Medicare scams are especially common during the open enrollment period, which runs from October 15 to December 7. Scammers often pose as representatives from Medicare, health insurance companies, or life insurance providers. To protect yourself, never share your Medicare ID, Social Security number, or health insurance details with anyone who contacts you unexpectedly or tries to pressure you into giving out personal information.
Medicare open enrollment runs from October 15 to December 7, and scammers are already gearing up. If you’re 65 or older—or helping a loved one navigate coverage—this is the time to be extra cautious.
With 69 million Americans enrolled in Medicare, fraudsters try to cash in on the program's wide scope of influence. In fact, earlier this year, the Department of Justice uncovered $14.6 billion in intended Medicare fraud losses in a single nationwide takedown. Broader estimates suggest Medicare fraud may cost taxpayers over $100 billion annually.
While the Federal Communications Commission (FCC) warns that health care scams can happen year-round, they may ramp up during open enrollment, when millions of people are actively reviewing and switching their healthcare plans. That’s when scammers know you’re paying attention, and they take full advantage.
The signs of a Medicare scam
Medicare scams may target you, your parents, your grandparents, or anyone navigating healthcare in retirement. And falling victim to one can lead to stolen benefits, drained savings, and compromised medical records.
These scams come in all shapes and sizes. In some cases, a scammer pretends to be a Medicare, health, or life insurance agent reaching out with a question (or even a discount) for a Medicare plan.
In other ploys, the fraudster claims that you’re eligible for “free” health services, such as genetic screening for certain chronic diseases or health equipment like braces or a wheelchair.
Whatever the ruse, the “agent” asks for a Medicare and/or Social Security number for account verification. Once provided, the scammer may submit false claims to Medicare under your name (a crime called medical identity theft), or commit other types of identity theft, such as taking out credit or loans under your name.
Sometimes scammers may even gather information about their victims beforehand. For example, they may know your age, healthcare provider, or that you have a chronic condition. Recently, scammers are also increasingly using AI-generated voices and spoofed caller IDs to impersonate agents or companies with an alarming accuracy.
To stay safe, here are five common types of Medicare scams to look out for:
Plan discounts or upgrades scams: A friendly caller from “Medicare” or “Blue Cross Blue Shield” says that you’re eligible for a health care plan that covers more and costs less than your current plan, and that—even better!—they can help enroll you immediately over the phone if you provide your Medicare ID and Social Security number.
New card scams: You receive a call, text, or email from a “Medicare agent” who says that your card will expire at the end of the year. They say they will issue you a new chip card if you can just confirm your Medicare number.
Free genetics testing scams: A health insurance provider calls to say that you’re eligible for a free genetics test that can screen for certain cancers and chronic conditions. They can book an appointment for you over the phone or send you a convenient at-home testing kit... if you provide your Medicare and Social Security numbers.
Medicare eligibility scams: You receive urgent, non-stop calls from “Medicare” warning that your current plan is about to be canceled or that you’ll no longer be eligible if you do not confirm your identity immediately.
Refund or rebate scams: A caller claims you’re owed a Medicare refund or rebate and asks for your Social Security or bank account number to “process” the payment. These scams often use high-pressure tactics and sound official, but they’re designed to steal your identity or drain your account.
Medical equipment scams
While Medicare makes it easy for beneficiaries to receive medical equipment like braces, wheelchairs, and walkers, which can help people overcome injuries and improve their health and lifestyle, scammers are known for taking advantage of this system.
They may reach a victim through an online ad, an unsolicited call or email, or even a fake storefront and use sales tactics to pressure victims into ordering equipment (typically without a doctor’s prescription). In many cases, the scammer gathers your personal information and then bills Medicare for unnecessary equipment, or equipment that’s never delivered.
To avoid medical equipment scams:
Do not order medical equipment unless it’s prescribed by your physician
Only order medical equipment through vetted suppliers recommended by a trusted source (like your doctor or insurance provider)
Do not accept medical equipment that’s offered out of the blue
The do’s and don'ts of avoiding Medicare scams
First and foremost, know that Medicare will not call, text, or email you unprompted. Like other government agencies, Medicare’s standard mode of communication is a letter sent via USPS. If a call or message comes through from a “Medicare agent,” do not answer or engage with it.
In addition, keep these do’s and don’ts in mind to stay safe this Medicare open enrollment season:
DO keep your Medicare and Social Security numbers and cards secure and in a safe place.
DO use the official government website (medicare.gov) to research and learn about what Medicare coverage entails.
DO call 1-800-MEDICARE (1-800-633-4227) with any questions or concerns regarding your Medicare coverage.
DO review all healthcare-related documents carefully and thoroughly including health bills, explanation of benefits (EOB), and Medicare Summary Notices (MSN). Make sure that they match the healthcare services and medications that you actually received. If they don’t reach out to your healthcare and insurance providers immediately.
DON’T give your Medicare number or Social Security number to a stranger, including anyone over the phone, via text, via email, or online.
DON’T answer calls or texts from “Medicare” or an unknown number.
DON’T panic if someone calls threatening to cancel your Medicare coverage or says that your card is expired. Hang up immediately and call 1-800-MEDICARE and/or your health insurance provider to ask about your plan.
DON’T accept any “free” medical equipment, testing, or healthcare service, especially in exchange for your Medicare number or Social Security Number.
DON’T discuss your insurance plan or healthcare information with anyone except for your trusted physicians, your health insurance provider, or yourState Health Insurance Assistance Program (SHIP) officer.
I’ve been scammed, now what?
If you or a loved one has fallen victim to a Medicare scam, don’t panic. Scammers are persuasive professionals, and you are certainly not the first to fall for the ruse. But also, don’t delay in reporting the crime.
Even if you only shared partial information, it’s worth reporting. Scammers can stitch together small details to commit large-scale fraud.
As an Allstate Identity Protection member, you can call our specialists any time. We're available 24/7 to provide support and help guide you through the next steps toward reclaiming your identity.
If you’ve divulged your Medicare number to a stranger, receive a bill for a health service you didn’t receive, or suspect any type of Medicare fraud, you can also do any one of the following to report the crime:
Call 1-800-MEDICARE (1-800-633-4227)
Call the fraud center of the Department of Health and Human Services Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477)
Visit tips.oig.hhs.gov to report the crime online
