Medicare Scam Calls Explained How to Identify and Report Them

Medicare Scam Calls Explained: How to Identify and Report Them

Medicare scam calls are on the rise, with criminals using sophisticated tactics to try and steal personal information from beneficiaries. In 2022 alone, over 140,000 complaints were filed about fraudulent Medicare calls according to the Federal Trade Commission.

With open enrollment season coming up, it’s crucial that Medicare beneficiaries learn how to spot and avoid these malicious calls.

This comprehensive guide covers everything you need to know, so arm yourself with knowledge so you can outsmart Medicare scammers. It’s your health, financial security, and identity at stake.

How Medicare Scam Calls Work

Medicare scammers use phone calls to try and trick seniors into handing over their sensitive personal data. While these cunning calls may seem legitimate on the surface, they are carefully crafted to steal your information.

Here are some typical scenarios fraudsters use:

Pretending to be from Medicare: Callers claim there is an issue with your Medicare account that requires immediate action to resolve. To “verify” your identity, they ask for personal details like your Medicare ID number.

Offering free medical devices or genetic testing: Scammers promise free health services but need your Medicare number first to ship supplies or schedule appointments.

Threatening to cancel your benefits: Callers say your Medicare will be terminated if you don’t confirm your personal information right away.

Touting better plan options: Scammers pose as brokers or Medicare reps to get you to “enroll” in a plan with more benefits. They collect your financial information under the guise of signing you up.

Promising refunds or rebates: Fraudsters say Medicare owes you money back for overpaying premiums but need to “confirm” your identity first before issuing a refund.

The goals of these calls is always the same – to manipulate you into revealing personal data like your:

  • Medicare number
  • Full legal name
  • Address
  • Social Security number
  • Banking details

Armed with this info, scammers can steal your identity, charge Medicare for bogus services, or even drain your bank account. That’s why it’s so important to recognize the signs of a scam call before you become the victim of Medicare fraud.

scam calls

Who Do Scammers Target with Medicare Phone Scams?

Medicare scammers cast a wide net, calling current beneficiaries as well as those becoming eligible for Medicare. Some of the key groups fraudsters prey upon include:

New Medicare Enrollees

Turning 65 is an exciting milestone, but it also makes you vulnerable to scammers. Criminals know that newly eligible seniors are looking for guidance on choosing plans and providers. By posing as Medicare assistants, they can more easily gain people’s trust.

Scammers also watch for the initial enrollment period when you first qualify for Medicare. Expect an uptick in scam calls around your 65th birthday and the months before and after. Don’t let your guard down just because someone sounds knowledgeable about the system.

Existing Beneficiaries

Medicare scam calls spike during open enrollment each year from October 15 to December 7. This period allows people to switch prescription drug or Medicare Advantage plans for the coming year.

Scammers call current beneficiaries pretending to offer better or cheaper options. They pressure people to act quickly before open enrollment ends. This rush tactic catches people off guard, making them more likely to share information.

Vulnerable Seniors

Fraudsters seek out older adults who live alone, have limited support systems, or seem confused. Victims who are socially isolated or suffering cognitive decline are more apt to trust any perceived help.

These ruthless scammers also target seniors with chronic health issues, using promises of medical equipment and supplies to build rapport. Then they go in for sensitive Medicare details.

Dual Eligibles

Low-income seniors qualify for both Medicare and Medicaid. Since dual eligibles deal with two complex government programs, they’re prone to getting tripped up by scam calls claiming there’s an issue needing urgent attention.

Unfortunately, dual eligible beneficiaries are disproportionately targeted by Medicare phone scams. Always be on high alert for any unsolicited calls regarding your benefits.

Red Flags – How to Identify Medicare Scam Calls

Scammers deploy some universal tricks to try and dupe Medicare beneficiaries over the phone. Watch for these common red flags:

They claim there’s a problem with your Medicare benefits – Issues with Medicare benefits are always conveyed through official letters, never random phone calls. Immediately hang up if told there is an issue with your account.

Threats are used to create urgency – Scammers press you to provide personal information “or else” face consequences like benefit cancellation or Medicare card deactivation. Don’t panic or act impulsively.

Asking for your Medicare number – Medicare representatives already have your Medicare number on file. Real Medicare staff won’t cold call requesting this sensitive data.

Questions about personal information – Scammers fish for key details like your full name, SSN, address, or date of birth. Never hand over information to an unsolicited caller.

Money is requested – Scammers may ask for payment to activate a new Medicare card, enroll you in a plan, or ship medical supplies. Never pay anything to someone who calls out of the blue.

High pressure sales tactics are used – Scammers push you to “act now” on an offer or give personal details immediately. Take your time and don’t be rushed into any decision by aggressive callers.

Callers have foreign accents – Many scammers operate overseas in places like Asia and Eastern Europe. A foreign accent doesn’t automatically mean fraud, but be extra vigilant if the caller sounds overseas.

Your Caller ID looks suspicious – Scammers use technology to spoof legitimate looking numbers. Calls can show up looking like they’re from a local area code even when they’re not. Don’t trust Caller ID alone.

An offer seems too good to be true – Free medical devices, genetic testing programs, significantly cheaper plans, and other “great deals” are almost always scams when pitched by unsolicited callers.

Trust your gut if a Medicare call seems off. You have the right to hang up or refuse to provide information.

What Happens When Scammers Get Your Medicare Number?

Once scammers have your Medicare number, financial data, or other personal information, you become highly vulnerable to fraud. Some of the ways criminals profit from your details include:

Fake billing and services – Scammers bill Medicare for medical services, devices, or treatments you never actually received. This is a massive expense to taxpayers.

Medical identity theft – Criminals use your number and identity to obtain healthcare services for themselves. Victims can then face issues getting claims paid if their benefits appear “maxed out.”

Opening credit accounts – Medicare numbers combined with a name, address, and SSN provide enough information to take out loans or credit cards in your name.

Draining bank accounts – Scammers now have account details needed to electronically transfer or withdraw your money. Always safeguard banking credentials.

Obtaining prescriptions – Fraudsters use Medicare IDs to get access to prescription medications that can be abused or sold illegally. Some scam calls fish specifically for pharmacy information.

Future vulnerability – Once information is out there, you’re susceptible to additional frauds. Criminals trade and sell stolen Medicare data on the black market.

Protect your good name and financial security by immediately reporting any suspected Medicare fraud. The sooner it’s flagged, the less damage scammers can inflict.

Tips for Spotting Spoofed Caller IDs

One of the ways scammers trick people is through using spoofing technology to falsify Caller ID information. Criminals make it seem like calls are coming from Medicare or a local number when that’s not the reality.

Here are some tips for spotting spoofed calls:

Medicare doesn’t make outbound calls – Medicare does not contact beneficiaries unless they specifically request a callback. Any proactive call claiming to be Medicare is spoofed.

Look for inaccuracies – Official organizations display calls with their full formal name, not something generic like “Health Insurance.”

Search online – Look up phone numbers that seem suspicious. You can search the exact number to see if other people report it as fraudulent.

Consider area codes – Compare the area code to your own location. If they don’t align, it adds credibility to the call being spoofed.

Examine prefixes – The first three digits of a spoofed number won’t correspond correctly to the area code it’s using. Cross-check the full number.

Ask questions – Don’t be afraid to ask an unsolicited caller why they are contacting you, what organization they work for, etc. to gauge legitimacy.

Call the real organization – Look up the official Medicare phone number and call to verify if they were indeed trying to reach you. The real Medicare won’t have a record of outbound calls.

Technology makes it easy for scammers to mask where calls are originating from. Stay skeptical of all surprise calls, even if Caller ID looks convincing.

What To Do if You Fall for a Medicare Phone Scam

If you realize you’ve fallen victim to a Medicare scam call and already provided personal information, remain calm and take these steps:

Step 1: Contact Medicare

Phone Medicare at 1-800-MEDICARE (1-800-633-4227) and explain you were targeted by a scam call. Medicare can document the fraud and start monitoring your account for suspicious activity. This call also establishes an official timeline of the incident.

Step 2: Report Identity Theft

File a report with the Federal Trade Commission (FTC) at alleging your identity was stolen. This FTC complaint allows you to dispute fraudulent charges and provides recovery assistance.

Step 3: Check EOBs and Claims

Carefully review Medicare Summary Notices and Explanations of Benefits looking for any services billed without your knowledge. Flag anything suspicious to Medicare so improper payments can be denied.

Step 4: Monitor Credit Reports

Check your credit reports from Equifax, Experian and TransUnion to see if any accounts have been opened without authorization. Consider putting a free 90-day fraud alert on your credit as well.

Step 5: Change Account Passwords and Pins

Update logins and passwords associated with all your financial accounts and healthcare services to prevent criminals from accessing them with your stolen information.

Step 6: Warn Your Medical Providers

Inform all doctors, specialists, pharmacies, and hospitals you use about the Medicare scam. Alerting them to the fraud helps prevent issues or confusion about your real medical history and their billing system.

By acting swiftly, you can contain damages from unscrupulous Medicare scammers. But remember, guard your Medicare card details closely to avoid becoming the victim of fraud in the first place.

Reporting Medicare Scams

If you receive a suspicious call claiming to be from Medicare, it’s vital to report the scam attempt to deter fraudsters. Here are the proper authorities to notify:

Medicare: Contact Medicare directly at 1-800-MEDICARE (1-800-633-4227) or by visiting your local Social Security office. Medicare needs to know about scams impersonating them in order to improve protections.

Federal Communications Commission: File an informal complaint with the FCC about illegal robocalls and spoofing practices used in the scam attempt. Visit or call 888-225-5322.

Federal Trade Commission: Report the Medicare scam call to the FTC through their online complaint assistant or by calling 877-FTC-HELP. The FTC analyzes scam patterns to support investigations.

Local police: File a police report about attempted fraud with your local law enforcement or police department. This creates an official record and paper trail.

State attorney general: Find your state AG office’s website to report instances of local Medicare fraud occurring within your state. They can prosecute scammers where cases apply.

Senior Medicare Patrol: Contact your local SMP to warn about scams targeting people in your area. They also educate Medicare beneficiaries on fraud prevention.

The more details you can provide on the specifics of the scam call, the better. For example, write down the date, time, phone number, any names used, what they asked you, etc.

The more data authorities have, the easier it is for them to pursue enforcement actions to protect Medicare consumers.

How to Block Annoying Medicare Calls

Beyond just reporting individual scam attempts, you can take proactive measures to reduce Medicare solicitation calls altogether by:

1. Registering your phone number on the National Do Not Call Registry at It’s illegal for legitimate businesses to call numbers on the registry.

2. Checking if your wireless carrier provides free robocall blocking solutions. AT&T, T-Mobile, Verizon and others automatically block some fraud calls.

3. Downloading robocall blocking apps like YouMail or Nomorobo to identify scam risks and shut down robocalls.

4. Asking your phone provider to apply anonymous call rejection which automatically blocks private and unavailable callers.

5. Using a call screening device that intercepts calls and displays the number for you to approve or deny. Avoiding unknown callers prevents scams.

6. Being vigilant about not answering calls from unfamiliar numbers. Let unknown calls go to voicemail and research numbers that seem suspicious.

7. Never interacting with an unwanted caller. Don’t press buttons or say anything if prompted. Scammers can exploit responses.

Combining robocall blocking technology with smart screening habits limits your exposure to Medicare scams. Reduce unwanted solicitation calls without missing important legitimate calls from doctors or loved ones.

Protecting Yourself Year-Round from Medicare Fraud

Avoiding scams requires vigilance all year, not just during annual open enrollment periods. Here are some general fraud prevention tips:

  • Never provide personal information over the phone to unsolicited callers. Treat Medicare details as confidential.
  • Shred old Medicare paperwork and statements so identity thieves can’t steal your information from the trash.
  • Review your Medicare claims regularly for charges from providers you don’t recognize. Report anything suspicious.
  • Avoid clicking links or attachments in unexpected emails about Medicare to avoid downloading malware. Delete the messages.
  • Use Medicare’s Member Portal to access your details instead of calling random numbers. Scammers can’t infiltrate the real Medicare portal.
  • Consult a Medicare counselor like your State Health Insurance Assistance Program (SHIP) if you need objective Medicare guidance. They provide trusted, unbiased assistance.
  • Warn others about current scams. Share information with family, friends, neighbors, and local senior communities when new Medicare scams are emerging.

Never assume a call, email, or piece of mail is from Medicare just because it looks official. Leverage common sense along with scam education to shield your sensitive information.

Final Thoughts

Medicare scammers get more advanced every year, using manipulative techniques to steal personal data and enroll seniors in bogus plans. Their tactics exploit fear, limited Medicare knowledge, and loneliness in order to perpetrate fraud.

But savvy Medicare beneficiaries who recognize common scam scenarios and red flags can outsmart these criminals. Safeguard your information and hang up on any suspect caller. Don’t let scammers jeopardize your healthcare and financial security.

Share this Medicare scam call guide with older loved ones to help protect them as well. Report fraudulent activity when it occurs. And consider installing robocall blocking solutions to decrease unwanted solicitation calls.

With knowledge and vigilance, we can shut down Medicare scammers and enjoy our golden years scam-free. Don’t become another statistic.

Key Takeaways: Avoiding Medicare Phone Scams

  • Medicare representatives will only call beneficiaries who request callbacks. Any surprise call claiming to be Medicare is fraudulent.
  • Never provide your Medicare ID number, Social Security number, banking details or other personal data in response to unsolicited calls.
  • Scammers pressure seniors to act immediately or risk benefit cancellation. Take your time and verify things directly with Medicare before responding.
  • Medicare will not call offering free medical equipment and genetic testing programs. These are hooks to steal your information.
  • File complaints with Medicare, the FCC, FTC and other authorities when you receive a scam call impersonating Medicare.
  • Monitor your Medicare claims summary for any services billed without your knowledge or consent as a sign of potential fraud.
  • Warn loved ones and neighbors about new Medicare phone scams so they can remain vigilant against senior fraud.

Also Read: Is Health With Bec Legit or Scam? Reviews & Complaints

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