Medicare fraud costs American taxpayers between $60 billion and $100 billion each year. Behind those numbers are real people who got a suspicious phone call, answered the wrong question or trusted the wrong person.
If you have Medicare, you could be a target. That’s not meant to scare you. It’s meant to arm you. Because once you know how these scams work, you become much harder to fool.
We spoke with Michael Baumann, MHA, director of corporate compliance at Banner Health, about what exactly to watch for, what to do in the moment and how to get help fast if something goes wrong.
Why Medicare scams happen
Scammers target people with Medicare for a reason. According to Baumann, they are looking for valuable personal and financial information.
“Scammers go after people with Medicare because they want to steal their personal information,” he said. “They may believe these individuals have extra money (like retirement savings), are more trusting, suffer from memory loss or may be less likely to report fraud.”
Once scammers get your information, they can:
- Use your health benefits
- Bill for services you never received
- Access your medical records
- Open bank accounts and take out loans in your name
The fallout from scammers can take months or even years to fix.
The most common Medicare scams
Medical identity theft scams are the most common type of Medicare fraud. Medicare fraud can happen at any time but fraudulent attempts tend to rise during Medicare open enrollment, which runs from October 15 to December 7 each year.
Scammers try to get your Medicare ID number or personal details. Once they have it, they may:
- Bill Medicare for services you never got
- Charge for more expensive treatments than what was done
- Order unnecessary tests using your name
- Use up your benefits
- Use your Medicare ID to open fake accounts
Tell-tale warning signs of a Medicare scam
Fake phone calls or robocalls
You may get a call that sounds official. They often use recorded messages or urgent language and will come from unknown numbers. It might say:
- “Medicare needs to update your information.”
- “You need a new Medicare card.”
- “Your benefits will be cut off.”
- “Act now or lose your benefits.”
- “This offer expires today.”
Important: Medicare will not call you out of the blue to ask for personal information.
Phishing emails and text messages
You might receive a message asking you to:
- Click a link
- Confirm your Medicare number
- Update your account
Important: Medicare will not text or email you to ask for personal information.
“Free” medical equipment or prescription medication offers
If someone is offering you something for free and just needs your Medicare information to process it, that is a scam. Scammers may offer free:
- Back braces
- Knee braces
- Genetic testing kits
They may tell you that Medicare will cover everything. But in reality, they are trying to bill Medicare using your information. You could end up with unwanted equipment or false claims tied to your record.
Important: Real Medicare benefits don’t work that way. Medicare will not send offers for free items or services.
New card scams
Some scammers claim:
- Medicare is issuing new cards
- Your current card no longer works
They may ask for your Medicare number to “send a replacement.”
Important: Medicare will never call you about your ID card or ask you for your Medicare number.
What should you do in the moment?
Baumann said the best move is simple: Don’t engage. Take these steps right away:
During a phone call
- Hang up immediately
- Do not answer questions
- Do not call them back
- Do not press any buttons (even to “opt out” of calls)
For texts or emails
- Do not click links
- Do not reply (not even to say “stop” or “remove me”)
- Delete the message
If someone visits your home
- Do not let them in
- Ask for official identification
- Call a trusted source to verify
You are not being rude by hanging up or deleting. You are protecting yourself.
How to protect yourself
You can lower your risk by building simple habits:
- Review your Medicare statements: Check your statements regularly and look for services you did not receive or charges that seem incorrect. Report anything unusual.
- Keep your information private: Only share your Medicare number with your health care provider or a trusted insurance representative. Never share with unknown callers, unverified websites or door-to-door visitors.
- Use trusted sources: If you have questions about Medicare, go directly to the official resources, like Medicare. Avoid clicking on links from emails or texts.
- Talk to someone you trust: If you are unsure about a call or offer, talk to a family member, ask your provider’s office or contact a trusted organization.
- Stay informed: Scams change over time. Staying aware helps you stay protected. Even learning a few common red flags can make a difference.
What to do if you think you’ve been targeted
If you think someone tried to scam you, report it:
- Call Medicare directly at 800-MEDICARE (633-4227)
- Contact the Office of the Inspector General at 800-447-8477
What to do if you think someone stole your medical identity
- Contact one of the three credit bureaus (Experian, Equifax or TransUnion) to freeze your credit and stop fake accounts from being opened
- Submit a report online to the Federal Trade Commission
Where to find safe, trusted help
If you have questions about your Medicare coverage or benefits, go straight to trusted sources. Here are resources you can count on:
- Medicare.gov
- Medicare Rights Center: 800-333-4114
- Center for Medicare Advocacy: 860-456-7790
- State Health Insurance Assistance Programs (SHIP): A free, unbiased, one-on-one Medicare counseling in your state. Find your local program at medicare.gov.
Takeaway
Medicare scams are common but you can protect yourself. When you stay alert and take simple precautions, you can protect your health, your identity and your peace of mind.
It is important to remember that most health care providers, health systems and Medicare representatives are there for you. Health care providers, such as Banner Health, follow strict rules to protect your privacy and keep your information secure.
