to change their coverage terms.

Because seniors are thinking about Medicare during this time and may even be seeking information about coverage, scammers become active. A victim may not think twice about receiving a call related to Medicare during this time, giving scammers an opening.

If you are unsure whether a call or email you receive during this time is legitimate, call the company or the Medicare department yourself. 

Don’t call a phone number that a random person gives you or sends to you, as that could lead directly to the scammer. Instead, do an Internet search on your own to find the contact information.

medicare card

Source: Medicare.gov

The 6 Most Common Medicare Scams

Another way to recognize a potential scam involving Medicare is to make yourself aware of the common techniques scammers use when creating a fake problem or benefit for you. If you hear any of the following scenarios, treat them with a large amount of skepticism.

1. Your Medicare is expiring

What is it? The scammer calls to let you know that your Medicare coverage is about to expire or will soon disappear. Only the scammer can help you restore it.

Why it works as a scam. A senior who receives this call and doesn’t have a clear understanding of how the Medicare system works may panic. When panicking, you’re less likely to think clearly and pay attention to any red flags about the situation. Scammers are counting on you responding emotionally, giving them a better chance at tricking you.

How to avoid it. Understand that Medicare is never going to ask you for important personal information like your Medicare number or your Social Security number (SSN). Any company actually involved with Medicare will already have this information.

2. You need a new Medicare card

What is it? The scammer tells you that your current Medicare card no longer works. The caller says the department needs to issue you a new card, but it can only do so after verifying your personal information. Of course, the scammer doesn’t have your information for verification; the scammer is counting on you to give it up voluntarily.

Why it works as a scam. No senior wants to go to a medical appointment without a valid Medicare card. If the victim is worried enough, the victim will willingly share the personal information that the scammer is requesting to try to fix the problem fast.

How to avoid it. Always remember that officials in the Medicare department will never call you without an initial request from you. If you actually have a problem with your Medicare account or card, you’ll receive an official letter in the mail.

3. Your Medicare plan costs are skyrocketing

What is it? A scammer calls you to let you know that the costs for your current Medicare plan are increasing significantly. However, the scammer is more than ready to help you switch to a different plan that’s more in line with your current plan costs. All the scammer needs is your Medicare number, your SSN, and your bank account number for direct withdrawal.

Why it works as a scam. No one wants to overpay for Medicare coverage or to receive a significant cost increase. Upon receiving this call, you are going to be far more willing to listen to anyone who offers you a bargain. You might let your guard down because of your concerns over a huge cost increase that you cannot afford.

How to avoid it. You should never agree to a new Medicare plan without doing some research on your own. Often, if you tell the scammer that you want to think about it, the scammer may become angry and tell you that you have to act now, or the lower cost will no longer be available. This is a significant red flag. No legitimate company is going to pressure you like this.

4. You are due to receive a refund because you overpaid for your plan

What is it? A scammer may contact you and tell you that you paid too much money last year for Medicare, meaning you can have a refund. All you have to do to receive your money is verify your personal information. 

Why it works as a scam. Who doesn’t want to receive a little extra money unexpectedly? Unlike winning a few dollars with a lottery scratch-off ticket, though, this extra money will never find its way to you, as it’s a scam. Even worse, you’ll lose control of your personally identifying information through this ID theft scam.

How to avoid it. Medicare would not reach out to you this way regarding an overpayment of your premiums. Don’t let a caller try to put pressure on you to give up your personal information by threatening to take away the bonus money if you don’t act quickly.

5. You can receive free medical care or supplies

What is it? A scammer calls you and tells you that you can receive free items as part of your current Medicare plan. This could include free medical supplies or access to vaccines or prescription drugs before anyone else.

Why it works as a scam. People like the idea of receiving preferential treatment or free things, so they’re willing to listen to someone promising these benefits. However, once you give the scammer your personal information or your Medicare number as part of the qualification process, you never receive your free items, and you could lose control of your identity.

How to avoid it. Be cautious about promises callers make regarding receiving free items as part of a Medicare plan. This can be challenging, as scammers are good at performing online research about your medical situation. They then can tailor the free items to perfectly fit your particular medical condition. Trust your gut feeling if you are uneasy about an offer like this.

6. You can receive free genetic testing

What is it? The scammer contacts you to let you know that you can receive a free genetic test as part of your Medicare plan. This test can help you spot potential markers for cancer and other genetic diseases. The scammer may even try to convince you to give up your personal information by telling you the tests can help your entire family understand its genetics better.

Why it works as a scam. Genetic testing can be expensive without having an insurance policy to help you pay for it. If you have a specific history of cancer in your family, Medicare likely will cover the testing. However, if Medicare turned you down for genetic testing in the past, you may be tempted to exchange some personal information or your Medicare number to receive testing for free.

How to avoid it. Be cautious any time someone calls you – with no prompting or request from you – to offer a free service or free testing. This is a red flag, as it’s a common tactic for scammers. If you have an interest in seeing whether you qualify for genetic testing related to cancer screening, reach out to your Medicare plan provider yourself.

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scam alert

Source: Thirdman on Pexels

8 Tips to Protect Yourself From Medicare Scams

No matter what techniques scammers use to try to steal your Medicare information, you can take a few steps to protect yourself. Use these tips to guard your personal information, including your medical information.

1. Protect your Medicare number

Do not give out your Medicare number to just anyone who calls. In fact, almost no one should call and request this number, as legitimate Medicare providers will already have it. Protect this number the same way you’d protect your SSN.

2. Keep a close eye on your statements

If you notice procedures or services that you did not use are appearing on your Medicare statement, this could be a sign of someone using your Medicare number in a scam.

3. Be wary of unsolicited free or bonus offers

Some scammers may try to trick you into giving up your personal information or your medical information by offering you free medical testing or a bonus medical product as part of your Medicare plan. If someone calls you out of the blue with this type of offer, it’s probably a scam.

4. Watch out for door-to-door salespeople

Although it’s rare for a Medicare scammer to visit you at your home, it does happen. Legitimate Medicare representatives are not going to travel to your home unless you initiate the contact, though.

5. Don’t automatically trust a caller ID or a website address

Scammers have the ability to spoof caller ID, and they can create fake websites that look legitimate in very little time. Don’t click links that you see in email messages, as they could lead to a fake website instead of the real one. Find the contact information for the company on your own and reach out yourself instead of trusting unsolicited calls or email messages.

6. Don’t give in to pressure tactics

If the person calling you about your Medicare coverage attempts to force you to make an immediate decision or is pressuring you in an uncomfortable manner, end the conversation. This is a surefire clue that you’re talking to a scammer.

7. Trust your gut feeling

If you are feeling uncomfortable about someone asking you for personal information related to your Medicare plan, you probably should trust that gut feeling. Hang up and search for a legitimate phone number to call to speak with the company directly.

8. Freeze your credit report

If you give out personal information to a potential scammer before you can catch yourself, you need to be proactive. Call the three credit bureaus to freeze your credit report and to report the potential fraud. Contact your bank and credit card issuers. Visit the Medicare fraud website to learn how to protect your Medicare account.

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Source: camilo jimenez on Unsplash

Don’t Let Scammers Steal Your Medical Information – or More

When it comes to stealing your information, scammers are never satisfied. If they steal your Medicare number, they’re going to try to use it to get your SSN. If they take your SSN, they’ll make a move to try to take something else.

The more information they have, the easier it is for them to try to assume your identity and steal your money.

Protecting yourself from such scams requires following a few steps, but it’s important. Additionally, older relatives may need some help when it comes to avoiding scams aimed at seniors.

Identity theft subscriptions can be an essential tool

One of the best ways to help seniors is through a subscription to one of the best identity theft protection services for seniors.

Retirees may not check their credit reports or credit scores very often because they don’t take out as many loans as younger people. This makes it tough for seniors to catch the early signs of a potential identity theft situation on their own. 

If you have a subscription to an ID theft protection service, such as Aura, it provides alerts when you have oddities occurring with your personal information. This can be an early warning sign that helps you take steps to avoid identity theft.

Medicare scams can be the tip of the iceberg with scams aimed at seniors. Don’t let the scammers gain a foothold. Be proactive about protecting yourself and your loved ones, starting with your medical and Medicare information.


Other Types of Scams You Should Be Aware of: