Common Scams Targeting Medicare Enrollees and How to Spot Them Early

Medicare is one of the most important benefits in many Americans’ lives, which is exactly why it attracts criminals. The common scams targeting Medicare enrollees tend to follow familiar patterns: a surprise phone call, a text message about a “new card,” a free gift in exchange for a number, or an urgent warning that coverage is about to end. Federal agencies, including the Centers for Medicare & Medicaid Services (CMS), the Federal Trade Commission (FTC) and the Department of Health and Human Services Office of Inspector General (HHS-OIG), have published guidance on these schemes for years. Knowing the patterns before anyone contacts you is the surest way to spot a scam early and stop it before any harm is done.

Why Medicare Fraud Targets Older Adults and New Enrollees

A Medicare number is valuable to a criminal because it can be used to bill the program for services that were never provided, or to build a profile for identity theft. Medicare is also complicated. People coming onto the program must sort through Original Medicare, Medicare Advantage, prescription drug coverage and supplemental policies, and many are doing so for the first time. Scammers count on that confusion, and they often present themselves as helpful guides who can simplify the process.

Timing matters as well. Most people have an Initial Enrollment Period that spans seven months around their 65th birthday, and the annual Medicare Open Enrollment Period runs from October 15 to December 7. Fraudsters know that these windows generate real mail, real marketing and real phone calls, so a fake message can blend in easily. Understanding the calendar, and recognizing that legitimate enrollment activity does not require handing over personal data to a stranger, removes much of that cover.

Medicare Impersonation Calls and Text Messages

One of the most frequently reported tactics involves someone claiming to represent Medicare. The caller may say that a new card is being issued, that a refund is owed, or that coverage will be suspended unless information is confirmed right away. Caller ID can be faked, so a number that appears to belong to a government office is not proof of anything. Medicare’s own guidance explains that it generally does not call people uninvited to sell products or to ask for personal information, with limited exceptions such as returning a call you placed yourself.

Text messages and emails follow the same script. They may contain a link that leads to a look-alike website designed to capture a Medicare number, Social Security number or bank details. A safe habit is to avoid clicking anything in an unexpected message. Instead, type the official address, Medicare.gov, into your browser, or call 1-800-MEDICARE (1-800-633-4227) and ask whether there is any real issue with your account.

Medicare Card and Medicare Number Scams

Beginning in 2018, CMS started replacing Medicare cards that displayed Social Security-based numbers with cards carrying a randomly generated Medicare Beneficiary Identifier. The change was meant to reduce identity theft, but it also gave scammers a new story to tell. Some callers have claimed that enrollees must pay a fee to receive a new card, or must confirm their existing number to avoid losing benefits. Medicare cards are issued at no cost, and a replacement can be requested for free through Medicare.gov or by calling 1-800-MEDICARE.

The underlying advice from federal agencies is simple: treat your Medicare number the way you treat a credit card number. Share it only with people you trust for care or coverage purposes, such as your doctors, pharmacists, insurers, or a counselor from a state health insurance program. If someone you did not contact asks for it, that request alone is a reason for caution.

Genetic Testing, Medical Equipment and “Free” Offer Schemes

Not every Medicare scam arrives by phone. HHS-OIG has warned the public about schemes in which people are offered “free” services or products, often at community events, through telemarketing or door to door. Genetic testing kits, braces, and other durable medical equipment are among the items that have appeared in these warnings. The basic fraud is that the offer is only a way to collect a Medicare number, which is then used to bill the program for tests or supplies that may be unnecessary or never delivered.

Medicare covers genetic testing only in limited circumstances, and generally requires that care be ordered by a provider who is treating you. Rules around medical equipment suppliers also place limits on unsolicited telephone marketing. When a stranger offers a cheek swab or a brace you never asked for and your own doctor has not recommended, it is reasonable to decline and to check with your physician before taking any step.

Enrollment Period Pressure and Misleading Plan Sales

Open Enrollment is a busy season for legitimate insurers and independent agents, and it is also a busy season for deception. Some sales pitches blur the line between honest marketing and misrepresentation, for instance by implying a connection to the government or by suggesting a plan is “required” or “the only one available.” Medicare Advantage and Part D plans are sold by private companies, and they are subject to CMS marketing rules, including limits on unsolicited contact. A caller who insists that you must switch plans immediately, or who will not allow time to compare options, is showing a classic pressure tactic.

Anyone who is unsure about a plan can use the plan comparison tools on Medicare.gov or speak with a SHIP counselor, who does not sell insurance. Taking a day or two to review the details is almost never a disadvantage, and a genuine offer will still be there after you have checked it.