Medicare scams are common and typically peak during open enrollment period from October 15 through December 7. In most cases, a scammer will reach out pretending to be a Medicare, health, or life insurance agent. To ward off Medicare scams, never provide your Medicare ID, Social Security number, or health insurance plan information to a stranger.
If you’re 65 or older — or if you care for a loved one who is — Medicare open enrollment is likely on your radar this time of year.
It’s also, unfortunately, on the radar of many identity thieves and scammers, who prey on the fact that roughly 20 percent of the U.S. population relies on Medicare.
With more than 65 million Americans enrolled in Medicare, identity thieves try to cash in on the service’s wide scope of influence. Senior Medicare Patrol estimates that around $60 billion is lost annually to Medicare fraud, scams, and errors.
And they tend to hit hard this time of year in particular. According to the Federal Communications Commission (FCC), rates of Medicare-related scams spike during open enrollment.
Know the signs of a Medicare scam
Medicare 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 number 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 and fraud, such as taking out credit or loans under their 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. Scammers can also use spoofing technology, which allows them to fake an identity on caller ID so that their call looks to be coming from “Medicare” or another trusted organization.
The four common types of Medicare scams to look out for, especially during open enrollment, are:
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 numbers.
New card scams: You receive a 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 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 Social Security and Medicare 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.
Highlight on 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 the unnecessary equipment.
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 your State Health Insurance Assistance Program (SHIP) officer.
How to stop Medicare scam calls and texts
Sign up for the Federal Trade Commission’s National Do Not Call Registry.
If a call from an unknown number — or a “government agency” — comes through, do not answer it (even to express anger or tell the caller to stop calling you). Doing so will only mark your number as “active,” thus increasing the calls you get.
If you’re an Allstate Identity Protection member and your plan includes our cybersecurity features, you can also activate Robocall Blocker to safeguard against scams by reducing the robocalls and spam texts you receive.
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.
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
As an Allstate Identity Protection member, you can call our identity specialists any time, using the number on your account dashboard. Our team is available 24/7 to provide support and help guide you through the next steps toward reclaiming your identity.
